Experiences of Iranian Nursing Students Regarding Their Clinical Learning Environment

Experiences of bullying and coping resources in nursing students during clinical placement

BACKGROUND

Nursing students are particularly susceptible to bullying due to their younger age, limited social experience, and less developed psychological resilience.

OBJECTIVES

To analyze nursing students' current state of bullying and coping resources, analyzing their relevance.

DESIGN

Cross-sectional study using a web survey.

SETTINGS

The study was conducted in six nursing schools in Hubei, Guangdong, and Gansu Provinces, China.

PARTICIPANTS

A total of 526 valid responses were obtained from January and March 2024.

METHODS

Data were collected using questionnaires for background data, the Negative Acts Questionnaire-Revised, the Hospital Workplace Violence Questionnaire, and the Workplace Violence Coping Resources Scale. The data were analyzed through descriptive statistics, Spearman's correlation analysis, and multivariate logistic regression.

RESULTS

The score for workplace bullying among nursing students during clinical placement was 26.00 (22.00, 37.00), indicating a mild level compared to the total median score of 55 on the scale. Of the 526 respondents, 306 (58.17 %) reported experiencing bullying during this period. The score for nursing students' coping resources was 60.00 (50.00, 69.25), indicating a medium-to-low level compared with the scale's total median score of 60. There was a negative correlation between workplace bullying and coping resources (rs = -0.244, p < 0.01), indicating that as the coping resources scores decreased, workplace bullying scores increased. Logistic analysis revealed that being single or not, whether the hospital organized lectures or courses on the subject during clinical placements, and organizational support were significant factors influencing workplace bullying (p < 0.05).

CONCLUSION

Nursing students were found to experience significant levels of bullying during clinical placements alongside moderate coping resources. The adequacy of these coping resources was closely linked to the incidence of bullying. To address this issue effectively, nursing education should focus on the contributing factors, promote a culture of safety, and enhance the coping resources available to students. These efforts are essential for the prevention and mitigation of bullying, ultimately fostering a supportive and empowering learning environment for prospective nurses.

Nursing students' bullying experiences from instructors and nurses in the clinical practice: A qualitative systematic review and meta-synthesis

OBJECTIVES

Nursing students are more prone to bullying from clinical instructors and registered nurses during clinical practice than on campus. This bullying has physical and psychological effects on them, but it receives less attention. This review integrated qualitative studies of bullying by instructors or nurses experienced by nursing students during their clinical practice.

DESIGN

A qualitative systematic review and meta-synthesis.

DATA SOURCES

The articles were sourced from PubMed, Cochrane Library, Embase, Web of Science, CINAHL, CNKI, Wanfang, and the retrieval time setting spanned from the inception to November 2023.

REVIEW METHODS

Published original studies of any qualitative research methods focused on bullying experienced by nursing students in clinical practice were included in this review. Two researchers independently screened titles and abstracts, assessed full-text articles for eligibility, and extracted data. The JBI Critical Appraisal Checklist for Qualitative Research (2024 edition) and meta-syntheses were used to assess, analyze, and interpret the methodological quality and findings from included studies. The Confidence in the Output of Qualitative Research Synthesis (ConQual) approach was used to assess confidence in the synthesized findings.

RESULTS

A total of 21 articles were included, yielding 110 research findings, which were integrated into 5 groups of results including 16 categories: the forms of experiencing bullying from the instructors and nurses in clinical practice of nursing students; the reasons nursing students experience bullying; the reactions and responses of nursing students to bullying; the negative impact of bullying on nursing students; the appeals of nursing students after experiencing bullying.

CONCLUSION

This review shows the bullying experienced by nursing students in clinical practice, including forms and causes of bullying, responses when faced with bullying, as well as the impact on physical and mental health, self-efficacy, and sense of professional identity. Hospital managers and educators must collaborate to effectively reduce bullying incidents and consider future research on long-term impacts. Prioritizing comprehensive training programs and management mechanisms, strengthening supervision of departments and instructors, enhancing interactions between schools and hospitals, and paying attention to the physical and mental health of interns are urgent and necessary.

Empowering nursing students: understanding and addressing bullying experiences in clinical training

INTRODUCTION

Bullying in educational environments, particularly among nursing students, is recognized as a significant challenge that can adversely affect their mental health and professional development. Therefore, this qualitative study aims to elucidate nursing students' experiences concerning the phenomenon of bullying during clinical training.

MATERIALS AND METHODS

This qualitative study employed a conventional content analysis approach. Sixteen nursing students were selected using purposive sampling. Semi-structured in-depth interviews were conducted to gather data. The collected data were analyzed using the method proposed by Lundman and Graneheim (2020). MAXQDA version 0.9.5 software was utilized for data management.

RESULTS

The mean age of the participants was 25.3 ± 3.9 years. Nursing students' experiences regarding bullying were articulated through five main themes, eleven categories, and twenty-two subcategories. The main themes included "contexts and agents of bullying," "type of bullying," "roots and causes of bullying," "characteristics of the bully," and "characteristics of the victims." The categories encompassed "educational settings," "healthcare environments," "administrative settings," "direct bullying," "indirect bullying," "clinical environment," "socio-economic factors," "psychological issues," "communication and emotional challenges," "individual challenges," and "educational challenges."

CONCLUSION

The findings indicate that nursing students encounter various forms of bullying from different individuals in educational, therapeutic, and clinical settings. This issue necessitates serious attention from educational institutions and healthcare organizations. Academic institutions should proactively enhance students' abilities to cope with this phenomenon. Additionally, healthcare organizations must take the initiative to develop anti-bullying policies to mitigate this challenge.

CLINICAL TRIAL NUMBER

Not applicable.

Nursing students' perceptions of inadequate nurse staffing in the clinical learning environment - a systematic narrative review

AIM

The aim of this study was to substantiate the perceptions and experiences of nursing students related to nurse understaffing in the clinical learning environment.

BACKGROUND

The quality of the clinical learning environment affects students' learning experiences, shapes their thinking about the profession and can influence their choice to stay or leave the profession. Understaffing in the clinical learning environment has an adverse impact on patient safety, quality of care outcomes and mortality. Understaffing has an impact on students' learning by reducing the quality of supervision and mentoring.

DESIGN

A systematic narrative review.

METHODS

Databases of Academic Search Premier, MEDLINE, Psychology and Behavioural Sciences, APA PsycINFO, APA PsycArticles, CINAHL, AMED were searched systematically. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The reviewers independently conducted study selection, quality appraisal and data extraction. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT). Thematic analysis was used to synthesise the findings.

