Nursing students' emotions, educational concerns, and the impact of study careers and professional futures during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

COVID-19 is a challenge to education systems worldwide. The aim of the study was to explore the impact of COVID-19-pandemic-related emotions and COVID-19-related concern for education on the study careers and professional futures of nursing students.

METHODS

The study was completed between March and June 2023 using a multi-stage sampling design. A total of 1126 nursing students were recruited to complete the questionnaire. The self-administered questionnaire consisted of basic characteristics of the subjects, the COVID-19-pandemic-related emotions scale, the COVID-19-related concern for education scale, and the impact of the COVID-19 on study careers and professional futures scale (SCPFI-19 S). One-way ANOVA/t-test, correlation coefficient analysis, and hierarchical linear regression analysis were used to explore factors influencing changes in study careers and professional futures, and the relationship between COVID-19-pandemic-related emotions and COVID-19-related concern for education.

RESULTS

Univariate analysis of variance indicated that residence, willingness, and whether to engage in nursing after graduation were related to SCPFI-19 S (P < 0.05). COVID-19-pandemic-related emotions and COVID-19-related concern for education were significantly and positively associated with SCPFI-19 S (r = 0.566, P < 0.01; r = 0.199, P < 0.01). Stratified multiple regression analysis showed that COVID-19-pandemic-related emotions and COVID-19-related concern for education of nursing students were significant predictors of SCPFI-19 S.

CONCLUSION

Overall, both COVID-19-pandemic-related emotions and COVID-19-related concern for education were significantly correlated with SCPFI-19 S. In future interventions, schools should consider structures and strategies to support students' mental health and educational trajectories during current and future epidemics or similar crises.

Alexithymia and negative emotions among nursing students: a moderated mediation model

Nursing students, who comprise a high percentage of China's college students, experience many psychological problems; however, few studies explored the mechanisms underlying these problems. This cross-sectional study explored the relationships and mechanisms of depression, anxiety, stress, and narrative disorders in senior nursing students. Questionnaires were administered to 380 senior nursing students in Hubei Province using the Sociodemographic Questionnaire, Toronto Alexithymia-20 Scale, Perceived Social Support Scale, 10-Item Connor-Davidson Resilience Scale, and Depression-Anxiety-Stress Scale. After controlling for sociodemographic variables, Hayes' PROCESS macros were used to test how psychological resilience moderates the relationships among narrative disorders, negative affect, and perceived social support. Bootstrap confidence intervals tested for indirect effects. Correlation analyses revealed that alexithymia was correlated significantly positively with depression-anxiety-stress (r = 0.57, 0.56, and 0.58, resp.) and significantly negatively with perceived social support (r = 0-0.46). Psychological resilience was correlated significantly negatively with alexithymia (r=-0.39) and depression-anxiety-stress (r=-0.31, -0.30, and-0.32, resp.) but significantly positively with perceived social support(r = 0.50). Perceived social support was correlated significantly negatively with depression-anxiety-stress (r=-0.33, -0.34, and - 0.42 resp.). Stress was correlated significantly positively with anxiety and depression (r = 0.81 and 0.77, resp.). Psychological resilience was a partial mediator between depression and dysphoria (β=-0.08, p < 0.05). Dysphoria directly predicted anxiety (β = 0.31) and stress (β = 0.37); moreover,alexithymia predicted depression not only directly but also through the mediating effect of psychological resilience. Therefore, educators and clinical administrators must promote and recognise negative emotions among nursing students to help ensure the nursing workforce's stability.

Choosing a nursing specialty: connection to nursing students' personality traits, clinical self-efficacy, adoption of technology changes, and specialty prestige; a cross-sectional study

BACKGROUND

Choosing a field of specialization within the nursing profession is affected by nurses' personality traits, self-confidence in performing clinical skills, and the field's prestige. A successful choice of area of expertise may improve nurses' job satisfaction and reduce job mobility. This study aims to examine the relationship between personality traits, clinical self-efficacy, perceived prestige, adoption of technological changes, and choice of specialty field among nursing students.

METHODS

A cross-sectional study was conducted. One-hundred-twenty-seven undergraduate nursing students in their fourth year of studies at a large university in Israel participated in the study. The questionnaire administered was comprised of six parts: demographic data, personality traits, adoption of technological changes, clinical self-efficacy, perceived prestige, and intention to select a field of specialization.

RESULTS

Acute disciplines were rated more prestigious than chronic disciplines, with intensive care and emergency medicine considered the most prestigious, while mental health and geriatrics were the least prestigious. Students' mean perceived confidence in performing nursing clinical skills was high and more than half considered themselves open to technology changes. Positive correlations were found between prestige and intention to choose a field of expertise (r = 0.41, p < 0.001) and the personality trait of openness and the intention to choose an acute care area (r = 0.26, p < 0.01).

CONCLUSIONS

Despite the gradual aging of the population and the increase in chronic morbidity, which demand a greater nursing focus on older adults, and notwithstanding the mental health reforms, nursing students perceive geriatrics and mental health as less prestigious fields. A career development path can be applied by developing a tool for occupational guidance designed to rank students' suitability for specialty fields and thus help them choose the area that best suits them.

