Nurse Education in Practice 51 (2021) 102996

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Nurse Education in Practice

journal homepage: www.elsevier.com/locate/issn/14715953

Experiences and perceptions of male nursing students in a single-sex class:

A qualitative descriptive study
Nianqi Cui a, 1, 5, Ruoxi Wang b, 2, 5, Feng Song c, 3, *, Jingfen Jin a, d, 1, 4, **
a
Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, China
b
Blood Components Department, Chengdu Blood Center, China
c
Medical Faculty, Yunnan University of Business Management, China
d
Changxing Branch Hospital of The Second Affiliated Hospital of Zhejiang University School of Medicine, China

A R T I C L E I N F O A B S T R A C T

Keywords: The shortage of human resources in nursing is a global challenge, and males may play an important role in
Single-sex education alleviating this shortage, especially in China. Just as single-sex education has a potentially positive impact on
Males women in male-dominated professions, it may also have the same impact on men in nursing, which may promote
Nursing students
male engagement in nursing. This study delved into the experiences and perceptions that are peculiar to male
Masculinity
Qualitative research
nursing students in a single-sex class. A qualitative, descriptive design was employed using conventional content
Gender equality analysis. A purposive sample of 12 male nursing students in a male-only class of a university in China partici­
pated. Individual semi-structured interviews were performed between January and March 2019. Data analysis
revealed five themes. Considering the negative peer influence and potential communication barriers of a male-
only nursing class, establishing a male nursing student alliance instead of a male-only nursing class may be a
better choice. In Asian culture, reconstructing the current social norms of gender is crucial to eliminating
prejudice and male dividends and changing the definitions of masculinity, all of which are conducive to the
development of male involvement in nursing.

1. Background
The shortage of nursing human resources is a global challenge for
healthcare systems worldwide. Although the global nursing workforce
numbers 27.9 million, an estimated shortage of 5.9 million nurses still
exists (WHO, 2020). To solve the global nursing shortage, increasing the
proportion of males in the nursing profession is a powerful option
(Petges and Sabio, 2020). However, according to the WHO (2020), only
approximately 10% of the worldwide nursing workforce is male. The
percentage of registered male nurses is 11.4% in the U.K. (Williams,
2017), 11.7% in Australia and 23% in the Netherlands (Harding et al.,
2018). However, in 2019, of the 4.09 million registered nurses in China,
only 2.3% were male (Chen et al., 2020). Male nursing students, as
potential male nurses, are still in the minority. Of those students
currently enrolled in an undergraduate nursing programme, approxi­
mately 11.4% of the students are male in America (Statistic Stats, 2019),
while in Norway, males comprise less than 10% (Jordal and Heggen,
2015). It is even more shocking that Zhejiang University enrolled a total
of only 10 male nursing students from 1995 to 2005 (Feng et al., 2019).
The shortage of nurses has become more notable in China due to the
implementation of the universal two-child policy (Zhang and Tu, 2020).
To encourage women to give birth, different provinces have extended
the offered maternity leave and the average maternity time offered is
between 128 and 180 days. Compared to women, paternity leave for

* Corresponding author. Medical Faculty, Yunnan University of Business Management, No.296 Haitun Road, Wuhua district, Kunming Yunnan, China.
** Corresponding author. Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng district,
Hangzhou, Zhejiang, China.
E-mail addresses: songfeng1982@yeah.net (F. Song), zrjzkhl@zju.edu.cn (J. Jin).
1
Present address: No.88 Jiefang Road, Shangcheng district, Hangzhou, Zhejiang, China.
2
Present address: No.3 East Yujie Street, People’s South Road, Chengdu Sichuan, China.
3
Present address: No.296 Haitun Road, Wuhua district, Kunming Yunnan, China.
4
Present address: No.66 Taihu middle road, Changxing Country, Huzhou, Zhejiang, China
5
Cui and Wang contributed equally to this work and should be considered co-first authors.