RESULTS

A total of eight research papers were included. Four themes were identified: inadequate support, feeling unprotected, being seen as a cover for staff shortages on shifts and patients ultimately suffer the consequences of understaffing.

CONCLUSIONS

This review revealed that understaffing in the learning environment meant that optimum level of supervision could not be provided, making students feel vulnerable and insecure, students felt unwelcome and used as cover for staff shortages. We recommend further examination of understaffing to inform policy for improvement in student-staff ratio, supervision and facilitation of learning.

Experiences of bullying among nursing students during clinical practice: a scoping review of qualitative studies

Bullying in the clinical setting has become a significant issue for nursing students. The experience of bullying during clinical practice can negatively affect students' mental and physical health, as well as their professional development. Nursing students are often targets of verbal abuse, intimidation, and discrimination from various individuals in the clinical environment. This behavior not only harms individual students but also affects the quality of patient care. The aim of this study is to provide a deeper understanding of the phenomenon of bullying toward nursing students, identify research gaps, and offer recommendations for future research. This study employed a scoping review method, with articles sourced from four major databases: CINAHL, PubMed, Scopus, and Web of Science. The main keywords used included "bullying," "nursing students," "clinical practice," and "verbal violence." Inclusion criteria were studies with nurse participants, original research articles, and published within the last 10 years (2015-2024). Data were manually extracted using tables and analyzed through a qualitative descriptive approach. Eleven articles met the inclusion criteria. This scoping review focuses on the findings of an exploration of the experiences of bullying experienced by nursing students, identifies research gaps, and provides suggestions for future research. Findings showed that nursing students experience various forms of bullying, including verbal violence and intimidation, often triggered by power imbalances in interactions with clinical staff and mentors. The impact of bullying is not only detrimental to students' mental health, but also affects their academic performance and quality of learning. Research gaps found include a lack of studies on the direct relationship between bullying and clinical assessment outcomes, as well as a lack of understanding of effective strategies to address bullying. This study recommends the need for clearer anti-bullying policies and transparent reporting systems, as well as further research to explore the impact of bullying in the context of nursing culture and education system.

Exploring the perceptions of nursing internship students and their faculty mentors regarding the complexities and hindrances associated with implementing the nursing process within the clinical setting: An in-depth qualitative investigation

Background

Utilizing the nursing process within clinical settings serves to enhance the scientific stature of the nursing field. Nonetheless, various research findings suggest that nursing internship students encounter difficulties when it comes to implementing the nursing process and may lack the necessary proficiency.

Objectives

The aim of this investigation is to identify the perceptions of nursing internship students and their faculty mentors regarding the complexities and hindrances associated with implementing the nursing process within the clinical setting.

Design

A qualitative content analysis.

Participants

Nursing internship students and their faculty mentors from the Isfahan School of Nursing and Midwifery.

Methods

In this study, individual interviews were conducted with 13 participants. The data for this study were gathered through these semi-structured interviews and subsequently analyzed using the Granheim and Lundman method. To ensure the validity and reliability of the data, the evaluative criteria of Lincoln and Guba were employed.

Results

The obstacles unveiled in this study can be categorized into three primary domains, each with its own subcategories: 1-Student role ambiguity (1-1 Lack of practical autonomy; 1-2 Insufficient proficiency in the nursing process; 1-3 Motivational deficiency). 2- Organizational Challenges (2-1 Shortage of nursing staff; 2-2 Suboptimal interpersonal dynamics); And 3- Gradual Erosion of the Nursing Process.

Conclusion

Recognizing the paramount importance of the nursing process in enhancing patient care quality is universally accepted. Therefore, it is imperative to systematically identify and tackle the challenges associated with its application. This study highlights that these challenges stem from various factors, including the multifaceted roles assumed by nursing students, organizational shortcomings within healthcare institutions, and the neglect or erosion of the nursing process in specific clinical settings. Addressing these issues is crucial for ensuring the effective utilization of the nursing process within the nursing profession and for optimizing patient care outcomes.

Challenges of nursing students during clinical training: A nursing perspective

Clinical training plays a fundamental role in nursing students' acquisition of professional capabilities. This study aimed to explore the perceived challenges nursing students face during clinical training. An explorative cross-sectional study was applied. A proportionate, stratified, random sample was enrolled in the study with inclusive criteria, including nursing students (2nd - 4th year) and interns who attended their internship in regional hospitals. A validated electronic questionnaire was used for data collection, which consisted of three sections and 29 items. The section that focused on the difficulties experienced by nursing students during their practical training included six elements: teachers, healthcare professionals, the students themselves, tasks, time management, and the location of the training. Another section inquired about the students' perspectives on the benefits of clinical training. A three-point "Likert scale" was applied. The findings indicated that mild (24%), moderate (62%), and severe (14%) degree of challenges were perceived by the study participants. The mean score for the total challenges during clinical training was 2.00 ± 0.28, and there were variations in the perceived challenges among grade levels. In conclusion, there are variations in the perceived challenges during clinical training among different grade levels. These challenges were related to teachers, health workers, the students, tasks, the time, and the place. Enhancing the nursing curricula alignment with practical training objectives is recommended, focusing on the development of technical and interpersonal skills with appropriate guidance, alongside positive clinical settings to help nursing students learn and boost their confidence in their approach.

The effect of the clinical supervision model on nursing internship students' nursing process-based performance: an experimental study

BACKGROUND

The nursing process is a systematic method for identifying the patient's problems and planning to resolve them. It is also a crucial pillar of high-quality nursing care. Nursing internship students may lack the necessary skills to implement the nursing process due to the increased independence, the absence of constant professorial supervision, and limited experience. The clinical supervision model is a method of clinical education that bridges the gap between theory and practice.

OBJECTIVE

This study was conducted to investigate the impact of the clinical supervision model on the performance of nursing internship students in each of the five stages of the nursing process, as well as overall.

METHOD

This experimental study was conducted in 2022. The 70 eligible internship students were conveniently selected and randomly assigned to either an intervention or a control group. In the present study, the clinical supervision model was implemented for the intervention group, while the control group received routine supervision. This was carried out over six sessions in three months. The data collection was conducted using a researcher-developed checklist of nursing process-based performance in both groups. Moreover, the Manchester questionnaire was used to evaluate the model in the intervention group. The variables considered as confounding factors included age, gender, marital status, number of monthly shifts, and grades of the nursing process credit completed in the third semester. SPSS version 16 software, descriptive statistics (frequency distribution, percentage, mean, and standard deviation), and analytical statistics (independent t-test, chi square, repeated measures Anova and LSD) were used to analyze the data.