Impact of an educational intervention on hand hygiene practice among nursing students, with a focus on hand drying efficacy

Background

Hand hygiene and its significance for reducing the spread of infection is well evidenced and has been brought into sharp focus following the COVID-19 pandemic. Although a crucial clinical skill in ensuring safe healthcare, little is known regarding nursing students' effectiveness of hand hygiene practice.

Aim

The aim of this study was to evaluate the impact of an educational intervention on hand hygiene practice, designed by the research team for first year pre-registration nursing students. Particular emphasis was placed upon hand drying technique and time.

Methodology

825 nursing students were observed and assessed for their hand hygiene practice in a clinical suite at a university setting. Nursing students were observed for compliance against set outcome measures involving hand hygiene preparation, hand and wrist washing technique, hand drying technique and time. Data were analysed quantitatively using SPSS.

Results

The educational intervention had a significant impact on the clinical skills learning of nursing students. 779 students passed the assessment at the first attempt (94.4%). Of the 46 students that failed to meet the necessary criteria, 45 satisfied the criteria at the second attempt; giving an overall optimal compliance of 99.9%. 99.6% of students complied with recommended hand drying standards.

Conclusion

This study offers an important contribution to the development and delivery of nursing education programmes. The educational intervention improved compliance with recommended hand hygiene technique and practice. Lack of attention to hand drying may negate effective hand hygiene in healthcare.

The impact of final-year clinical placements on nursing students' career planning for the graduate year and beyond

AIMS

This study had three objectives: 1) to determine final-year nursing students' career preferences and long-term career plans; 2) to investigate factors influencing nursing students' specialty choices following their final-year clinical placement(s); and 3) to understand how final-year clinical placements can be used to develop the career interests of nursing students to different nursing specialties.

BACKGROUND

Clinical placement provides an insightful experience that may influence students to feel inclined to work in certain specialties. Therefore, each clinical placement should promote students' learning and enhance positive experiences that could develop their career interests and encourage them to seek employment in the specialty on graduation.

DESIGN

A cross-sectional online survey.

METHODS

The survey was structured using the Career Decision Self-Efficacy Scale - Short Form. The questionnaire was distributed to final-year nursing students (N = 222) at two public universities in Western Australia. This study specifically reports on the Goal selection and Planning domains of the Career Decision Self-Efficacy Scale - Short Form, which were explored through additional questions prompting participants to explain their career preferences and reasons for their nursing specialty choices.

RESULTS

Most participants, fifty-three percent, had low confidence in making career decisions. The Goal Selection and Planning questions measured the students' confidence in choosing a suitable practice destination and preparing for their professional careers. Overall, participants prefer employment in hospital settings both in the short- and long-term aspects of their nursing career. The factors influencing the students' career decisions were classified into three main categories: the clinical environment, educational factors and individual factors.

CONCLUSIONS

The nursing curriculum may encourage nursing students to work in some specialties over others. This study provides insight into factors that may promote or inhibit students' career choices and how students may be motivated to pursue the less preferred nursing specialties.

Test anxiety: Perceptions of Omani nursing students - A descriptive qualitative study

BACKGROUND

Excessive anxiety may have a detrimental effect on nursing students' performance. Understanding students' experiences of test anxiety (TA) is crucial to improve their academic performance and help them lead a successful professional life.

OBJECTIVES

To explore TA from the perspective of nursing students, identify the factors that affect TA and possible interventions to reduce it.

METHOD

the setting is a nursing college from Oman. All regular undergraduate nursing students from years 2, 3, 4 and 5 and bridging students (those doing BSc nursing after a diploma in nursing) were invited through their cohort leaders. The interested participants from each cohort signed the consent to participate in the focus group.

RESULTS

Thirty students from different academic years participated in five focus groups, each comprising 5-8 undergraduate students and lasted from 45 to 60 minutes. Approximately 80% of the students experienced moderate to severe TA. The causes were divided into students, courses and examiner-related factors. Other themes were signs and symptoms of TA, the impact of TA on different aspects of life, effective management techniques and suggestions for improvement. The findings indicate that TA improves with experience as students advance academically. Furthermore, bridging students face less TA in their clinical practice than regular students and TA impacts more aspects of their lives.

CONCLUSION

This study highlights the TA experiences of nursing students at different levels and in different programs. the findings showed that most students experienced test anxiety, but the perception of TA improved when students advanced their academic lives. the distinct experiences of Omani nursing students highlight the importance of tailored interventions to mitigate its impact on academic performance and overall well-being.

Barriers and facilitators to the formation of professional identity among nursing students: A four-year longitudinal qualitative study

BACKGROUND

Nursing professional identity (NPI) is essential for nurses to develop their nursing profession. It reflects the competencies consistent with the professional practices of nurses and contributes to them providing better healthcare and public health. The formation process of NPI started with undergraduate nursing education and continued throughout the nursing career.

OBJECTIVE

To explore nursing students' perceptions of facilitators and barriers to the formation of NPI during their study.

METHODS

A 4-year longitudinal, qualitative research design with yearly semi-structured interviews undertaken from 2019 to 2022. The reflexive thematic analysis methodology was applied for the data analysis.

