Newly graduated nurses’ perceptions of a final clinical practicum facilitating transition: A qualitative descriptive study

Status and associations of transition shock among nursing students during clinical practice: A cross-sectional study

AIM

This study aimed to investigate the current state and influencing factors of transition shock among nursing students during clinical practice.

BACKGROUND

Transition shock among nursing students can significantly impact their academic performance and well-being. Understanding the key factors contributing to this shock is crucial for developing effective support strategies and improving overall educational outcomes.

METHODS

This cross-sectional study was conducted on October 8-28, 2022 at four tertiary Class A hospitals in Changsha, Hunan Province, located in south-central China. A convenience sample of 620 full-time nursing students was surveyed to collect demographic information and assess their transition shock levels using the transition shock scale. Data analysis included descriptive statistics, nonparametric tests, correlation analysis, and multiple regression. STROBE checklist was used for the methodology in this study.

RESULTS

A total of 564 nursing students were ultimately included in the study. The average overall transition shock score was 46 (41, 52). Attitude toward the nursing profession had an independent influence on nursing students' transition shock (p < 0.05). Additionally, the number of night shifts, choosing nursing as the first choice, being class leaders, education level, future plans, school scale, and monthly household income contributed to different dimensions of transition shock (p < 0.05).

CONCLUSION AND IMPLICATIONS FOR NURSING POLICY

Nursing students experience moderate transition shock, with attitude towards nursing as a key influencing factor. Clinical managers should implement targeted measures to better support nursing students improve their attitudes.

Assessing the relationship between teaching quality and satisfaction with clinical teachers among medical students: a correlational cross-sectional study

OBJECTIVES

This study aimed to determine the relationship between teaching quality and satisfaction with clinical teachers among medical students at Ardabil University of Medical Sciences.

DESIGN

A correlational cross-sectional study was conducted in 2023 on 255 medical students in Ardabil (northwest Iran).

SETTING

The study was conducted in Ardabil, a city in northwest Iran, within a medical school that trains future healthcare professionals. This environment allows for assessing the educational quality and clinical training provided to a diverse group of medical students.

PARTICIPANTS

Participants were selected through simple random sampling. Data were collected using a demographic information form, the Persian version of the System for Evaluation of Teaching Qualities questionnaire, and the Medical Students' Satisfaction with Clinical Education questionnaire.

RESULTS

The overall mean scores for teaching quality and satisfaction with clinical teachers among medical students were 3.37±0.56 and 3.22±0.72, respectively. The highest mean score for teaching quality was related to professional attitude towards students (3.46±0.83), while the lowest was for the teaching and learning environment (3.28±0.68). Multiple linear regression analysis revealed that subscales of teaching quality (student assessment and feedback) and residence status were predictors of satisfaction with clinical teachers, accounting for 31.4% of the total variance (F=9.908, p<0.001).

CONCLUSION

The study highlights that regular and constructive feedback is pivotal for promoting student development in clinical education. We propose that clinical educators implement structured feedback mechanisms to improve educational conditions that encourage ongoing student communication. Additionally, assessing learners' performance systematically can help educators identify specific areas where students require further assistance. We can enhance learning outcomes by fostering an environment that prioritises feedback and evaluation and better equips students with the necessary skills to address real-world challenges. Ultimately, these improvements will benefit students and educators, leading to a more effective clinical education experience.

Nursing students' readiness towards the 'new normal' in clinical practice: a distributed cognition qualitative perspective

BACKGROUND

Clinical practicums are a core component of baccalaureate nursing education. Following the coronavirus pandemic, there have been extensive changes in the workforce environment that may potentially affect nursing students' experience and readiness for clinical practicums.

METHODS

A qualitative study was conducted to explore final-year nursing students' experiences and readiness for their final clinical practicum before becoming a registered nurse. A purposive sample of 24 final-year baccalaureate nursing students was included in this study. Individual semi-structured interviews were conducted face-to-face via Zoom. The data was analysed using an inductive thematic analysis approach.