https://doi.org/10.1016/j.nepr.2021.102996
Received 25 March 2020; Received in revised form 18 October 2020; Accepted 10 February 2021
Available online 15 February 2021
1471-5953/© 2021 Elsevier Ltd. All rights reserved.
N. Cui et al.
men is generally 15–30 days in China. This means that male nurses may
play a more important role in alleviating the shortage in the nursing
workforce in China.
The style of nursing education proposed by Nightingale was that of
an apprenticeship, which meant that women were ‘natural’ nurses who
did not need to receive an education when there were doctors present to
supervise them in hospitals (Palmer, 1983). The effects of this belief
included the ideas that nursing did not require too many skills, that
nursing had a low value compared to the medical profession of men, and
that males were inappropriate as nurses as this was a feminine caregiver
role (Palmer, 1983). Although notable differences exist between cultures
and societies, discrimination and prejudices towards male nurses are
considered to be common to both Western and Eastern countries
(Kronsberg et al., 2018). Men who became nurses are viewed as
anomalies and effeminate and labelled gay (Adeyemi-Adelanwa et al.,
2016). Male nursing students, similar to male nurses, are also teased and
ridiculed about being homosexual (Powers et al., 2018). In China,
nursing is considered to be a profession with a low social status, and
Chinese traditional feudal culture supports the idea that men should
engage in occupations with higher social status (e.g., doctors or lawyers)
(Zhang et al., 2014). Therefore, there may be greater prejudice against
male nursing students in China. The ultimate impact of prejudice and
discrimination against males in nursing is that it is a deterrent to men
choosing nursing as a career (Muldoon and Reilly, 2003). In addition,
the turnover intention rate of male nurses is high, above 83.3% in China
(Xian et al., 2020), while the dropout rate among male nursing students
is 28.1% in the UK (McLaughlin et al., 2010) and 40%–50% in Australia
(Stott, 2007).
Nursing is one of the few female-dominated professions. The 5th goal
of 2019 Sustainable Development Goal from the United Nations is:
“Achieve gender equality and empower all women and girls” (Economic
and Social Council of United Nations, 2019, p. 11). To promote gender
equality and reduce gender gaps, many measures are aimed at women
only in male-dominated professions, such as economics. For example,
the Harvard Business School has implemented a new programme named
The Undergraduate Women in Economics Challenge as a special training
programme for females aimed at increasing the presence of women in
economics and decreasing gender disparities (Goldin, 2014). Single-sex
education may have potential contributing effects on gender equity, as
compared to co-education (Gibb et al., 2008). Booth et al. (2018) proved
that single-sex classes cause women to adopt behaviours associated with
better academic outcomes, such as attending more classes and per­
forming optional assignments, under the UK system. Women who study
in a single-sex class may be more confident and have higher levels of
self-efficacy (Gist and Mitchell, 1992); in addition, they may not feel
threatened by gender stereotypes or psychologically related threats
(Cohen et al., 2006). In view of the stereotype, whether single-sex ed­
ucation for male nursing students has the same effect as that for women
in single-sex education is still unknown.
Nursing schools would simply not be able to offer single-sex classes
because it is illegal for either a state-owned or private educational
establishment to discriminate against students because of their sex in the
UK (National Association of Citizens Advice Bureau, 2012). Citizens,
regardless of nationality, race, sex, occupation, property status or reli­
gious belief, must have equal opportunities for education according to
the Law of China (Ministry of Education of the People’s Republic of
China, 1995). Admission policies and school curricula are also included
in these regulations. However, colleges and universities have autonomy
in regard to their teaching formats, according to the law in China (The
National People’s Congress of the People’s Republic of China, 1999),
which makes single-sex education possible in China. Meanwhile, studies
have suggested that women have higher levels of empathy than men
(Klein and Hodges, 2016); thus, gender-sensitive interventions con­
cerning clinical communication skill training programmes and tailored
education should focus on male nurses and nursing students (Strekalova
et al., 2019). Based on the above background, the leadership of X
2
Nurse Education in Practice 51 (2021) 102996
University have formulated the following hypothesis: single-sex educa­
tion may have a potentially positive impact on male nursing students.