RESULTS

Ninety-three nursing students were recruited, joining a group or individual interview. The four-year nursing baccalaureate program revealed a dynamic formation process of NPI: "Outsider of nursing", "Entering the nursing courses", "Building nursing competence", and "Thinking and acting like a nurse". A total of 12 themes were identified to present the barriers and facilitators to the NPI formation at different stages. Specifically, the six barriers include conflict between their ideals and reality, sociocultural stereotypes about nursing, the negative impact of COVID-19, the pre-internship concerns, struggling to meet expectations, and potential danger and discrimination in the healthcare settings. The enablers were: self-motivation and inner belief towards the nursing profession, the power of role models, the improvement of nursing capacity, well integration into the healthcare professional teams, understanding of the clinical environment, and recognition and encouragement from others.

CONCLUSIONS

The formation of nursing students' NPI is an ever-changing process, with various intrinsic and extrinsic influences during their four-year study. Nursing educators are suggested to prepare and develop students' professional comportment in their theoretical and clinical practice to develop their professional identity as a nurse.

Nursing students' perceptions of unfinished nursing care: A cross-sectional study

AIM

To investigate the prevalence, patterns and reasons for unfinished nursing care as perceived by nursing students.

BACKGROUND

Unfinished nursing care (UNC) is a frequently observed phenomenon in the acute care setting. To date, studies have focused primarily on the perspective of nurses or patients, but another important perspective is that of nursing students who provide nursing care in all healthcare settings.

DESIGN

A descriptive cross-sectional study.

METHODS

The study included 738 undergraduate nursing students from nine Slovak universities. Data were collected between September 2022 and February 2023 using the Slovak version of the Unfinished Nursing Care Survey tool (UNCS). Data were analyzed using descriptive and inferential statistics.

RESULTS

The mean composite score of UNCS was 2.48 (SD=0.68). In general, 100% of nursing students reported that nurses missed at least one or more nursing care activities during their last clinical placement. The average number of missed nursing care activities was 11.2 per nurse as perceived by nursing students during their last clinical placement. Nursing students reported that the most frequently omitted nursing care activity was spending time with patients and their caregivers (3.15 ± 1.11; 92.9%). The most frequently reported reason for UNC was an inadequate number of nurses on the ward (4.31 ± 1.01; 98.1%). In the study, reported UNC could be predicted by previous experience in healthcare, previous clinical rotation, number of patients per shift, perceived staff adequacy and outcome expectations (p <0.05).

CONCLUSIONS

The findings reveal that UNC is a widespread phenomenon and all nursing students report this phenomenon during their clinical placements. Spending time with patients and their caregivers emerged as the most frequently omitted nursing care activity, highlighting the importance of patient-centered care. The primary reason cited for UNC was an inadequate number of nurses, highlighting staffing issues as a significant contributing factor. These findings emphasize the need for targeted interventions to address staff shortages and improve nursing education to prepare students to address UNC in their future practice.

Nursing students' internationalization: Virtual exchange and clinical simulation impact cultural intelligence

BACKGROUND

There is a need for globally competent nurses; however, some cannot train abroad. Internationalization at home strategies seek to teach intercultural and international competencies to all students, regardless of location.

PURPOSE

This study evaluated the impact of a virtual exchange and clinical simulation program on nursing students' cultural intelligence.

METHODS

The Global Nursing Care (GNC) program was designed to improve nursing students' global competencies, particularly cultural intelligence. It was implemented in two universities in Spain and the USA. A quasi-experimental, analytic, and longitudinal study involved 261 nursing students, 57 from the GNC program and 204 in the control group. Sociodemographic data were collected, and the Cultural Intelligence Scale was used to measure cultural intelligence.

DISCUSSION

All cultural intelligence dimensions were augmented following program participation. Moreover, students who participated in the program presented higher cultural intelligence than the control group.

CONCLUSION

The results suggest that program participation was associated with a statistically significant gain in nursing students' cultural intelligence.

Validation of an instrument to measure knowledge, attitudes and skills towards Evidence-Based Practice in nursing students in Colombia

BACKGOUND

Evidence-Based Practice (EBP) is crucial for the nursing profession, as it helps professionals make informed clinical decisions based on the best available evidence. Most EBP competency assessment tools focus on specific technical knowledge or skill components, and most have been tested on medical students. The Evidence-Based Practice Competence Questionnaire (EBP-COQ-E) is an instrument that assesses the competence in EBP in nursing students. The objective of the article was to evaluate the psychometric properties of the EBP-COQ-E instrument in final year nursing students in Colombia.

DESIGN

A validation study was conducted using a cross-sectional design.

METHODS

The population included nursing students from 19 programs in Colombia, who were selected during the years 2020 and 2021 based on their university enrollment in the last year of training in nursing programs with current qualified registration by the Ministry of Education and who had attended the least one subject related to research. The data were collected through a virtual platform and the researchers consolidated it into a general database. The EBP-COQ-E instrument consists of 25 items grouped into three factors: attitude towards EBP, skills for EBP and knowledge about EBP. The items were answered on a Likert-type scale from 1 to 5. An exploratory factor analysis was performed and an internal consistency analysis of the instrument.