RESULTS

Intergroup analysis revealed that there was no significant difference between the scores of nursing process steps and the total score before the intervention in the control and intervention groups, as well as in baseline characteristics (P > 0.05). According to the intragroup analysis, the intervention group showed a significant increase in both the total scores and scores of nursing process steps over time (P < 0.001), whereas the control group exhibited contradictory results (P > 0.05). Finally, the "P-Value Intervention" demonstrated the effectiveness of this training model in improving the performance of the intervention group based on the nursing process compared to the control group. The mean score of the Manchester questionnaire in the intervention group was 136.74, indicating the high impact of implementing the clinical supervision model in the intervention group.

CONCLUSION

The results indicated that the implementation of the clinical supervision model led to improved utilization of the nursing process by nursing internship students at all stages. Therefore, it is recommended that nurse educators utilize the clinical supervision model by providing feedback on errors in action during supervision sessions to enhance the quality of nursing care provided by nursing internship students and improve patient safety in clinical environment.

Global prevalence of bullying and associated factors among nursing students during clinical practice: A systematic review and meta-analysis

OBJECTIVE

This meta-analysis aims to estimate the global prevalence of bullying among nursing students during clinical practice and identify associated factors.

DESIGN

Systematic review and meta-analysis.

REVIEW METHODS AND DATA SOURCES

We conducted a comprehensive literature search across ten databases (PubMed, Cochrane, Web of Science, Embase, CINAHL, PsycINFO, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG) from their inception to January 3, 2023. Two researchers independently screened potentially eligible studies, extracted data, and assessed study quality. Data were analyzed using random-effects or fixed-effects models. Subgroup analyses and meta-regression explored the influence of participant and study characteristics on bullying prevalence. Publication bias and sensitivity analyses were also performed.

RESULTS

We included 28 studies (N = 9511) from 13 countries on five continents. The pooled estimate of bullying prevalence among nursing students during clinical practice was 65.60 % (95 % CI 55. 75 to 74.27), with no evidence of publication bias (t = 1.51, p-value = 0.14). Subgroup and moderator analyses highlighted the impact of country, continent, publication year, and assessment tool on bullying prevalence.

CONCLUSION

Nursing students face a high prevalence of bullying during clinical practice. Addressing this issue in nursing education requires prioritizing associated factors, fostering a culture of safety, providing effective training, and promoting individual resilience. These actions can prevent and mitigate bullying, creating a supportive and empowering learning environment for future nurses.

Exploring Undergraduate Nursing Students' Perceptions on Clinical Learning Environment in the UAE: A Focus on Perceived Benefits and Challenges

Introduction

Establishing a supportive clinical environment is paramount for enhancing nursing students' engagement in clinical practice, their clinical proficiencies, and satisfaction. The increase in nursing student enrollment at the Nursing College, driven by the collaborative efforts between Abu Dhabi Health Services Company (SEHA) and universities, has given rise to concerns regarding the quality of education and clinical instruction. These concerns are primarily due to the increased student-to-instructor ratio. Furthermore, the unsupportive clinical settings and learning tensions underscore the need to understand students' learning experiences and address research gaps within the field of clinical learning in the United Arab Emirates (UAE).

Objectives

The purpose of this study is to investigate the undergraduate nursing students' perceptions of their clinical learning environment, with a focus on perceived benefits and challenges.

Methods

This study used a cross-sectional survey design. The researchers administered a five-point Likert scale questionnaire, which had been adapted and contextualized, to a convenience sample of 217 third and fourth-year nursing students who willingly participated in this study.

Results

Despite the presence of positive aspects, such as diverse clinical experiences and strong support from both clinical instructors and peers, several challenges affect the students' clinical learning. These challenges encompass disparate perceptions of supervision among staff nurses, learning tensions related to student academic workload, insufficient clinical supervision, and difficulties in finding assistance when needed.

Conclusion

There is a clear need to enhance the overall ward learning environment to optimize students' academic motivation and clinical skills. Several measures can be taken to achieve this goal, including incentivizing and reducing the workload of staff nurses, investing in the professional development of clinical instructors, promoting peer interactions and group learning, and adopting a block pattern of education in years three and four for better clinical knowledge assimilation and reduced theoretical workload.

Bullying behaviors and intention to drop-out among nursing students: the mediation roles of sense of belonging and major satisfaction

Bullying in academic settings has long-lasting implications on students' well-being and career prospects, particularly in fields like nursing that require a high level of interpersonal skills and emotional resilience. This study explored the relationships between experiences of bullying and intentions to drop out among Iranian nursing students, with major satisfaction and a sense of belonging serving as mediating factors. A cross-sectional research design was employed from April to June 2023. Undergraduate nursing students (n = 386) filled out a five-part questionnaire namely demographic and educational information, bullying behaviors in nursing education environments, the Belongingness scale, intention to drop out, and academic major satisfaction scale. The study confirmed that experiences of bullying positively correlated with intentions to drop out, negatively affected students' sense of belonging and major satisfaction, and established that course satisfaction and a sense of belonging acted as mediators between bullying and intentions to drop out. The findings show the urgent need for anti-bullying interventions targeting faculty behavior and educational strategies aimed at fostering a sense of belonging and course satisfaction among nursing students.

Nursing students' rights in clinical practice in South Korea: a hybrid concept-analysis study

PURPOSE

This study aimed to derive a conceptual definition and attributes for nursing students' rights in clinical practice in South Korea.

METHODS

This concept-analysis study was conducted at a nursing school in South Korea. The participants were recruited using purposive sampling. The inclusion criteria were being a fourth-year nursing student and having two or more semesters of practical experience. The hybrid model used in this study had three stages. First, 12 studies were reviewed during the theoretical stage. Second, 10 in-depth interviews were conducted during the fieldwork stage. Third, in the analytical stage, the concept of nursing students' rights related to clinical practice was defined and the attributes were derived.

RESULTS

The analysis established five attributes of nursing students' rights: the right to learn, the right to be protected from infections and accidents, the right to be cared for and supported, the right to be respected, and the right to be recognized as a member of a nursing team. A key theme that emerged from this study was having the right to learn in a safe and supportive environment.

CONCLUSION

It is necessary to develop a measurement tool based on the above five attributes and to verify its effectiveness.

Exploring the Barriers and Coping Strategies Faced by Male Nursing Students in Japanese Nursing Education

PURPOSE

Nursing is traditionally considered a female profession, and male nursing students face gender stereotype barriers. Most studies of male nursing students in Japan focus on their learning experiences in maternal nursing, and little is known about the experiences of male nursing students in their usual learning environment. Therefore, the purpose of this study is to explore the barriers and coping strategies of Japanese male nursing students in nursing education, including classroom and practical training.