Therefore, in 2017, the university established the “male-only nursing
class”, which occurs prior to students’ admission. The admission policies
and curricula for the male-only nursing class are the same as those for
the other advanced diploma nursing classes at the university. Before
they enter a hospital for clinical practice, we hope to understand expe­
riences and perceptions from the perspective of the students in
male-only nursing classes to verify the above mentioned hypothesis.
1.1. Objective
The objective of this research was to explore closely the experiences
and perceptions of male nursing students studying in a single-sex class.
2. Methods
2.1. Research design
This study applied a qualitative descriptive (QD) approach, for which
individual semi-structured interviews were employed to acquire insights
into male nursing students’ perceptions and experiences concerning the
male-only nursing class. Higgs and Cherry (2009) proposed that quali­
tative research approaches are contributing to an understanding of the
complexity within perceptions and experiences.
2.2. Setting
This study was conducted in a male-only nursing class that included
49 male students in X university (one single-sex class within a co-
educational university), who studied in a co-educational class before
university. In 2017, the advanced diploma nursing program recruited
588 nursing students including 49 male nursing students and the other
539 female students were randomly assigned to the other 9 regular
classes. Nursing education in China comprises a secondary nursing
program, an advanced diploma nursing program, and a baccalaureate
degree nursing program (Gao et al., 2019). The purpose of the advanced
diploma nursing program is to cultivate applied technical nursing talents
(Jiang and Duan, 2017). The reason that most students apply to the
advanced diploma nursing program is that the entrance requirements
are more stringent for the baccalaureate program, and students who do
not meet the requirements frequently apply to the advanced diploma
program. The advanced diploma nursing program in the university in­
cludes 3 years and 6 semesters. Nursing students study curriculum
during the first four semesters and practice in the clinical hospitals
during semesters five and six. The authors of this study had no direct
involvement in the establishment of this nursing class.
2.3. Participants
A purposive sampling was used. Before the interview, the first author
(N.C) wrote a letter clarifying the aim of this study and soliciting the
cooperation of participants, and invited the male nursing students who
were willing to actively express their perceptions and experiences on the
male-only class to participate. The rest of the team were not involved in
the recruitment process of participants. Seven students initially signed
up for the study. To increase participation and the demographic di­
versity of the sample, we used the snowball sampling technique, which
proved useful in identifying additional participants through the agency
of previous participants by way of their referrals.
2.4. Collection of data
Data collection was performed from January to March 2019. De­
mographic information of the participants included age and nationality.
An individual interview was conducted face-to-face with each
N. Cui et al.
participant using a semi-structured interview guide (Appendix 1). Prior
to the study’s commencement, this interview guide had already been
pilot-tested. The interview, which generally spanned about 30 min–60,
was unfolded in Chinese and recorded by a researcher who had received
training (N.C), in an interview room of the university where privacy was
protected. There had been no contact between the researcher and these
participants, which was useful to evade the possible influence or inter­
ference from the researcher in the middle of the interviews. Data
collection occurred concurrently with data analysis. This process helped
researchers identify thematic saturation, which occurred with the ninth
male nursing student. To confirm thematic saturation, three additional
students were interviewed. However, these additional interviews did not
bring out new themes or information. Hence, the recruitment of par­
ticipants continued until no new information emerged (Polit and Beck,
2012).
2.5. Ethical approval
Ethical approval was obtained from the institution of the corre­
sponding author (F.S) (ref. 2018032) before the onset of the study.
Ahead of these interviews, written informed consent was provided by
each participant who agreed to participate. All participants could
withdraw from the study at any stage without needing to disclose the
reason. The audio-recordings as well as transcripts were tagged with
pseudonyms so that confidentiality and anonymity were assured, and
were safely archived in files protected by passwords.