RESULTS

Three themes depicting students' experiences and clinical readiness were elucidated. The themes included: (1) Experiencing multiple concerns, (2) requiring a network of support, and (3) easing the transition to professional practice. Students considered the final clinical practicum as challenging and demanding which evoked numerous concerns.

CONCLUSIONS

Considering the stress that final-year nursing students experience, it will be important to devise strategies ranging from personal, relational, and environmental protective factors to enable their successful transition and completion of clinical practice.

Assessing the psychometric properties of the Arabic version of the Nursing Practice Readiness Scale among Saudi nursing students

Readiness to practice nursing is essential for nursing students to ensure that they are conscientious, have a sense of responsibility, and are rational in performing their clinical practice. This study tested the psychometric properties of the "Nursing Practice Readiness Scale" Arabic version (NPRS-A) to assess Saudi nursing students' readiness to practice nursing in clinical settings. This study used a methodological design to examine the psychometric properties of the NPRS-A among 373 nursing students in Saudi Arabia. The findings provide evidence of the NPRS-A's good content validity. The PCA revealed five distinct components with a "cumulative variance explained" of 69.2%. The test of difference on the nursing practice preparedness between students from different levels showed that students in the 2nd year were less prepared than junior and senior nursing students. The correlation test showed that a higher GPA and higher self-reported readiness are more ready to practice nursing in clinical settings. The research showed an overall Cronbach's alpha of 0.957. The establishment of the NPRS-A is significant, not only in Saudi Arabia but other Arabic-speaking countries. Nurse educators and nursing education policymakers can use this version to assess nursing students' learning needs to be prepared to practice nursing.

The nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in clinical practicum: a European cross-sectional study of graduating nursing students

BACKGROUND

A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students' clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher's cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries.

METHODS

A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher's pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018-2019. The data were analyzed using a Chi-Square test, Pearson's correlation coefficients, and linear models.

RESULTS

A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher's pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher's pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country.

CONCLUSIONS

This study reveals that nurse teachers play an essential role in supporting and guiding nursing students' final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers' pedagogical cooperation role within the clinical learning environment.

Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study

AIM

The aim of the present study was to elucidate health-promoting and -impeding aspects of peer-learning by examining nursing students' descriptions of learning together as peers, and how this might interact with their health.

BACKGROUND

Peer-learning is a useful strategy for teaching and learning in nursing students' clinical practice education. In the research, benefits such as improved cooperation and increased self-confidence have been described and labelled as health-promoting.

DESIGN

A qualitative descriptive approach METHOD: Thirteen first-year nursing students aged 22-45 years, who had completed their first clinical practice education on a medical or surgical hospital ward, participated in one-on-one semi-structured interviews. The interviews were analyzed using qualitative content analysis.

RESULT

Working as a pair was primarily described as positive, as the peers felt basic support from each other, even though they described negative experiences that limited their own development and challenged their patience.

CONCLUSION

Peer-learning as a model for supervision in clinical practice incorporates valuable health-promoting aspects, as the students felt safe, supported, increased self-confidence, and participation. The interaction between peers helped them grow as human beings, and the mutual support the peers felt was a vital health-promoting aspect that limited the impact of the described health-impeding aspects, which included sometimes finding peer-learning trying, stressful and irritating.

Learning Experience of Chinese Nursing Students during Clinical Practicum: A Descriptive Qualitative Study

The change in clinical environment can have a significant impact on nursing students’ clinical learning and as a consequence, to their competency. Students’ learning experiences could provide important insights for improving the existing approach towards clinical education. This descriptive qualitative study aimed to explore nursing students’ clinical learning experience. Focus group interviews were conducted with 20 final year nursing students studying a bachelor nursing programme at a self-financing tertiary institution in Hong Kong. Thematic analysis was conducted. 16 female and four male students were recruited. Six themes were identified: Anxiety towards clinical practicum, expectations of roles and responsibilities in practicum, ward environment, adequacy of support, learning attitude, and practicum arrangement. The findings suggest that nursing students are more discontented with their clinical training than before. Nursing faculty must look for possible ways to improve the clinical learning environment.

