Nursing students' self-directed learning abilities and related factors at graduation: A multi-country cross-sectional study

Nursing students' knowledge, attitudes and learning occasions about pressure injuries at the time of graduation: A multi-method pre-post pandemic study

INTRODUCTION

Pressure injuries (PIs) are a significant issue in healthcare system: nursing students are recommended to be prepared to assess the risk, prevent and manage them. However, despite the coronavirus disease-2019 (COVID-19) pandemic significantly affected nursing students' learning opportunities no data regarding their impact of PIs knowledge, attitudes and learning occasions have been documented to date.

AIMS

To describe the post-pandemic knowledge and attitudes regarding PI prevention and management and to compare clinical learning opportunities in the field of PIs before and after the COVID-19 pandemic.

METHOD

A descriptive multi-method study involving students at the time of their graduation in the before (n = 114) and after the pandemic (n = 113). The Italian versions of the Pressure Ulcer Knowledge Assessment Tool (PUKAT-IT) and Attitude Toward Pressure Ulcer Prevention (APuP-IT) scales were used. Data regarding pre- and post-pandemic learning opportunities were retrospectively collected from the Student Portfolio of Skills.

RESULTS

The average PUKAT-IT score was 57.92 % (cut-off 60 %), which indicates insufficient knowledge; the average APuP-IT score was 78.19 % (cut-off 75 %), which shows positive attitudes towards PI. Comparing the pre- and the post-pandemic groups, learning opportunities in PI risk assessment and prevention significantly decreased (overall 38.90 vs 32.27 and 35.26 vs 25.97, respectively) while those regarding the PI management remained stable.

CONCLUSION

In the post-pandemic times, nursing students' knowledge about PIs remains insufficient while their attitudes are adequate; the pandemic significantly reduced students' exposure to prevention and assessment learning opportunities during their internship, which suggests a need to update educational strategies to ensure appropriate knowledge and learning experiences in this field.

Factors associated with self-directed learning among undergraduate nursing students in Vietnam

AIM

This study purposed to determine nursing students' self-directed learning abilities and related factors.

BACKGROUND

Self-directed learning is a significant and practical approach for nursing students in their lifelong learning.

DESIGN

In this study, a descriptive cross-sectional study was used to assess the level of SDL undergraduate of 411 undergraduate nursing students from four academic years.

METHODS

The Self-directed Learning Abilities and Related Factors Questionnaire was used to measure the Self-directed Learning Abilities of the Nursing Students. Descriptive statistics were used to analyze the data and a logistic regression analysis was performed to evaluate the factors influencing self-directed learning abilities.

RESULTS

Of the 411 nursing students, most belonged to the female group. Moreover, most of the nursing students have permanent residence in rural areas. The average score of general self-directed learning abilities of nursing students was 3.88 ± 0.3. Only 33.8 % of the respondents had a high level (mean score ≥ 4) of self-directed learning abilities. There was a significant relationship between place of residence, grade obtained in previous level education, current grade point average, academic workload, assessment methods, learning resources and self-directed learning abilities (p<0.05).

CONCLUSIONS

The self-directed learning ability level was low in this nursing student sample. Therefore, this study may increase nursing educators' attention to designing appropriate strategies to improve students' self-directed learning abilities.

Perceived competences by graduated nurses before and during COVID-19 restrictions: A repeated cross-sectional study from 2019 to 2022

AIMS

To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions.

BACKGROUND

Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era.

DESIGN

A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach.

METHODS

Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group).

RESULTS

The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4-69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60-65.8), higher in the second (66.6, 95 % CI 63.6-69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9-66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis.

CONCLUSIONS

A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical relevance. The findings may inform reflections regarding innovations in the clinical placements pathways as well as in the strategies supporting newly graduates nurses in their transition from education to health-care settings.

Influential factors associated with core competencies of diabetes specialist nurses and correlation with self-directed learning ability: A cross-sectional study

AIMS AND OBJECTIVES

This study aimed to investigate the current status of the core competencies and self-directed learning ability of diabetes specialist nurses and to explore the relationship between these core competencies and their self-directed learning ability.

DESIGN

A cross-sectional survey design was used.

METHODS

This cross-sectional study was conducted via a web-based questionnaire platform in China from January 14 to April 24, 2023. The survey included a general information questionnaire, a diabetes specialist nurses' core competencies self-assessment scale, and a nursing staff's self-directed learning ability evaluation scale. The data was collected online. Descriptive, correlation and multiple linear regression analyses were conducted using SPSS 26.0 software.

RESULTS

118 diabetes specialist nurses from 11 cities participated in this study. A positive correlation was observed between the core competencies of diabetes specialist nurses and their self-directed learning ability. The characteristics affecting the core competencies of diabetes specialist nurses included age, participation in external learning and communication and self-directed learning.