RESULTS

A total of 1021 final year students from 19 university nursing programs participated, with a mean age of 23 years and where 83% identified themselves as female. The results showed good internal consistency and construct validity for the instrument, with a Cronbach's alpha of 0.89. In the exploratory factor analysis, 3 factors were found that explained 51% of the variance of the data. Together these three factors had statistically significant positive correlations.

CONCLUSION

The study contributes to the validation of the Evidence-Based Practice Competence Questionnaire (EBP-COQ-E) which is a valid and reliable tool to assess knowledge, attitudes and skills in EBP in nursing students in the Colombian context. Training in EBP is crucial to guarantee the quality of performance of future professionals in care practice and the EBP-COQ-E can be useful and applicable where it is necessary to evaluate this competence in training processes.

The effects of hospice care education on first-year undergraduate nursing students in mainland China: A mixed-methods study

BACKGROUND

With the rising number of people with end-stage chronic diseases, the demand for hospice care has increased dramatically. As the future health professionals for the implementation of hospice care, undergraduate nursing students in mainland China still lack knowledge and skills of hospice care, thus hospice care education plays a vital role in its development.

OBJECTIVES

To understand the effects of hospice care education on nursing students' death attitudes, end-of-life attitudes, humanistic care qualities, and their learning experiences.

DESIGN

This study used a mixed-methods design.

SETTING

A University of Chinese Medicine in mainland China.

PARTICIPANTS

The first-year undergraduate nursing students (n = 65).

METHODS

A mixed-methods study was conducted to evaluate the impact of a hospice care course from March to June 2021. The quantitative part included a quasi-experimental study designed with pre- and post-intervention measurements and the qualitative part included a descriptive qualitative study with semi-structured individual interviews.

RESULTS

The quantitative data revealed that after the course, nursing students experienced improvements in their death attitudes, end-of-life attitudes, and humanistic care qualities. Two categories were identified from the qualitative data. The category of "Gain from learning" included 4 themes (Confronting death and thinking about life; Understanding and agreeing with the idea of hospice care; Perceiving the humanistic spirit of medicine; Enhancing of the nursing discipline cognition and professional identity) and the category of "Course feedback" included 2 themes (Expressing recognition for the course arrangement; Making suggestions on the course optimization).

CONCLUSIONS

Hospice care education had a positive influence on nursing students. Students expressed satisfaction with the course arrangement. However, future hospice care courses should further optimize the curriculum designs by increasing the discussion of death-related topics, sharing more real clinical cases, recruiting students from different majors, and providing clinical practice, to provide high-quality nursing education for the development of hospice care.

Knowledge levels and evidence-based approaches of undergraduate nursing students on suctioning practices: A cross-sectional study

BACKGROUND

Suctioning is one of the nursing interventions frequently applied in clinical and intensive care units. In order to perform suctioning correctly and effectively, it is important for nursing students to acquire and develop this skill during their undergraduate theoretical and practical education.

OBJECTIVES

The study aims to reveal the knowledge levels and evidence-based approaches of nursing students about suctioning practices.

DESIGN

The study is a descriptive and cross-sectional study.

SETTINGS

It was carried out in the Faculty of Nursing of two state universities in Konya between March and June 2022.

PARTICIPANTS

A total of 506 undergraduate students participated in the study.

METHODS

Data were collected using the Personal Information Form, the Knowledge of Suctioning Questionnaire, and the Attitude towards Evidence-Based Nursing Questionnaire. Data were analyzed by calculating number, percentage, mean, and standard deviation, and using the multiple linear regression analysis.

RESULTS

The mean Attitude towards Evidence-Based Nursing Questionnaire score of the students was found to be 63.04 ± 7.91, and their mean Knowledge of Suctioning Questionnaire score was 33.46 ± 14.63. 83.8 % of the students obtained a low score from the questionnaire. Senior students had high scores on the Attitude towards Evidence-Based Nursing Questionnaire, which are significant predictive variables affecting the level of knowledge about suctioning (p < 0.05).

CONCLUSIONS

It was found that the high scores of the students on the Attitude towards Evidence-Based Nursing Questionnaire had an effect on their level of suctioning knowledge. The study also revealed that being a fourth-year student and receiving training on suctioning affected the level of suctioning knowledge.

Psychometric evaluation of the Chinese version of the attitudes, subjective norms, perceived behavioural control and intention to pursue a career in mental health nursing scale

AIM

To adapt culturally and assess the reliability and validity of the Attitudes, Subjective Norms, Perceived Behavioural Control and Intention to Pursue a Career in Mental Health Nursing (ASPIRE) scale among Chinese nursing students.

BACKGROUND

Mental health nurses make up a substantial proportion of the mental health workforce and are pivotal for improving access to professional mental health care. However, a shortage of mental health nurses persists across various countries. Although new nursing graduates have the potential to alleviate the labor shortages, there is currently no standardized tool specifically designed to measure nursing students' intentions to pursue a career in mental health nursing in China.

DESIGN

A quantitative and cross-sectional design.