Nurse teacher's perceptions on teaching cultural competence to students in Finland: a descriptive qualitative study

BACKGROUND

Cultural diversity in healthcare settings requires that care professionals are able to provide culturally competent care. This means that educational institutions have a crucial role to play in equipping students with the skills to deal with diversity in cross-cultural and multicultural contexts. Ensuring that cultural competence is part of the educational curriculum is therefore essential.

PURPOSE

This study aims to examine what elements influence the implementation of cultural competence content in nursing education from a nurse teacher's perspective.

METHODS

A descriptive qualitative design was used consisting of semi-structured interviews with nurse teachers (n = 12). Inductive content analysis was applied to explore their perceptions on teaching cultural competence at a University of Applied Sciences (UAS) in Southern Finland.

RESULTS

Analysis from the open coding of interviews indicated that there are three main categories of importance regarding students' cultural competence education: exposure to diversity in the teaching environment; teacher's experience and understanding of cultural competence; and integrating cultural competence into the curriculum.

CONCLUSIONS

The findings suggest that more transparency and cooperation between nurse teachers and the university administration is necessary to ensure the inclusion of cultural competence in nursing education. For instance, teachers should receive training related to cultural competence and evidence-based teaching methods. The curriculum should include a course or workshop about cultural competence with clear learning objectives and evaluation criteria for the purpose of grading. Finally, the educational institution should commit to developing a culturally competent organisation through internationalization and the maintenance of a diverse environment.

Clinical learning environment and graduating nursing students' competence: A multi-country cross-sectional study

The purpose of this study was to explore nursing students' perceptions of their final clinical learning environment and its association with their self-assessed competence, satisfaction with nursing education, and turnover intentions at graduation in six European countries. A multi-country comparative cross-sectional study was conducted with nursing students (n = 1746) from the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain using the Nurse Competence Scale and the Clinical Learning Environment and Supervision scale. Nursing students' overall perceptions of their final clinical learning environment and supervision were positive in all the countries studied. The correlation between the students' perceptions of their final clinical learning environment and competence was statistically significant and positive. Satisfaction with the nursing program and clinical practicum and no consideration of career change were related to positive perceptions of the final clinical learning environment. Highlighting the importance of the supervisory relationship and pedagogical atmosphere, nursing students' positive perceptions of the final clinical learning environment and supervision contribute to a better level of self-assessed competence and satisfaction with the nursing program and clinical practicum, leading to lower turnover intentions.

Clinical Teaching Effectiveness of Undergraduate Student Nurses in the United Arab Emirates

Introduction

Clinical supervision is a crucial aspect of developing nursing students' knowledge, skills, and professional attitudes. The characteristics of clinical instructors have a significant role in the progress and transition of students into their future professional roles.

Objective

The study aimed to examine the behaviors of effective clinical instructors as perceived by nursing students and faculty members in the UAE.

Methods

The study followed a cross-sectional quantitative research design to explore nursing students' and faculty members' perceptions of clinical instructors' effective behaviors that facilitate students' clinical practice. Data were collected from a convenience sample of 147 nursing students and 17 faculty members who completed an online version of the study survey at four nursing programs in the UAE.

Results

Students rated personality (M = 4.96, SD = 1.91) and teaching ability (M = 4.94, SD = 1.96) as the highest behaviors for effective clinical instructor. They perceived effective clinical instructor to be organized (M = 5.19, SD = 1.88), shows self-confidence (M = 5.16, SD = 1.84), able to answer questions (M = 5.16, SD = 1.90), emphasizes what is crucial to learn (M = 5.11, SD = 1.81), and takes responsibility for his/her actions (M = 5.11, SD = 1.90). While faculty members perceived effective clinical instructor to encourage a climate of mutual respect (M = 5.56, SD = 1.27), be approachable (M = 5.47, SD = 1.32), demonstrates clinical skill and judgment (M = 5.53, SD = 1.46), takes responsibility for his/her actions (M = 5.53, SD = 1.37), and be a good role model (M = 5.47, SD = 1.32).