METHODS

A qualitative descriptive design was used to study 20 male nursing students from eight Japanese universities. Purposive sampling using the snowball method was used to recruit participants. Semistructured interviews were used to gather data about the participants' thoughts and experiences in nursing education. All interview data were analyzed using thematic analysis.

RESULTS

Four themes emerged from the data: (1) nursing choices of own volition; (2) loneliness due to the female-dominated environment and marginalization; (3) dealing with barriers and seeking support; and (4) positive experiences in nursing education. Male nursing students face barriers such as loneliness and feelings of alienation. Family support, mutual support among male nursing students, and the presence of role models were factors that addressed these barriers and positively influenced career choice.

CONCLUSIONS

This research suggests that nursing educators need to understand the barriers faced by male nursing students and provide a gender-neutral learning environment for all students.

Student nurses' experiences of workplace violence: A mixed methods systematic review and meta-analysis

OBJECTIVES

To identify the prevalence of student-directed violence on clinical placement and description of their related experience during clinical placements.

DESIGN

Mixed methods systematic review and meta-analysis conducted following Joanna Briggs Institute guidelines and reported according to Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

DATA SOURCES

CINAHL, Embase, Medline, Proquest, PsycINFO and Google Scholar.

REVIEW METHODS

Included studies were peer reviewed, published primary studies where pre-registration nursing students were surveyed about their experiences of physical, verbal, or sexual aggression, bullying or racism during clinical placement. Studies were quality assessed but not excluded based on the result. A convergent segregated approach to synthesis and integration was undertaken. Prevalence data were extracted and pooled using both random and quality effects models; separate analyses were conducted by violence type, source, and region. Qualitative data were thematically analysed.

RESULTS

14,894 student nurses from 42 studies were included across the meta-analyses. There was substantial heterogeneity in the included data. Pooled prevalence rates ranged from racism 12.2 % to bullying 58.2 %. Bullying (38.8 %) and physical aggression (10.2 %) were most perpetrated by nurses whereas sexual aggression was perpetrated mostly by patients (64.2 %) and physicians (18.6 %). Qualitative findings identified students' descriptions of reasons for, effects of, strategies for dealing with and higher education establishments' responsibilities with regards to workplace violence.

CONCLUSIONS

Student nurses commonly experience violence during their clinical placements. Given the potential debilitating physical and psychological sequelae of all forms of violence then this study further emphasises the need to use multiple strategies to prevent violence and to better equip student nurses to manage potentially violent incidents, their responses to violence, and to whistle blow or report when they are subject to violence.

The effect of professional portfolio learning on nursing students' professional self-concepts in geriatric adult internship: a- quasi-experimental study

BACKGROUND

Professional self-concept is one of the important outcomes of nursing professionalism. There is a lack of adequately planned curriculum may limit nursing students' practical knowledge, skills and professional self-concept in providing comprehensive geriatric-adult care and promoting nursing professionalism. Professional portfolio learning strategy has allowed nursing students to continue professional development and enhance nursing professionalism in professional clinical practice. However, there is little empirical evidence in nursing education to support the use of professional portfolios in blended learning modality among internship nursing students. Therefore, this study aims to examine the effect of the blended professional portfolio learning on professional self-concept among undergraduate nursing students during Geriatric-Adult internship.

METHODS

A quasi-experimental study two-group pre-test post-test design. A total of 153 eligible senior undergraduate students completed the study (76 in the intervention group and 77 in the control group). They were recruited from two Bachelor of Sciences in Nursing (BSN) cohorts from nursing schools at Mashhad University of Medical Sciences (MUMS), in Iran, in January 2020. Randomization was undertaken at the level of school via a simple lottery method. The intervention group received the professional portfolio learning program as a holistic blended learning modality, though the control group received conventional learning during professional clinical practice. A demographic questionnaire and the Nurse Professional Self-concept questionnaire were used for data collection.

RESULTS

The findings imply the effectiveness of the blended PPL program. Results of Generalized Estimating Equation (GEE) analysis was indicated significantly improved professional self-concept development and its dimensions (self-esteem, caring, staff relation, communication, knowledge, leadership) with high effect size. The results of the between-group comparison for professional self-concept and its dimensions at different time points (pre, post and follow up test) showed a significant difference between groups at post-test and follow up test (p < 0.05),while at pre-test there was no important dissimilarity between two groups (p > 0.05).The results of within-group comparison for both control and intervention showed that there were significant differences in professional self-concept and for all its dimensions across the time from pre-test to post-test and follow-up (p < 0.05), and also from post-test to follow-up it was significant (p < 0.05) for both groups.

CONCLUSION

This professional portfolio learning program demonstrates as an innovative and holistic blended teaching-learning approach to improve professional self-concept during professional clinical practice among undergraduate nursing students. It appears that the use of a blended designed of professional portfolio can promote a link between theory and the advancement of geriatric adult nursing internship practice. The data obtained from the present study can be useful for nursing education to evaluate and redesign a curriculum for development of nursing professionalism as a quality improvement process and groundwork to develop new models of teaching-learning and assessment.

Nursing students' experience during their practicum in an intensive care unit: A qualitative meta-synthesis

Background

Clinical practicum provides nursing students with more opportunities to learn their professional knowledge and develop basic nursing skills. Intensive care unit (ICU) is often used as one of the clinical practicum departments for nursing students. Due to the characteristic fast-paced working environments, high acuity of patient care, and technical complexities of an ICU, nursing students are more susceptible to experiencing stress and lack of confidence in these settings, which hinders their professionalization and affects patient care.

Objective

The study aimed to summarize and evaluate the nursing students' experience in an ICU during their practicum and to provide a supportive ICU clinical practicum environment for them. One of the main objectives was to increase the ICU specialty nurse reserve and improve nursing care in the ICU.

Methods

The following databases were searched for related qualitative publications in Chinese and English by systematic searches across January 2022, including the nursing students' experience in ICU during their practicum: PubMed, Cochrane Library, Web of Science, and so on. The qualitative meta-synthesis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two reviewers independently selected these studies and carefully evaluated the quality of each study. Meta-synthesis was then used to summarize the results.

Results

Eleven sub-themes and 3 themes were revealed in 9 studies: challenges of clinical practicum in the ICU, the expectation of support from multiple sources, and the importance and necessity of practicum in the ICU.

Conclusion

Performing one's practicum in ICU was considered by the nursing students in this review as a beneficial practicum despite the challenges involved. The appropriate guidance and monitoring should be given by hospital managers and college educators.

Nursing students' perceptions on clinical learning environment and mental health: a multicenter study

OBJECTIVE

this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature.

METHOD

data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study.

RESULTS

there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores.