METHODS

Following email authorization from the author, the Chinese version of the ASPIRE scale was translated following the cross-cultural adaptation process guidelines established by the American Association of Orthopedic Surgeons (AAOS). A questionnaire survey was conducted among 540 nursing students from three universities in Hunan Province from April 2023 to October 2023. Nine experts were invited to evaluate the content equivalence of each item. Item analysis, exploratory factor analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability were used to test reliability and validity.

RESULTS

The Chinese version of the ASPIRE scale retained 14 items and it has high content validity. Pearson correlation analysis revealed a statistically significant difference in the correlation between the total scores of the items (P < 0.001). Exploratory factor analysis indicated that the one-factor solution explained 65.82% of the total variance and confirmatory factor analysis results indicated a good fit (CMIN/DF = 2.64, RMSEA = 0.079, GFI = 0.908, IFI = 0.964, SRMR = 0.0326). The Cronbach's alpha coefficient for the scale was 0.958 and the test-retest coefficient was 0.783.

CONCLUSION

The Chinese version of the ASPIRE scale has great reliability and validity and can be used for assessing Chinese nursing students' intention to pursue a career in mental health nursing.

Religious attitude and sense of citizenship effect on organ donation in nursing students: A cross-sectional study

AIM

This study examined the effect of religious attitude and sense of citizenship to organ donation attitudes and organ donation willingness among nursing students.

BACKGROUND

Organ donation is an issue that should be evaluated together with medical, religious, social, economic, cultural, legal and ethical variables. However, there is no research examining the effect of religious attitudes or sense of citizenship on organ donation attitudes and willingness.

DESIGN

A descriptive, correlational study.

METHODS

A total of 225 nursing students participated in the study between February and April 2020. The data were collected with the Ok-Religious Attitude Scale, the Sense of Citizenship Scale, an Organ Donation Questionnaire and the Organ Donation Attitude Scale.

RESULTS

A sample of 187 nursing students participated; 50.8% of them were in the stage of thinking about organ donation willingness. Older nursing students (β =.231, p<.001) was positively affected to the positive organ donation attitude, while being male (β = -.151, p=.035) was negatively affected. Male gender (β=0.201, p=.004) was positively affected to the negative organ donation attitude. Acceptance of differences (β=-0.262, p<.001) and relationship with God score (β=-0.189, p=.006) were negatively affected to the negative organ donation attitude. Regarding the participants' willingness to donate, acceptance of differences (β=.213, p=.004) was found to be a significant predictor.

CONCLUSIONS

In this study, it was found that being female, relationship with God and acceptance of differences had a positive effect on organ donation attitude. Acceptance of differences was found as important factor in organ donation willingness.

Fluctuating cohesion: A grounded theory study of nursing students engaged in a combined debriefing format

AIM

This study explored the social processes enacted by nursing students when they engage in a combined format of structured peer debriefing followed by instructor-led debriefing after in-person simulation. The aim was to gain insight into nursing students' perceptions and how peer processes influenced reflection and learning.

BACKGROUND

Debriefing, a key component of clinical simulation, promotes development of nursing students' reflective processes and enhances learning. In-person group-debriefing led by faculty/instructors is the most used debriefing format in healthcare simulation education. Yet, recent studies indicate instructor-led formats may increase students' anxiety and limit their capacity for reflection, a crucial step in clinical reasoning and decision making. Investigations into learner-centered formats support peer debriefing as a reasonable alternative to traditional instructor-led debriefing. However, current peer debriefing studies provide little insight into the social interactions and processes supporting reflection and learning; and little theoretical basis exists for the integration of alternatives to instructor-led debriefing formats (such as peer debriefing) into simulation-based education.

DESIGN

This qualitative study used a Straussian grounded theory design.

METHODS

Senior-level baccalaureate and associate degree nursing students from an U.S. public university with first-hand experience using the combined format of peer debriefing followed by instructor-led debriefing were recruited to participate in focus-group interviews. Data gathered from semi structured interviews were analysed using the iterative process of constant comparison. Theory building was aided using memoing, theoretical sampling and conceptual diagramming.

RESULTS

The sample consisted of 34 students. Study findings revealed the core category of the constructed theory, 'Fluctuating cohesion', involved students' pervasive sense of going back and forth between a sense of unity (we-ness) and separatism (me-ness) while engaged in the combined debriefing format. The theory integrated five related categories: discovering the process, normalizing experiences, developing mutuality, dynamic balancing and engaging informal social connections. Findings illustrated the processes students enacted to take ownership for learning and proactively discuss their clinical decision-making with the instructor. In turn, reflection was enhanced by increased receptiveness to subsequent expert feedback.

CONCLUSIONS

The study findings demonstrated that augmenting instructor-led debriefing with peer debriefing leveraged the beneficial nature of peer interactions, promoted psychological safety, facilitated nascent team behaviors and enhanced reflective thinking. The resultant theory that was generated from the findings and grounded in participants' experience, provides a meaningful framework that may inform future learner-centered debriefing formats aimed at optimizing debriefing effectiveness.

Testing a modified motivational interviewing counseling program

BACKGROUND

Motivational Interviewing is a well-established person-centered counseling approach toward positive behavioral change. However, several limitations have been reported using motivational interviewing applications.