Conclusion

Understanding clinical instructors' effective behaviors and supporting them during students' clinical experiences inspire a productive teaching-learning environment that is crucial to improve students' motivation, expand their learning opportunities and improve their hands-on skills.

Relationships between reality shock, professional self-concept, and nursing students' perceived trust from nursing educators: A cross-sectional study

BACKGROUND

Nursing students establish their professional role through clinical practice. However, during the first clinical practice, they might experience reality shock given the gap between theory and practice, which could negatively influence their professional self-concept. Furthermore, nursing educators in clinical practice play an important role in improving nursing students' clinical experience.

OBJECTIVES

To examine the relationship between nursing students' reality shock and professional self-concept, and to examine the associations of perceived trust from nursing educators with nursing students' reality shock and professional self-concept.

DESIGN

A cross-sectional, descriptive correlational study.

SETTING

Nursing schools in one metropolitan area and three cities in South Korea.

PARTICIPANTS

Data were collected from 184 nursing students who experienced their first clinical practice in preceding four weeks of data collection.

METHODS

Surveys assessing participants' characteristics, reality shock, professional self-concept, and perceived trust from nursing educators were conducted. A hierarchical regression analysis was performed to examine the relationship between reality shock and professional self-concept, and the relationships between perceived trust from nursing educators and nursing students' reality shock and professional self-concept.

RESULTS

Nursing students' reality shock was negatively related to their professional self-concept. Perceived interpersonal relationship with nursing educators was positively related to professional self-concept and negatively related to the experienced reality shock. Furthermore, this negative relationship decreased when reality shock was combined with perceived interpersonal relationship with nursing educators.

CONCLUSIONS

Nursing students' reality shock during their first clinical practice may be negatively associated with the establishment of their professional self-concept. However, students' reality shock could be reduced by enhancing their interpersonal relationship with the nursing educator, which might reduce the negative association of reality shock with professional self-concept. Therefore, nursing educators should develop skills to establish interpersonal relationships with students to positively influence students' clinical adaptation.

Final clinical practicum, transition experience and turnover intentions among newly graduated nurses: A cross sectional study

BACKGROUND

The shortage of nurses is a global issue, and turnover rates are especially high for newly graduated nurses. The transition from student to nurse is often described as challenging, and the final clinical practicum before graduation is suggested to be important in preparing graduating students for the transition. However, little is known about the actual relationships between the final clinical practicum, transition and turnover intentions.

OBJECTIVES

To examine whether the final clinical practicum experience is associated with the transition experience and turnover intentions of newly graduated nurses, and whether the transition experience mediates the potential relationship between the practicum and turnover intentions.

DESIGN

Cross-sectional survey study.

SETTINGS

The study was carried out in Finland (October-December 2018).

PARTICIPANTS

Registered nurses graduated within the past two years (n = 712).

METHODS

A new survey instrument with five subscales was developed for measuring the final clinical practicum experience. Transition experience was measured on four scales that demonstrated the emotional, physical, socio-developmental and intellectual domains of the transition: Psychological distress, sleep quality, role conflict/ambiguity, perception of transition and educational preparation. Turnover intentions from job and profession were asked about with two questions. Structural equation modelling was used to explore the associations between the variables. The models were adjusted for multiple potential confounders.

RESULTS

Final clinical practicum experience was associated with all domains of the transition experience and turnover intentions. The association between the practicum and turnover intentions was partly mediated by the emotional (psychological distress) and socio-developmental (role conflict and ambiguity) domains of the transition.

CONCLUSIONS

Our findings provide new evidence about the associations between the specific final clinical practicum dimensions and turnover intentions and the specific mechanisms linking this association. These results highlight the importance of final clinical practicums and suggest targets for improving nurses' transition processes during their first years in practice.