CONCLUSION

the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students' perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

The Influence of Reducing Clinical Practicum Anxiety on Nursing Professional Employment in Nursing Students with Low Emotional Stability

Nursing students experience anxiety during clinical practicum, which may interfere with their learning in clinical practice and nursing employment after graduation. This study explored: (1) the factors of the difference in anxiety levels between pre- and post-practicum in nursing students; (2) identified their anxiety events in a clinical environment; and (3) the correlation between emotional stability and 5-year nursing professional employment. The study was designed as a mixed method. A longitudinal secondary analysis method and a qualitative approach with open questionnaire were conducted. The emotional stability subscale of Lai’s Personality Inventory and the Beck Anxiety Inventory, as well as open questionnaires were administered. Research data were collected through the purposive sampling of 237 nursing students (mean age was 20.96, SD = 1.29) of 4.2% male and 95.8% female in a central Taiwan hospital in 2013, and the participants were followed up in 2021 to show 70% in clinical service. Most of the nursing students exhibited significantly decreased anxiety levels in the post-practicum period. Compared to nursing students with high emotional stability, those with low emotional stability exhibited higher differences in their anxiety levels between the pre- and post-practicum periods. Low emotional stability is critical in a pre-practicum BAI score. However, the high pre-practicum BAI score would decrease to normal range after enrolling to practicum setting. So, as to their 5-year nursing professional employment after graduation. Teachers foster a positive learning atmosphere that emphasizes the importance of “we are family” to students. Teachers and advisors need to make efforts in leading the low emotional stability nursing students to learn effective coping and adapting strategies in clinical practicum.

The barriers and facilitators of developing clinical competence among master's graduates of gerontological nursing: a qualitative descriptive study

BACKGROUND

Clinical competence development is a main goal of specialized nursing courses. Nonetheless, some master's graduates of gerontological nursing programs have inadequate Clinical competence. The aim of this study was to explore the barriers and the facilitators to clinical competence development among the master's graduates of gerontological nursing.

METHOD

This qualitative descriptive study was conducted in 2020. Participants were twenty nursing master's students, master's graduates, and instructors of gerontological nursing. They were purposively selected from several faculties of nursing and midwifery in Tehran, Isfahan, and Kashan, Iran. Semi-structured interviews were held for data collection and the conventional content analysis proposed by Graneheim and Lundman was used for data analysis. Data were managed using the MAXQDA 10 software.

RESULTS

The main barriers to clinical competence development were students' neglectfulness towards learning, inefficiency of educational system, and ineffective management. The main facilitators to clinical competence development were effective educational planning and management improvement.

CONCLUSION

There are different personal, educational, and managerial barriers and facilitators to clinical competence development among master's graduates of gerontological nursing. Effective educational planning and management improvement are needed for clinical competence development among master's students and graduates of gerontological nursing.

Coping with the Experience of Bad Sleep and Fatigue Associated with the Nursing Clinical Practicum

Nursing students experience anxiety during clinical practicum, which may interfere with their learning of clinical practice. This study explored the practicum anxiety symptom experience of clinical nursing students. The methodology was mixed research design consist of questionnaire and a qualitative research design following a grounded theory approach. Research data were gathered via theoretical sampling from 37 female college nursing students practicing in a Central Taiwan hospital and analyzed using the content analysis method. The mean age of the subjects was 20.7 ± 1.35 years old. The practicum-related anxiety symptom experience was made up of core dimensions associated with the nursing clinical practicum, such as bad sleep and fatigue, and covered six themes. Students first encountered anxiety-inducing situations in the clinical setting, and then they began coping through self-adaptation and teachers' help. In cases of coping failure, students began to have a bad sleep in the night and then felt tired and fatigued all day. These themes became a repeating cycle during the clinical practicum. This conceptual model shows that students experienced bad sleep and fatigue as a result of anxiety symptoms during the clinical practicum. Bad sleep and fatigue are critical anxiety symptoms for nursing students in clinical practice. Nursing teachers should pay attention to bad sleep and fatigue in nursing students and help students to improve their mental and physical health.

Percepciones de estudiantes de enfermería sobre el Ambiente de Aprendizaje Clínico y la salud mental: estudio multicéntrico

Resumen Objetivo: este estudio tuvo como objetivo evaluar las percepciones de estudiantes de enfermería de universidades públicas de tres países de la Unión Europea sobre la salud mental y los Ambientes de Aprendizaje Clínico, tema poco estudiado en la literatura. Método: la recolección de datos se realizó mediante un formulario de datos demográficos, la Escala de Evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería y el Mental Health Continuum Short Form. Se incluyeron en el estudio un total de 571 participantes de Turquía, Lituania y Portugal. Resultados: hubo una diferencia significativa entre los tres grupos con respecto al Ambiente de Aprendizaje Clínico y al estado de salud mental (p < 0,001). La supervisión fue el elemento más valorado. Los estudiantes portugueses obtuvieron los puntajes promedio más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería (p<0,001). La edad, el sexo y la salud mental influyeron en los puntajes de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. Conclusión: los resultados indicaron que los estudiantes de Enfermería portugueses obtuvieron los puntajes más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. También se reveló que las percepciones de los estudiantes sobre el Ambiente de Aprendizaje Clínico se vieron afectadas por la edad y el género, y que sus percepciones sobre la salud mental fueron influenciadas por los puntajes de la escala de evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería.

Nursing students’ perceptions on clinical learning environment and mental health: a multicenter study

Objective:

this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature.

Method:

data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study.

Results:

there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores.

Conclusion:

the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students’ perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

Mentoring of nursing students-A comparative study of Japan and five European countries

AIMS

This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan.

METHODS

The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis.

RESULTS

Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring.

CONCLUSION

Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses.

Development and Validation of the Nursing Students' Rights Awareness Scale in Clinical Practice: A Scale Development Study

Nursing students perform clinical training in a variety of clinical practice fields, so their rights are important. Efforts are needed to accurately identify and measure the awareness of nursing students' rights. This study aimed to develop and evaluate the psychometric properties of nursing students' rights awareness scale. The study procedure was carried out in four stages: the concept analysis, item development, scale development, and scale evaluation stage. First, in the concept analysis stage, the attributes of the concept were derived. Second, in the item development stage, preliminary items were derived, and the content validity was verified. Third, in the scale development stage, a preliminary and main survey were conducted, and item reduction was implemented. Fourth, in the scale evaluation stage, construct validity and reliability were verified. The collected data were analyzed using the SPSS 24.0, and item analysis was conducted using skewness, kurtosis, and item-total correlation scores. The construct validity was assessed by exploratory factor analysis, convergent validity, and divergent validity. The reliability was analyzed using Cronbach's alpha coefficient and composite reliability. The final version of the scale was tested on 240 nursing students from three cities in South Korea. From the construct validity, three factors and 14 items were selected. The factors included "the rights to be protected, cared for, supported, and respected" (eight items), "the rights to be recognized as a member of a nursing team" (three items), and "the rights to learn" (three questions). The reliability of the scale was also verified. Through this study, the scale was developed to identify the rights of nursing students in clinical practice. The implication of this study is that it has laid the foundation for measuring the rights of nursing students applicable in clinical settings for the first time. The limitation of this study is that data were collected in some regions. Therefore, it is necessary to verify the validity and reliability of the scale in various cultures.