PURPOSE

This study explored the potential of an innovative intervention (namely, modified motivational interviewing) to address the limitations associated with the original form of Motivational Interviewing.

METHODS

The research used a phenomenological qualitative design to include three focus groups with a total sample size of 24 university nursing students to examine their experiences with the Modified Motivational Interviewing. The focus groups were transcribed verbatim and then coded to extract the themes.

RESULTS

The following ten themes emerged from the data analysis: increasing discrepancy; ambivalence; ready, willing, and able; change as a natural process; the role of the modified motivational interviewing facilitator; spontaneous generalization; peer support facilitates change; help-seeking behavior; practical applications of the modified motivational interviewing; and problems encountered during the implementation of modified motivational interviewing.

CONCLUSIONS

The proposed intervention can potentially be a cost-effective replacement for the original format of motivational interviewing intervention. Further research is needed to support the modified motivational interviewing.

Multicultural personality profiles and nursing student attitudes towards refugee healthcare workers: A national, multi-institutional cross-sectional study

BACKGROUND

Multicultural organizations in the era of globalization require intercultural leadership skills. Healthcare, as a sector serving diverse populations, necessitates culturally sensitive staff. Intercultural nurse education should start in undergraduate education. A tailored approach is needed, especially in the context of Poland's refugee crisis.

OBJECTIVE

To investigate how a multicultural personality profile and specific intercultural perspectives affect the attitudes of nursing students towards Ukrainian refugee background healthcare professionals.

DESIGN

A nationwide cross-sectional multicentre online survey study was conducted. The questionnaire was distributed with the aid of the Lime Survey web platform.

METHODS

The study utilized a Polish version of the Multicultural Personality Questionnaire. The questionnaire also included demographics and questions assessing intercultural competence and attitudes towards refugee medical professionals. K-Means Cluster Analysis was used to classify different patterns of multicultural personality. P-value <0.05 was deemed to be statistically significant.

PARTICIPANTS

The study sample consisted of 1325 undergraduate nursing students from 39 nursing schools in Poland: 54.0% in first year, 28.7% in second year, and 17.3% in third year. Most respondents were female (N = 1229, 90%).

RESULTS

Using cluster analysis respondents were categorized into four groups based on their level of three analyzed multicultural personality traits: cultural empathy, social initiative, and open-mindedness (high, low, average or mixed level). Statistical analysis demonstrated that personality profiles significantly affected nursing students' attitudes towards refugee health professionals (p = 0.003). Additionally, students' willingness to engage in intercultural communication classes and their belief in the learnability of intercultural competence also impacted their attitudes (p < 0.001 for both). Further analysis revealed correlations between personality profiles, belief in competency acquisition, and willingness to enhance competencies.

CONCLUSION

The design of intercultural competence education for undergraduate nursing students should be preceded by a mapping of the students' personality profile and a needs analysis in this regard, which may contribute to long-term effectiveness of such initiatives.

Nursing students' perspectives and learning experiences of participating in a palliative and end-of-life care simulation programme: A qualitative study

BACKGROUND

Simulation-based learning has become an integral part of the nursing curriculum, allowing students to acquire clinical knowledge and relevant skills and apply them to real-life clinical encounters. However, little is known about the best practices in palliative and end-of-life care simulations.

OBJECTIVE

To explore the perspectives and learning experiences of undergraduate nursing students participating in a newly developed advanced practice nurse-led palliative and end-of-life care simulation program.

DESIGN

A descriptive qualitative study based on focus group discussions.

SETTINGS

A healthcare simulation centre at a university in Singapore.

PARTICIPANTS

A purposive sample of 75 third-year undergraduate nursing students who had attended a palliative and end-of-life care simulation program.

METHODS

Eight face-to-face focus group discussions were conducted and audio recorded. Data were analysed using inductive thematic analysis.

RESULTS

Four themes encompassing 12 subthemes were derived: (1) Patient, family and caregiver needs during palliative and end-of-life care, (2) Nursing competencies in palliative and end-of-life care, (3) Experience of palliative and end-of-life care simulations and (4) Suggestions for future palliative and end-of-life simulations. The students expressed their support for including advanced practice nurses as facilitators and suggested the use of other simulation modalities such as virtual simulations to enable the participation of all students and provide a wider range of simulated scenarios.

CONCLUSIONS

Simulation-based learning plays a crucial role in the palliative care curriculum. Clinical experts should be involved as facilitators to provide essential insights. It is also vital to consider students' prior experiences with death and dying, which may positively or negatively influence their palliative and end-of-life care competencies.

RECOMMENDATIONS

Nursing schools should utilise clinical experts and other simulation modalities to improve students' learning experiences, provide more simulation experiences and overcome resource constraints such as limited curriculum time.

Game4NurseSupervisor: Development of a board game for nursing mentoring

AIM

To describe the stages of developing a board game prototype to promote knowledge about nursing mentorship.

BACKGROUND

Clinical supervision in nursing is a vital strategy for the quality of care. The use of gamification through a board game can enhance knowledge about mentoring in nursing.

DESIGN

We present a pilot study describing the development phases of the board game "Game4NurseSupervisor®."