CONCLUSIONS

The training of diabetes specialist nurses can focus on core competencies, and the ability to self-direct learning can be used as an entry point to customize feasible theoretical and practical courses. The training system can further improve diabetes specialist nurses' core competencies and self-directed learning abilities.

RELEVANCE TO CLINICAL PRACTICE

A reference can be established that nursing managers and nursing educators can use to develop training programs for specialist nurses by validating the link between their core competencies and self-directed learning skills.

PATIENT OR PUBLIC CONTRIBUTION

Participants were involved solely in the data collection process. No participant contributions were required for the study's design, outcome measurement or implementation.

Self-directed learning in dental hygiene students: Impact of locus of control and personality traits

OBJECTIVES

The purpose of this study was to identify demographic variables, the level of self-directed learning (SDL), locus of control (LOC), and personality traits in dental hygiene (DH) students and to identify predictive variables for SDL.

METHODS

Cross-sectional survey research was conducted with a convenience sample of DH students (n = 229) in the United States using a web-based survey. The validated instruments used were the Self-Directed Learning Instrument (SDLI) to determine level of SDL, the Academic Locus of Control (ALC) scale for college students to evaluate LOC, and the Big Five Inventory-2-Extra Short Form (BFI-2-XS) to identify personality traits. Descriptive, correlation, and regression analyses were performed.

RESULTS

The completion rate was 68.9% (n = 159). The average SDLI score of the sample was 82.59, indicating a high overall level of SDL. The average ALC score was 10.34, indicating an overall internal LOC. Internal LOC (B = -0.319, SE = 0.082, β = -0.330, p < 0.001) and an open-minded personality trait (B = 1.156, SE = 0.363, β = 0.233, p = 0.002) emerged as significant predictors of learning motivation (B = -0.138, SE = 0.057, β = -0.214, p < 0.017) and self-monitoring (B = 0.553, SE = 0.253, β = 0.167, p = 0.030) SDLI constructs.

CONCLUSION

SDL among DH students can be cultivated by enhancing their learning motivation and self-monitoring skills. This may be achieved by helping learners increase their internal locus of control and open-mindedness. Future studies should explore exercises to help promote these traits.

Self-directed learning and clinical competence: The mediating role of the clinical learning environment

Introduction

Recognizing the factors affecting clinical competence among internship nursing students is crucial. This study was aimed at determining the effects of self-directed learning on internship nursing students' clinical competence under the mediating role of the clinical learning environment.

Methods

This cross-sectional research was performed on 300 internship nursing students selected by convenience sampling with a structural equation modeling (SEM) approach. Data were collected in one stage with three tools: the Self-Directed Learning Readiness Scale for Nursing Education, Education Environment Measure, and Clinical Competence Questionnaire. Data analysis was performed in SPSS version 21 and Smart-PLS version 3 with partial least squares-SEM. Measurement and structural model data were assessed with a significance threshold of p < 0.05.

Results

A total of 20.5 % of the variance in clinical competence was explained by self-directed and clinical learning environments. Self-directed learning had a significant positive effect on clinical competence (path coefficient = 0.14, 95 % CI: 0.02, 0.26; p = 0.027), and on the clinical learning environment (path coefficient = 0.41, 95 % CI: 0.31, 0.52; p < 0.001). A relationship was observed between the clinical learning environment and clinical competence (path coefficient = 0.38, 95 % CI: 0.25, 0.50; p < 0.001). The indirect effect of self-directed learning on clinical competence was positive and significant (path coefficient = 0.11, 95 % CI: 0.07, 0.17; p < 0.001). Self-directed learning had a significant total effect on clinical competence (path coefficient = 0.30, 95 % CI: 0.19, 0.40; p < 0.001).

Conclusions

According to the results, we recommend that nursing education managers and instructors consider plans to enhance self-directed learning among nursing students and improve the clinical learning environment.

Comparative study of clinical reasoning competence and self-directed learning competence in nurses across varied years of experience

OBJECTIVES

To compare and analyse the differences in the clinical reasoning competence of nurses with different working years and their relationship with self-directed learning competence.

METHODS

A cross-sectional survey design (online investigation) was used. A total of 376 nurses were recruited from four independent hospitals in China. Online questionnaires collected data on nurses' demographic characteristics and assessed their clinical reasoning and self-directed learning competence. Pearson correlation analysis, t-test, analysis of variance (ANOVA) and multivariate regression analysis were used.

RESULTS

Clinical reasoning competence scores of nurses with working years >10 years were higher than those of other nurses. Self-directed learning competence scores of nurses with working years of <1 year and (from ≥1 year to <3 years) were lower than those of nurses with working years of 6-10 years and >10 years. Self-directed learning competence scores of nurses with working years of 3-5 years were lower than those of nurses with working years of >10 years. There was a positive correlation between clinical reasoning competence, self-directed learning competence and each dimension among nurses of different working years. There are differences in the influence of different dimensions of self-directed learning competence on clinical reasoning competence among different working years.