Bullying in nursing students: A integrative literature review

The purpose of this integrative review was to analyse the current situation of bullying in nursing students through an exhaustive review of the last 10 years. As the sources of information, we used electronic databases, such as Medline, CINAHL, PubMed, Cochrane, and SciELO, using bullying, nursing students, and clinical environment as search terms. We based the methodology of the study in PRISMA checklist. Articles were selected for their relevance and suitability for the purpose, and they were constructed into a table. A critical appraisal was done using MMAT TOOL and AACOODS checklist. Papers were analysed using a constant comparison and a concept mapping. Finally, 30 articles were included. We analysed: prevalence, profile of the victim and perpetrator, type of violence, and bullying consequences. Bullying prevalence varied from 9-96% according to the author. Differences about the influence of sociodemographic variables were detected, there is no consensus about age, gender, or educational level. Bullying in nursing students is an important problem that affects all spheres of their life. Harassment also has consequences for the patient and for the health organization, so it is really important to take action regarding bullying and to act to victims, perpetrators, and health organizations. Regarding to implications for nursing practice, we found that some interventions were useful to reduce bullying, so it is important to participate in intervention programmes to eventually stop this problem. This study has revealed that more research on the efficacy of psychological intervention programmes to help students cope with bullying situations is essential.

Challenges faced by student nurses and midwives in clinical learning environment - A systematic review and meta-synthesis

OBJECTIVES

This systematic review aimed to offer insight and understanding, through synthesis of findings from studies that report on perspectives of student nurses/midwives, clinical instructors, clinical nurses/midwives on the challenges faced by student nurses/midwives in the clinical learning environment (CLE).

DESIGN

All primary qualitative research studies published in the English language that reported on the views of student nurses/midwives, clinical instructors and clinical nurses/midwives on the challenges faced by student nurses/midwives in the CLE were included.

DATA SOURCES

The electronic databases of Medline EBSCO (1946-), CINAHL (1970), Embase Ovid (1974-), ScielO, WHOLIS (2002-), ASSIA (1985-), Web of Science (1956-), PsycINFO (1800s-) and Maternal and Infant Care (1970-) were searched in November 2019.

REVIEW METHODS

Retrieved papers were reviewed independently by two authors for selection by title, abstract and full text, and two authors agreed for inclusion of the papers. The COREQ criteria checklist was used for assessment of methodological quality of the included studies.

RESULTS

The review included 32 studies published over 22 years between 1997 and 2019 involving 853 nursing/midwifery students, clinical instructors, and clinical nurses/midwives from 14 countries. Three key themes emerged: 'The support structure', 'Personal factors', and 'Planning and organisation - influence of extrinsic factors'.

CONCLUSION

Attitude of clinical staff, instructors, and significant others had a major influence on students' clinical learning. Lack of a sense of belongingness and self-motivation to learn, and perceived fear of doing errors were some of the demotivating factors. Lack of resources to facilitate need-based training, staff shortages, workload and inconsistencies between theory and practice were other key challenges in the CLE. Understanding the challenges faced by students in clinical practice can help overcome the barriers leading to development of competent and confident nurses and midwives.

Experiences of undergraduate nursing students during clinical practice at health facilities in Western Cape, South Africa

BACKGROUND

This study explored the experiences of undergraduate nursing students during clinical practice at healthcare facilities in the Boland Overberg area in Western Cape, South Africa. Few studies have been done on experiences of nursing students during clinical practice. However, there are still inadequacies, which lead to the deterioration of clinical practice quality.

OBJECTIVES

To explore and describe the experiences of undergraduate student nurses during clinical practice in healthcare facilities in Boland Overberg, in Western Cape, South Africa.

METHOD

A qualitative, exploratory descriptive design was applied. Data collection was done using focus-group interviews to ascertain the undergraduate student nurses' experiences during clinical practice in healthcare facilities in the Boland Overberg area in Western Cape Region. Thirty-eight undergraduate nursing students from Boland Campus were selected, using purposive sampling. The sample size was based on data saturation. Colaizzi's method of coding and thematic content analysis was used to interpret the data. Ethical principles were adhered to.

RESULTS

After data analysis, the following themes emerged: clinical learning environment, challenges and inability to reach objectives.

CONCLUSION

During clinical practice in healthcare facilities, students were confronted with dilemmas which must be addressed with proper planning to decrease the challenges in clinical education of future nurses. The findings can be used in planning of nursing education, could provide help to develop effective clinical teaching strategies in nursing education and to support these undergraduate nursing students.

Psychometric evaluation of Persian version of the balanced measure of psychological needs scale among university students

Aim

The purpose of the present study was to evaluate the reliability, validity and factor structure of the Persian version of the BMPN in Iranian university students.

Design

Cross‐sectional.

Methods

Study was conducted among Iranian medical sciences students from April to May 2020. A total of 660 students participated in the online self‐administrated questionnaire. Construct validity, convergent and divergent validity, and reliability of P‐BMPN were evaluated.

Results

The Exploratory factor analysis showed that the Persian version of the BMPN has 17 items with four factors: dissatisfaction, autonomy Satisfaction, relatedness satisfaction and competence satisfaction that explained 40.17% of the total variance. Based on confirmatory factor analysis, all goodness‐of‐fit indices confirmed the model fit.

Conclusion

These results suggest that the Persian version of the BMPN is a reliable and valid measure to assess satisfaction and dissatisfaction of the psychological needs in Iranian university students.

Barriers to and facilitators of nursing students' adjustment to internship: A qualitative content analysis

BACKGROUND

Identifying factors affecting nursing students' adjustment to the internship conditions can enable nursing officials to make important decisions that can help students benefit more from their internship period according to expected goals.

OBJECTIVES

The present study was conducted to explain the facilitating and inhibiting factors of nursing students' adjustment to the internship.

DESIGN

The qualitative content analysis approach was used.

SETTING

The present study was conducted at a nursing and midwifery school affiliated with a large metropolitan medical university in northern Iran.