METHODS

The study comprised three phases. The first phase involved a modified e-Delphi study with experts to collect and validate the content to be integrated into the board game. The second phase focused on constructing the prototype of the board game. Finally, the third phase involved testing the prototype in sessions held in two healthcare units, followed by an evaluation through a questionnaire.

RESULTS

The e-Delphi study, involving a panel composed of 59 experts, progressed through two rounds, resulting in 61 cards divided into four categories. The second phase involved constructing the board game, incorporating interactive elements such as "Game4NurseSupervisor®." In the third phase, 25 nurses, consisting of clinical practice nurses, participated in the testing phase and expressed satisfaction with the game. Highlighted benefits included reflective, playful, dynamic, interactive and educational aspects.

CONCLUSIONS

The conclusions suggest that "Game4NurseSupervisor®" could be a valuable tool for promoting knowledge about nursing mentorship, providing an innovative and interactive approach to skill development. This study makes a valuable contribution by addressing a previously unexplored aspect of nurse mentor training: the potential of board games.

Development and validity of an intermediate conceptual measurement (ICM) -based measurement tool for the nursing professional values of undergraduate students

BACKGROUND

Nursing professional values are the foundation of nursing practice. There has been no research to develop an instrument to measure professional values in nursing based on intermediate conceptual measurement theory.

OBJECTIVES

To develop an ICM-based measurement tool for the nursing professional values of undergraduate students.

DESIGN

A cross-sectional study.

METHODS

The Nursing Professional Values-Intermediate Conceptual Measurement (NPV-ICM) was developed using the steps of Cunningham's process to generate questionnaire items. The tool was devised in three stages: identifying the intermediate concepts, developing stories reflecting the intermediate concepts and setting up options for action and justification in the stories and setting up scoring criteria for the measurement tool. The tool was tested through internal consistency reliability, content validity and calibration correlation validity.

RESULTS

This study resulted in five nursing professional values situational stories containing five themes (care, altruism, responsibility, respect and justice) respectively. Each situational story contained a varying number of action options and justification options, totalling 72 Richter 5 level options and 20 ranked items. Reliability and validity were found to be good, with a total Cronbach's α of 0.93 and Cronbach's α of 0.75-0.80 for each situational story and calibrated correlational validity was found to correlate significantly between the total Nursing Professional Values Scale Revised (NPVS-R) scores and the NPV-ICM.

CONCLUSIONS

The NPV-ICM created in this study possesses high reliability and validity. It alters the values perception research, moving from abstract conceptual measurements to measurements of particular values actions and justifications for participation in activities. And the study presents preliminary evidence supporting the reliability of the NVP-ICM as a measure of professional values.

Knowledge, skills, and attitudes (KSAs) of adaptable academic nurse educators

AIM

Using the Knowledge, Skills, and Attitudes (KSAs) framework, the aim of this study was to explore the specific knowledge, skills and attitudes of adaptable nurse educators to help inform the preparation of current and future educators for smooth transitions during periods of change.

BACKGROUND

External events, such as hurricanes, earthquakes, floods and wildfires can force programs to relocate and suspend classes for several days or weeks. These natural disasters have the potential to have a negative impact on the number of nursing students graduating on time as well as the quality of the clinical education experience and preparation for practice. Many lessons about educator adaptability can be learned from the COVID-19 restrictions. Identifying the KSAs of adaptable nurse educators during the rapidly changing educational landscape provided the opportunity for a foundational needs assessment to guide the preparation of educators for seamless transitions during times of change.

DESIGN

To identify the KSA's of adaptable nurse educators, an exploratory qualitative study using focus groups was conducted. The study used thematic analysis.

METHODS

The research team developed, and pilot-tested focus group interview questions based on content areas identified in the literature. Targeted questions included queries specific to the KSAs necessary for adaptation and successful teaching using simulation. Educators from pre-licensure nursing programs in the United States participated in one of five 60-minute focus groups held virtually via a secure online meeting platform.

RESULTS

Adaptable nurse educators have knowledge of resources, ongoing assessment, evaluation and teaching strategies and an understanding of the skillsets of their colleagues. Their skills include leadership, teamwork, redesigning learning and assessment. They demonstrate qualities such as resilience, empathy, acceptance, openness and positivity.

CONCLUSION

With the current nursing workforce crisis, external events cannot be allowed to slow academic progression and graduation from nursing programs. In this exploratory qualitative study using focus groups, the KSAs held by adaptable nurse educators were explored. The findings of this study highlight the importance of collaboration and teamwork in academic institutes. The findings can be used as the foundation for nursing programs to prepare for future external events.