2.6. Data analysis
For the purpose of guaranteeing the credibility of the whole tran­
script, the accuracy of each piece of those transcripts was checked by the
two researchers (N.C and R.W). The approach of conventional content
analysis was applied to the analysis (Hsieh and Shannon, 2005). Coders
(N.C and R.W), in the first place, looked through the transcript of every
participant’s interview from the beginning to end for multiple times so
as to obtain a broad picture of their perceptions and experiences. Sub­
sequently, the researchers hand coded all narrative data line by line
which correlated to those participants’ perceptions and experiences
regarding the male-only nursing class. The two coders deliberated about
the coding of each piece of transcripts and employed an iterative process
to form unanimous decision on those codes, the definition of coding, as
well as the expansion or collapsing related to any codes (Garrison et al.,
2006). The initial coding was conducted in Chinese and was followed by
translating the findings into English for comparison through the agency
of a peer reviewer (J.J) and for producing the report (Squires, 2008,
2009). The investigators were fluent in both Chinese and English and
were responsible for the translation. Based on the coded data, re­
searchers established a matrix of themes (Bradley et al., 2007). Quota­
tions connected with each of these themes were selected and utilized to
highlight the various fashions in which these participants described
themes, thus affording us an opportunity to construe the themes’
boundaries and allowing our findings to become enriched and more
pertinent (Averill, 2002).
2.7. Rigor
We applied the Standards for Reporting Qualitative Research as the
guideline to make sure the reporting of the study was transparent
(O’Brien et al., 2014).
3. Findings
The final sample consisted of 12 participants who were all sopho­
mores. The participants’ ages ranged from 18 to 21, with an average age
of 19.6. Seven participants were China’s main nationality and five were
ethnic minorities. Data analysis revealed five themes: (1) male students
3
Nurse Education in Practice 51 (2021) 102996
experienced strangeness at the beginning of the single-sex class; (2) the
single-sex class increased their professional identity moderately; (3) the
single-sex class allowed them to maintain masculinity and avoid femi­
ninity; (4) a relaxed but poor learning environment existed; and (5) a
male nursing student alliance might be more advantageous. These
themes are discussed in greater detail below and quotations from the
participants are included to support the descriptive narrative and enrich
understanding.
3.1. Male students experienced strangeness at the beginning of the single-
sex class
Having an experience of strangeness in the male-only nursing class
was the most common theme in the data. Almost all participants (n = 9)
stated that the male-only nursing class was not only different but rather
strange to them at beginning. Participants would simply state, “It’s just
strange” (M7). There was an element to this strangeness that they held a
perception that females should be the majority of students in nursing
classes. For example, M4 described:
I knew that nursing is mainly for girls and there are few boys, so I
thought the class should be dominated by girls.
Indeed, many participants expressed how “precious” they thought
they would be as a male nursing student before being admitted to the
male-only nursing class and how “normal” they felt after. For instance,
M1 stated, “I thought I would be ‘the giant panda’ in my class before I
was admitted.” The giant panda is known as a national treasure of China.
Some participants described this experience as being so marked as to be
“brief”. After becoming familiar with the other students, the strangeness
experienced by the students gradually disappeared. For example, M10
described:
When I was familiar with everyone, I thought it was not strange.
3.2. The single-sex class increased their professional identity moderately
Similar to the public’s perception of nursing, the participants
expressed that their perception of the profession was that nursing be­
longs to females and that few men learn nursing. For example, M8
described the situation as follows:
Previously, I thought nursing jobs should be taken by girls, while
boys should work as doctors, and the nursing profession doesn’t have
a high social status.
Participants stated that the male-only nursing class increased their
professional identity moderately. The single-sex environment fostered a
perception among the students that there were many males who studied
nursing. One participant (M7) explained this as:
I found that so many boys study nursing later. Everyone is the same.
Participants also attributed this professional identity to the strength
of class unity. According to one participant(M7), “I can feel that I am a
member of the group.” Many participants expressed that because the
male nursing students lived in the adjacent dormitories this increased
opportunities for contact with each other and allowed them to become
closer to each other. M5 described:
The dormitories of the same class are very close. We call each other
brothers, just like a family. We are close to each other, which also
increases my sense of professional identity.