PARTICIPANTS

A total of 17 final-year nursing students who did morning shifts during the week and a day-long (morning and evening) shift per week, were selected through purposive sampling with maximum variation.

METHODS

Data were collected over 17 months through face-to-face semi-structured interviews, then carefully transcribed and analyzed using Graneheim & Lundman qualitative content analysis approach.

RESULTS

Support systems, the internship structure and its setting, and personal and professional factors were the three themes identified as facilitators and barriers of adjustment.

CONCLUSION

According to the results, factors affecting students' adjustment to internship manifest their effect over a continuum, in the form of adequate/poor support, high/low self-efficacy, and appropriate/inappropriate internship structure and setting. Moreover, support systems are among the most important factors affecting nursing students' adjustment to the internship. Furthermore, the role of hospital staff in accepting or rejecting the conditions and issues that participants face during their internship is very important.

The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals

AIMS AND OBJECTIVES

To analyse nursing students' perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals.

BACKGROUND

Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace.

DESIGN

Cross-sectional, correlational study.

METHODS

One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students' satisfaction with the clinical learning environment and learning process was measured using a 4-point Likert scale developed by the researchers. The STROBE checklist was used in this paper.

RESULTS

Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction.

CONCLUSIONS

This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies.

RELEVANCE TO CLINICAL PRACTICE

Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.

Attitude of nursing students following the implementation of comprehensive computer-based nursing process in medical surgical internship: a quasi-experimental study

Background

The nursing process is the core and the standard of practice in nursing profession. Nowadays, the use of information technology in the field of nursing processes, education and practice has been emphasized. Since nurse’s attitudes towards clinical information systems are considered as an indicator of the success rate of information systems, and nurse’s attitudes about the nursing process can affect their execution of the process. So the purpose of this study was to evaluate nursing students’ attitudes towards the nursing process software.

Methods

In this quasi-experimental study, 160 undergraduate nursing students (terms 4–8) in Tabriz University of Medical Sciences were selected by convenience sampling. To evaluate the effectiveness of nursing process software in this study, Mazlom and Rajabpoor (IJME 14(4):312–322, 2014) a questionnaire consisting of 21 components based on a five-point Likert scale was completed by students after using the software. Data were then analyzed by SPSS 19 software.

Results

The mean score of students’ attitude toward nursing process software was high (80.70 ± 5.58). The nursing students’ highest scoring attitudes were respectively related to “Effectiveness of software in prioritizing patient care and problems”, “Completeness of patient’s electronic information compared to handwritten mode” and “Software’s effectiveness in saving your time”. The lowest scoring attitudes towards the software was respectively related to the “feeling of fairness in labor division”, “the effectiveness of the software in determining your workload” and “the feeling of satisfaction in labor division”. There was a statistically significant relationship between gender and age, and student’s attitude toward nursing process software.

Conclusions

According to the results and analysis of nursing student’s attitudes toward nursing process software, the use of such software would be welcomed by students. It seems that changing policies in the educational and clinical substructure of nursing in order to develop, adapt and use the nursing process software is an important responsibility for nursing authorities to consider. Providing educational and clinical technology equipment, periodic evaluation of software by stakeholders and promoting the use of this software, can be fundamental steps in operationalizing the findings of this research.

Wellness among nursing students: A qualitative study

Nursing students typically experience high levels of stress and anxiety in nursing schools, and this is often compounded by having to combine complex classroom theories with practice. Healthy behaviors are subsequently neglected, diminishing academic efficiency and personal wellbeing. Student nurses need to adopt healthy lifestyles since wellness has been shown to promote positive health outcomes. Nonetheless, studies on the perception of wellness, and descriptions of its facilitators and barriers in wellness promotion among nursing students remain limited. This qualitative descriptive study aimed to explore facilitators and barriers to promote wellness among nursing students in Thailand. Data was gathered using focus groups with 80 undergraduate third and fourth-year nursing students, comprising 64 females and 16 males. Four themes emerged from content analysis regarding the facilitators of promoting wellness: healthy living; belief in animism; self-optimism; and receiving support. Barriers to wellness were three themes of stressors involved in students' lives: pressure from instructors; behaviors of staff nurses; and being perceived as untrustworthy. It is vital to promote wellness among nursing students to encourage their health care choices and to support them through their studies.

Nursing Students’ Perceptions of the Dedicated Education Unit Model in 2 UAE Hospitals

Background: Initially developed in Australia, Dedicated Education Unit (DEU) is an innovative approach to support the growth and development of nursing students while on clinical placement in the hospital setting. With the increasing number of nursing students requiring clinical placement, nursing needed to explore further ways to support students and preceptors in the clinical area. Methods: The study followed a sequential explanatory mixed-methods design to investigate participants’ perceptions of the effectiveness of the DEU model in improving nursing students’ learning experiences. The DEU model was implemented in 2 Abu Dhabi Health Services Company (SEHA) hospitals in Al Ain City, and feedback was obtained from both students and their preceptors via survey and focus group sessions. Results: The study showed positive results with students feeling supported to learn new knowledge and skills by their preceptors. Preceptors reported that they were better able to facilitate student placements in an environment that supported learning. Conclusion: The introduction of the DEU model has supported increasing numbers of students in the clinical area and provided an improved environment for learning.

Saudi Nurses' Competency Learnings and Experiences from the Newly Developed Advanced Nursing Practice Diploma Program in Saudi Arabia: A Phenomenological Study

Introduction  In response to Saudi Vision 2030, the Saudi Commission for Health Specialties has taken the lead in supporting healthcare system development by providing advanced nursing practice training diplomas. The aim of this study is to explore the experience of nursing trainees during their enrollment in the newly established Saudi Commission for Health Specialties (SCFHS) Advanced Nursing Practice (ANP) diplomas. Methods  We employed a descriptive phenomenological approach in this study. Collaizi's distinctive process was utilized as a guide for the data analysis of 12 interviews. Results Exploring the participants' experiences revealed four themes: (1) the organizational culture valuing the learner and their learnings; (2) the commitment to continuous quality care improvement; (3) challenges in the trainer-trainee relationship; and (4) the vague career track of the trainees. Conclusion The identified challenges faced by the nursing trainees may hinder the optimum utilization of these program outcomes. Interventions to overcome the identified challenges should be initiated by all stakeholders.

The effects of group mindfulness-based cognitive therapy in nursing students: A quasi-experimental study

BACKGROUND

Academic and clinical stressors are experienced by most nursing students enrolled in a nursing education program. The students who cannot effectively deal with these stressors experience stress, anxiety and depression.

OBJECTIVE

The aim of this study was to determine the effects of group mindfulness-based cognitive therapy on mindfulness, depression, anxiety, and stress levels in nursing students.