Prevalence of test anxiety and its determinants among nursing students in Selangor, Malaysia

The current education system significantly emphasizes tests and evaluations as crucial factors in determining a student's future career path. It has been shown that nursing students have moderate to high levels of Test Anxiety (TA), which results in decreased academic performance, low self-esteem, and an inability to complete the program and pursue a career in nursing successfully. This study aimed to determine nursing students' level of TA and its relationship with demographic characteristics. Four hundred twenty-one nursing students at seven private universities and colleges in Selangor participated in this cross-sectional study. The level of TA was measured using the TA Inventory (TAI). A total of 62.5% of the respondents had mild TA, 25.4% had moderate TA and 2.1% had severe TA. There were significant relationships between TA level and household income (χ2 = 6.70, p = 0.035) and ethnic groups (F (3,417) = 5.20, p = 0.002) where Chinese and Indians are protective from TA compared to the Malays and other ethnic groups and high anxiety was significant in the Ringgit Malaysia (RM 3000) and below group. The study's findings indicate that a significant percentage of nursing students involved in the research had mild to moderate levels of test anxiety (TA) and there is a significant association between TA and demographic characteristics. The results indicate the importance of early identification of TA and the need for interventions to overcome TA to ensure they are emotionally, physically, and academically successful.

Perceptions and experiences of Generation Z nursing students during their practicum in an intensive care unit: A qualitative study

Background

Influenced by socio-cultural and world events, Chinese society has significant intergenerational differences. With rapid economic and cultural development, the unique characteristics of Generation Z nursing students in China may influence the clinical education environment. However, the research on Generation Z in China is still in its infancy.

Objectives

This study aimed to explore the experiences and perceptions of Generation Z nursing students during their practicum in an intensive care unit (ICU) in the context of China's unique cultural and historical background.

Methods

A phenomenological approach was used in this qualitative study. Semi-structured, face-to-face interviews were conducted with fifteen Generation Z nursing students doing practicum in the ICU in a third-level hospital in Shanghai, China. The data were analyzed using Colaizzi's seven-step method.

Result

Three themes emerged: intelligent medical services empowering critical care, perception of multiple challenges, and affirmation of the teaching work in the ICU.

Conclusions and implications

The clinical instructors should use a combination of online and offline pedagogy, give positive guidance through role modeling, and develop the self-learning skills of Generation Z nursing students. This might help Generation Z nursing students relieve the stress of practicum in the ICU, more quickly adapt to the clinical environment, and enter nursing positions. The result of this research provided valuable information to help clinical practicum programs in China effectively educate Generation Z nursing students. Good education ensures that health care is safe and effective, making it easier for patients to get better.

Practice tutors' readiness to support nursing students who require reasonable adjustments for clinical placement

BACKGROUND

Preregistration nursing students (trainee nursing associates and student nurses) may have a disability or impairment that requires reasonable adjustments while they are on clinical placement. At The Open University, practice tutors support nursing students on clinical placement, which includes overseeing the facilitation of any such reasonable adjustments. However, they may not feel prepared to provide this support.

METHOD

A qualitative approach with a broad interpretivist paradigm was adopted. Data were collected from three focus groups that included a total of 10 nursing practice tutors. Audio data were transcribed and analysed using complete coding followed by thematic analysis.

FINDINGS

Three main themes were identified - it's complex; impact of engagement; and a cohesive approach - along with associated subthemes.

CONCLUSION

Despite their clear interest in helping nursing students who require reasonable adjustments for practice-based learning, practice tutors can be hindered by barriers resulting from a lack of both training and guidelines. The complexity of the practice tutor role and student issues can compound this. Consistency in practice tutor training is recommended, as well as regular access to peer support to address these difficulties and develop the skills and knowledge.

Correlation of academic emotion and hardiness personality of undergraduate nursing students

BACKGROUND

Academic emotion is a fundamental emotional concept closely linked to academic achievement. Understanding the connection between academic emotion and the personality trait of hardiness is pivotal in maintaining a stable career orientation throughout one's educational career. Therefore, in pursuit of fostering the robust growth of nursing careers, it is imperative to delve into the academic emotions experienced by undergraduate nursing students. This study endeavors to mitigate the impact of gender differences among nursing students while investigating the intricate relationship between academic emotions and the trait of hardiness in their personalities.

METHODS

This study employed a cross-sectional research design. We gathered data from a convenient sample of 292 nursing students enrolled at Shanxi University of Chinese Medicine. Each student provided demographic information and responded to a general academic mood questionnaire, as well as a Hardiness Personality Rating Scale. Subsequently, we used canonical correlation analysis to evaluate the correlation between academic emotion and tenacity personality in 292 undergraduate nursing students.

RESULTS

We discovered that academic emotions among nursing students are predominantly characterized by feelings of disappointment and boredom. Furthermore, personality hardiness is primarily influenced by the dimensions of engagement and control. It is important to note that a heightened level of negative, low-arousal academic emotions can diminish the level of engagement. The first typical correlation coefficient corresponding to academic emotion and hardiness were 0.660. The linear combination of standardized variables of the first typical variable corresponding to academic emotion (X1) = -0.444*negative hyperarousal -0.443 * positive hyperarousal + 0.694 * negative hypoarousal -0.260 * positive hypoarousal. The standardized variable equation of the first typical variable corresponding to hardiness personality (η1) = 0.235* hardiness -0.433* control -0.530* investment -0.303* challenge.

CONCLUSIONS

Nursing students generally believe that their input is out of proportion to the return, and this unbalanced emotional experience will seriously affect their academic emotions in China. It is suggested that paying attention to cultivating their tenacious personality traits in the teaching process may help to enhance their academic emotions and enhance the sense of belonging and identity of nursing students engaged in the nursing profession.