3.3. The single-sex class allowed them to maintain masculinity and avoid
femininity
Participants discussed the reactions they received from friends when
N. Cui et al.
they decided to pursue a nursing degree. According to one participant
(M3), “My friend said: ‘Why are you going into a female career? I’m
afraid you’ll turn into a sissy’.” Male nursing students worried that
studying nursing would make them feminine. For example, M2
described: “I’m worried that I might become feminine in a woman’s
career.” The reason why they hold this perception was that they thought
that masculinity and femininity could be influenced by careers that are
traditionally viewed as female. Another participant (M7) described this
perception:
This kind of influence is imperceptible. Slowly, you will talk like
girls, act like girls, and your behavior and other things will change.
Participants agreed that the male-only nursing class helped them to
develop masculinity and avoid feminity. According to one participant
(M3), “I told my friend: ‘Do you know? I am in the male-only nursing
class. There are no girls in the class, so I won’t be a sissy’!” Some par­
ticipants in the male-only class indicated that they were more masculine
compared with male nursing students in the regular class where the girls
are the majority. As one participant (M2) indicated:
I think I’m more masculine than them (male nursing students in the
regular class).
3.4. A relaxed but poor learning environment existed
Most of the participants reported they experienced that the learning
environment was poor in the male-only class, as highlighted in this
statement (M8): “The learning environment of the male-only nursing
class is really poor!” In this learning environment, male nursing students
who studied in the class would feel that they were singled out. One
participant described this experience (M11):
There is a feeling that if you study hard in the male-only nursing
class, it’s too weird. This learning environment is bad for our
learning outcomes.
Nine participants expressed their hope that no more male-only
nursing classes would be established in the future. For example, one
student (M11) said, “I don’t think it’s good to establish a male-only
nursing class.” In contrast, three participants supported establishing
the male-only nursing class. They expressed that the learning experience
in the male-only class was relaxed. Participants described that the
experience of relaxation was related to the low levels of competitiveness
among male nursing students. One participant stated that (M6):
After all, there are only a few male nurses in many departments and
they are in high demand. I think that many male nursing students in
the class do not study hard because of the low employment pressure.
They also attributed this relaxation to the nursing practical training
course. Participants expressed that it was not embarrassing, but relaxing
to study these courses in the male-only class. For example (M9):
When including scenario simulation like indwelling catheter, I would
be embarrassed if there is a girl watching me.
3.5. A male nursing student alliance may be more advantageous
Some participants suggested that the university could establish an
alliance for male nursing students, which would be an informal orga­
nization to develop activities for male nursing students. Participants
suggested the idea of a male nursing student alliance came from the
concept of male nursing alliances in hospitals. One participant described
this as (M4):
In fact, I think we can establish the male nursing student alliance just
as the hospital has established the male nurse alliance.
4
Nurse Education in Practice 51 (2021) 102996
Participants indicated that there are several reasons why the male-
only class should be replaced by a male nursing student alliance. First,
the male-only nursing class reduced the communication between men
and women. One participant described this perception (M12), “The
working environment includes male nurses and female nurses. We are
lacking communication with girls.” Second, the establishment of male-
only nursing classes cannot change this experience and may even
make male nursing students miss this stage of adapting to being in the
minority. One participant described his concern (M1), “We will be the
minority and surrounded by women eventually. We do not learn how to
get along with women now, do we have to wait for work?”
4. Discussion
The present study explored the experiences and perceptions of stu­
dents in a male-only nursing class. As far as we know, this is the first
study to address this topic from the perspective of male nursing students
in single-sex education.
Perhaps the most important finding in our study is the idea of
establishing a male nursing student alliance instead of a male-only
nursing class. Actually, establishing a student organization for nursing
is not a new idea. In 2014, The Northern Prairie Alliance (NPA), an
official student organization, was established as a chapter of the
American Association for Men in Nursing (AAMN) at Northern Illinois
University to create a supportive environment for men in nursing
(American Association for Men in Nursing (AAMN), 2018). As a voice in
the support and encouragement of men in nursing at the national level,
membership in the AAMN is open to any nurse—male or female—to
better facilitate discussion (AAMN, 2018). Similarly, the NPA is open to
all undergraduate and graduate students, and one does not need to be
male to join. Therefore, we hope to emphasize that male nursing student
alliances should be open to all male or female nursing students to meet
gender equity and diversity needs.