DESIGN

This quasi-experimental study was carried out using a nonrandomized control group pre-test, post-test, and follow up design.

SETTING

Department of Nursing, Faculty of Health Sciences, University of Aksaray, Turkey.

PARTICIPANTS

Eighty-two second-year undergraduate university nursing students.

METHODS

The group mindfulness-based cognitive therapy program was conducted with the experimental group. The Mindful Attention Awareness Scale (MAAS) and The Depression, Anxiety and Stress Scale (DASS) were measured at pre- and post- intervention, and at a 4-months follow-up.

RESULTS

The post-test mean scores of MAAS of the experimental group were statistically higher than the control group (p = .006). When the mean scores obtained in the pre-test, post-test and follow-up measurements were compared, the mean scores of MAAS increased (p = .000) and stress scores decreased significantly in the experimental group (p = .004).

CONCLUSION

A group mindfulness-based cognitive therapy program conducted with nursing students had an effect on students' mindful attention awareness and stress levels. These study results indicate that this program can be used to reduce the levels of stress in nursing students.

Proceso de Atención de Enfermería como instrumento del cuidado, significado para estudiantes de último curso

Introducción: El Proceso de Atención de Enfermería (PAE) como guía para el cuidado, se aplica desde que inicia la formación académica. Comprender el significado que tiene para estudiantes del último curso permite visualizar la importancia y dificultades que se presentan en su aplicación, para proponer estrategias que fortalezcan la calidad educativa. Objetivo: Comprender el significado del PAE que tienen los estudiantes del último curso de Enfermería. Método: Estudio con enfoque cualitativo. Referencial teórico y metodológico fue el Interaccionismo Simbólico y la Teoría Fundamentada en los Datos. Muestra por saturación teórica. Colecta de datos con entrevistas semiestructuradas en 17 estudiantes del 10° ciclo de una universidad privada de Lima Este. Análisis de datos basado en la codificación de Strauss y Corbin posibilitó la identificación de categorías y subcategorías, y el fenómeno central. Resultados: Emergieron cinco categorías: 1) Cuidado enfermero utilizando el PAE desde el inicio de su formación (Condición causal); 2) Satisfacción o insatisfacción al dar cuidado con el PAE (Contexto); 3) PAE como herramienta de investigación en formación profesional (Condiciones Intervinientes); 4) Dificultades en la aplicación del PAE en el cotidiano de los profesionales (Estrategias de Acción/ Interacción) y 5) Mejora de la práctica al dar cuidado con PAE (Consecuencias). Conclusiones: El fenómeno central es el PAE, instrumento que guía el cuidado de enfermería para brindar a las personas atención integral y con fundamento en evidencia científica; a partir de la experiencia profesional con una proyección positiva al campo laboral, no exenta de limitaciones en su aplicación en el campo hospitalario.  

Relationship between depression, anxiety, cognitive distortions, and psychological well-being among nursing students

PURPOSE

The aim of this study was to determine the relationship between depression, anxiety, cognitive distortions, and psychological well-being among nursing students.

DESIGN AND METHODS

This descriptive, correlational, cross-sectional study was conducted with 330 nursing students. Data were collected using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Cognitive Distortion Scale (CDS), and the Psychological Well-being Scale (PWBS).

FINDINGS

The PWBS negatively correlated with the BDI, BAI, and CDS (P < .05). Preoccupation with danger was the strongest predictor, followed by hopelessness, self-blame, total CDS and BDI (P < .05).

PRACTICE IMPLICATIONS

Nursing students should be evaluated for psychological well-being to prevent psychiatric symptoms such as anxiety and depression.

The effect of mentoring program on adjustment to university and ways of coping with stress in nursing students: A quasi-experimental study

BACKGROUND

Mentoring programs are effective in improving some characteristics related to university adaptation, such as increasing student satisfaction, gaining social skills and effective communication, reducing stress and anxiety, and improving cognitive and psychomotor skills as well as academic performance.

OBJECTIVE

The aim of this study was to determine the effect of mentoring program on adjustment to university and ways of coping with stress in nursing students.

DESIGN

This quasi-experimental study was carried out using a nonrandomized control group pretest and posttest design.

SETTING

The study was conducted at a university school of nursing in Turkey.

PARTICIPANTS

Ninety-one first-year undergraduate nursing students were included in the study.

METHODS

The 8-week peer mentoring program was conducted with the experimental group. The Adjustment to University Scale (AUS) and The Ways of Coping Inventory (WCI) were measured at preintervention and postintervention.

RESULTS

The posttest mean scores of AUS of the experimental group were statistically higher than the control group (p < .05). The posttest mean scores of optimistic and seeking social support approaches of the experimental group were also statistically higher than the control group (p < .05). Mentoring program had an effect on self-confident, optimistic, seeking social support, submissive, and helpless approaches in the experimental group (p < .05).

CONCLUSION

Mentoring program had a positive effect on adjustment to university and ways of coping with stress in nursing students. These study results indicate that this program can be used to increase the adjustment to university and ways of coping with stress in nursing students.

Conceptualizing and determining core clinical competencies in nursing students: a qualitative study

AIM

This study aimed to conceptualize and explain the core clinical competencies of nursing students in Iran.

BACKGROUND/INTRODUCTION

Despite the national and international efforts to modify nursing curricula such that the students' clinical competencies are improved, there is still a widespread concern about this issue, perhaps due to the impact of factors other than the curriculum itself, such as the lack of a clear definition for the concept of clinical competency and its main components in nursing students.

METHODS

This qualitative study was conducted using conventional content analysis. The participants were selected through purposive sampling and included 14 senior students of bachelor of nursing, four nurses working in teaching hospitals and six clinical instructors. Individual semi-structured interviews were used for data collection. After recording and transcribing the interviews, content analysis was used to extract the concepts.

FINDINGS

The main theme of the study was 'multidimensionality of the concept of clinical competency,' which had six main categories, namely 'adoption of and adaptation with the nursing practice,' 'nursing knowledge,' 'self-direction in clinical learning,' 'patient care skills,' 'professional ethics' and 'the development of professional behaviours.'

DISCUSSION/CONCLUSION

Clinical competency and its dimensions among students comprise a multidimensional concept. Having a clear and comprehensive understanding of this concept and focusing on its core axes may be the most important step in improving students' clinical competency.

IMPLICATIONS FOR NURSING, HEALTH AND EDUCATION POLICY

Policymakers and nursing education authorities can identify the problems existing in the students' clinical competency and provide them with practical solutions for a standard professional education through a clear understanding of the concept of clinical competency and its dimensions.