CONCLUSION

There were differences in clinical reasoning and self-directed learning competence among nurses with different working years. Self-directed learning competence is a positive predictor of nurses' clinical reasoning competence, which applied to nurses with all working years; however, the specific effect of self-directed learning competence on clinical reasoning competence differed among nurses with different working years.

IMPLICATION FOR NURSING MANAGERS

Nursing managers should pay attention to the development characteristics of clinical reasoning competence and self-directed learning competence of nurses with different working years and determine effective intervention strategies according to specific influencing factors.

What affects self-regulated learning ability in undergraduate nursing students: A structural equation modelling approach

AIM

To examine how the effects of hardiness, self-efficacy and positive academic emotion related to the SRL ability of undergraduate nursing students.

DESIGN

A cross-sectional survey was designed.

METHODS

A total of 395 Chinese undergraduate nursing students from two undergraduate colleges filled out the questionnaires from May to June 2019. The relationships between hardiness, self-efficacy, positive academic emotion and SRL ability were analysed by structural equation modelling.

RESULTS

The response rate was 94.05%. SRL ability was significantly positive correlated with hardiness, self-efficacy and positive academic emotion in undergraduate nursing students. Self-efficacy (β = 0.417, p < 0.001) and positive academic emotion (β = 0.232, p < 0.001) showed a direct effect on the SRL ability. Although hardiness showed no direct effect on the SRL ability, it affected SRL ability through three indirect ways: self-efficacy (77.778%), positive academic emotion (14.184%) and the chain mediating effect from self-efficacy to positive academic emotion (8.038%).

CONCLUSIONS

Nursing students with a higher level of hardiness would have higher self-efficacy, and more positive and stable academic emotions to obtain the better SRL ability. The produced model provides insights into several factors associated with SRL ability of nursing students. Hardiness, self-efficacy and positive academic emotion should be emphasized in the education of nursing students because these factors could improve their SRL ability and promote their life-long learning.

Correlation analysis of self-directed learning ability, self-efficacy and academic burnout of junior nursing college students in closed management colleges

AIMS

To understand the status quo of self-directed learning ability, self-efficacy and academic burnout of junior nursing college students, since the closed management mode was implemented during COVID-19 pandemic disease.

DESIGN

Cross-sectional study.

METHODS

Participants came from 3,051 junior nursing college students of a college in Zhengzhou City, Henan Province, China. Data were collected by online questionnaire and analysed by SPSS25.0 (a statistical package for social science) and AMOS24.0 software.

RESULTS

High self-directed learning ability and self-efficacy were related to low levels of academic burnout (p < .01). In addition, the analysis of mediation effect indicated that the influence of self-directed learning ability on academic burnout was not mediated by self-efficacy.

Contribution of nursing students to clinical settings: A multi center cross sectional study

AIMS

To describe the contribution of nursing students to clinical settings based on the perceptions of nurse preceptors and to examine whether certain characteristics of nurses' professional activity are associated with a positive perception of nursing students.

BACKGROUND

Most clinical agencies receive many nursing students each year, who acquire clinical competencies under the guidance of a registered nurse preceptor. However, there is limited evidence of the contributions made by nursing students during clinical placements.

METHODS

A multi-center cross-sectional study was carried out between June and December 2019. A convenience sample of Registered Nurses (n = 927) was recruited from four public hospitals in Spain. The Nursing Student Contributions to Clinical Settings' questionnaire was used. In addition, sociodemographic, work and teaching activity variables were collected. Multivariable logistic regression was used to determine the variables associated with positive student contributions.

RESULTS

The nursing student contributions were deemed favorable by 70.7% of the nurse preceptors, mainly because the nursing students are future professionals who know the center, support the development of the nurses' teaching role and constitute a link between the health center and the university. Certain professional characteristics of the Registered Nurses were significantly associated with a positive perception of the contributions of nursing students: having daily coffee breaks (Odds ratio: 2.60; 95% Confidence interval:1.27-5.32), high levels of professional satisfaction (Odds ratio: 2.13; 95% Confidence interval:1.21-3.75) and work in medical-surgical units (Odds ratio: 1.62; 95% Confidence interval: 1.08-2.41). In contrast, nurses with greater work experience (≥ 30 years) (Odds ratio: 0.48; 95% Confidence interval: 0.27-0.85) and who worked at units where 10 or more students perform clinical practice (Odds ratio: 0.57; 95% Confidence interval: 0.36-0.90) were associated with a lower probability of positive perceptions.

CONCLUSIONS

In Spain, the contributions made by nursing students to clinical settings are favorable, both for the nursing profession and for healthcare institutions. Their contributions are influenced by the professional characteristics of the Registered Nurses, as well as the environment and the teaching activity within the units.