Intraprofessional communication can play a major role in deter­
mining the experiences that male nursing students will have as they
journey through an undergraduate nursing programme (Christensen,
2018). Men are forthright, directive, decisive and purposeful, whereas
women tend to take a more pragmatic approach to the way in which
they communicate (Holmes, 2006). The direct communication style of
male nursing students often causes offense and tenseness with their fe­
male colleagues (Christensen, 2018). Because of the setting of the
examined male-only nursing class, men lost more opportunities to
communicate with female nursing students during the study period. This
may make it more difficult for men to communicate with women once
they are registered nurses (RNs) working with peers of both genders.
Meanwhile, clinical communication skill training programmes that are
considered to be gender-sensitive may be interventions that can support
and promote male nurses (Strekalova et al., 2019). One male nursing
student said, “I would be embarrassed if there was a girl watching me”.
In the real working environment, when there are women watching these
male nurses, they may feel nervous or under pressure because they have
not previously adapted to the situation, especially as newly RNs. In
particular, novice nurses may have a greater risk for errors than expe­
rienced RNs (Berkow et al., 2008). We believe that these male nurses
may face greater levels of peer pressure. One study previously consid­
ered peer pressure as a source of issue for novices and found that patient
outcomes are affected when novice nurses feel pressure (Morrow, 2009).
Therefore, nursing management needs to integrate actions aimed at
helping male novice nurses relieve peer pressure.
One question that is often faced by male nursing students is “Why are
you going into a female career?“. Setting barriers to the process of men
entering the field of nursing maintains men’s higher social status (Evans,
2004). In traditional Chinese feudal culture, occupations dominated by
males are naturally regarded as higher status occupations, such as
lawyers or doctors (Hu, 2013). Men who do not engage in a traditionally
higher social status job are considered incapable of entering those
N. Cui et al.
occupations. Given that prejudice against men is an obstacle for men to
engage in nursing and the reality is that we need men to join nursing, the
fundamental measure to reverse this situation is to achieve equality
between men and women. Considering the role of feminism in gender
equality, feminism is positive for both men and women in nursing
(Sullivan, 2002). Actually, feminism has been exploring the root causes
of gender inequality. Gender theory as an important research achieve­
ment of feminism explains the causes of gender inequality. Ann Oakley,
as one of the representatives of feminism, pointed out that different
gender divisions of labour are not determined by sex but by social norms
of gender inequality (Oakley, 2015). This distinction reveals the con­
struction and inequality of gender culture from the perspective of gender
norms. In this view, because gender is constructed, it can be decon­
structed and changed. However, men face the problem of masculinity,
and the definition of masculinity deeply affects male nurses (Evans,
2004). Connell (2005) claimed that the most prominent type of mas­
culinity in the West was hegemonic masculinity. All of them are obliged
to position themselves according to the expectations and descriptions of
this masculinity (Carlsson, 2020). The fear of losing masculinity makes
male nurses succumb to societal gender norms by expressing less
empathic behaviour in their work (Evans and Frank, 2003). Brown
(2009), for example, argued that men are challenged to distance
themselves from work that is perceived as feminine and to retain the
privilege of hegemonic masculinity. Our study also found that main­
taining masculinity is one of the reasons why male nursing students
support the establishment of single-sex classes in the future. Empha­
sizing that male nurses are macho may be a possible way to encourage
males to engage nursing. A recruitment poster launched by the Oregon
Center for Nursing in 2003 stated, ‘Are you man enough to be a nurse?‘,
emphasizing that male nurses are macho and that nursing is an occu­
pation appropriate for ‘real’ men. (Evans, 2004). However, these mea­
sures are based on the knowledge construction of male-centred binary
opposition.
Gender inequality not only brings prejudice to men in nursing but
also brings about extra dividends. Our study found that the relaxed but
poor learning environment of male-only nursing classes is related to the
low levels of competitiveness among male nursing students. In the view
of male nursing students, whether they study hard or not, it is easy to
find a job. By 1970, although men comprised no more than 10% of the
British nursing population, they occupied 33% of the top nursing posi­
tions (Evans, 2004). Bradley (1989) credited the Salmon Report with
transforming the image of male nurses who, because of their sex, are
perceived as possessing managerial traits. Although there is no clear
report from China, hospitals in China are more likely to hire men when
recruiting nurses. Reconstructing the current social norms of gender is
crucial to eliminating prejudice and male dividends and changing the
definitions of masculinity, all of which are conducive to the develop­
ment of males in nursing because nursing needs not just men but also
talented men.
4.1. Limitations
With regard to the research methods, some limitations need to be
acknowledged. This study recruited participants from one advanced
diploma nursing programme at a university in southwestern China.
Although male nurses are still in the minority worldwide and thus may
experience heightened visibility, differences in cultural norms may still
lead to the weak transferability of the current findings to another cul­
ture. The other limitation of this study is that according to the relevant
laws on gender equality in different countries, nursing schools may
simply not be able to offer single-sex classes. At the time of this study,
the surveyed male nursing students had not yet practised in a hospital, so
the impact of single-sex class on male nursing students and registered
nurses after the commencement of engaging in practice was not made
clear. Another limitation of this study is that we did not investigate the
sexual orientation of the surveyed male nursing students, which may
5
Nurse Education in Practice 51 (2021) 102996
have a potential impact on the findings. This study also contained self-
selection bias because the students who chose to participate may have
had more interest in single-sex education than did the students who
chose not to participate.
5. Conclusion
Considering the negative peer influence of and potential communi­
cation barriers to male-only nursing classes, establishing a male nursing
student alliance instead of a male-only nursing class may be a better
choice; such an alliance can also create a supportive environment for
men in the field of nursing. However, emphasizing that male nurses are
macho may be a possible way to encourage males to engage in nursing.
Reconstructing the current social norms of gender is crucial to elimi­
nating prejudice and male dividends and changing the definitions of
masculinity, all of which are conducive to the development of males in
nursing.
CRediT author statement
Nianqi Cui: Conceptualization, Methodology, Data Curation,
Writing-Original draft preparation, Writing-Reviewing and Editing
Ruoxi Wang: Conceptualization, Methodology, Data Curation,
Writing-Reviewing and Editing
Feng Song: Conceptualization, Writing-Reviewing and Editing, Su­
pervision, Project administration, Funding acquisition,
Jingfen Jin: Conceptualization, Methodology, Data Curation,
Writing-Reviewing and Editing
Availability of data and materials
The datasets generated and/or analyzed during the current study are
not publicly available due to concerns about participant privacy.
Although references to specific institutions have, to the best of our
ability, been removed, there may be areas where participants have
provided details in interviews about institutional characteristics that
could be identified. Our participants did not consent to have full tran­
scripts of their interviews made publicly available.
Funding
This work is supported by the Science Research Foundation of
Yunnan Education Bureau [grant numbers: 2019J0541] and Zhejiang
University Academic Award for Outstanding Doctoral Candidates [grant
numbers: 202059].
Declaration of interests
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Acknowledgments
All authors have made substantial contributions. We appreciate the
male nursing students who participated the study and we would like to
thank Dan Wu, Jiayan Wang, Manjie Luo, Shuangyi Cao who finished
the Initial transcription. We would like to thank Marcia A Petrini, Yidan
Zhang and Hui Zhang who have given support for the revision of the
early draft.
Appendix A. Supplementary data
Supplementary data to this article can be found online at https://doi.
org/10.1016/j.nepr.2021.102996.
N. Cui et al. Nurse Education in Practice 51 (2021) 102996

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