A sense of belonging and perceived stress among baccalaureate nursing students in clinical placements

Understanding Staff Needs for Improving End-Of-Life Care in Critical Care Units: A Qualitative Focus Group Analysis and Service Evaluation

Objectives: Critical care is a place of frequent death, up to a quarter of those admitted die during admission. Caring for dying people provides many challenges, practically, professionally and personally. The aim of this study was to better understand the perspectives of staff caring for dying people in critical care and identify their priorities for improvement. Method: Three multidisciplinary focus groups of critical care staff at a large central London hospitals trust were facilitated with a semi structured format and digitally transcribed. Inductive thematic analysis was conducted to extract themes. Results: N = 34 (18 nursing, 7 allied health professionals, 6 medical, 3 clerical/administrative). The five themes were structured as priority statements: "We need to recognise" included the subthemes of being "sick enough to die" and potential rapid deteriorations in this setting; "We need to understand" with subthemes of perspectives on dying and prioritising time for conversations; "We need to connect" with subthemes of therapeutic relationship and physical presence; "We need to collaborate" with subthemes of critical care working and empowerment, and cross teams working; "We need support" with themes of experiencing support and making time to support others. Conclusion: We present an approach to identifying critical care departmental priorities for an end-of-life care improvement programme. The themes extracted will be used to evaluate systems for dying in critical care, aiming to empower staff to provide excellent care every time they look after a dying person. Relevance to Practice: This service evaluation identifies key priorities among critical care staff regarding end-of-life care. The insights can guide service improvements, such as tailored training and enhanced support for staff, to ensure better communication, collaboration, and quality care for patients at the end of life.

"I Will Be a nurse:" Identity and Belongingness in Nursing School

A nursing shortage is anticipated within the next decade. Knowing what factors draw individuals to the field of nursing and help them finish their degree is important for recruitment to nursing school, but what is equally important is knowing how individuals connect and see themselves in the field of nursing. One of the contributions of health communication is examining the processes of identity formation in nursing school to determine how they construct their years of nursing school. Using Qualitative Longitudinal Research (QLR) and the model of communication and identity, the research presented in this article examines the experiences of nursing students (n = 32) at one university. The research summarizes the phases of identity that can be characterized as three distinct stages of getting in, scrubbing in, and fitting in. The research also highlights what helps students stay with nursing, feel like they belong to the field, and how this can be translated into communicating what potential nurses need to succeed.

Summer Camp Clinical Placements in Young Families Nursing: An Interpretive Description Study

PURPOSE

Obtaining meaningful clinical experiences with paediatric and perinatal (young families) populations is increasingly challenging for nursing programs. Care for this population has largely moved to outpatient and tertiary settings. Therefore, a current trend is to use non-traditional clinical settings. While summer camps offer rich learning experiences for nursing students, they are seldom used as clinical placements. Faculty at an Atlantic Canadian university sought a novel way to engage students in young families' learning by partnering with overnight summer camps, staffed by counsellors, camp administrators, and on-site nurses. Campers included those with lived experience of cancer, diabetes, physical and developmental challenges, and socioeconomic challenges. This study assesses how young families course outcomes were met by an innovative clinical experience within a Bachelor of Nursing program and describes the perceptions and experiences of those involved.

METHODS

Study participants included students (n = 4), camp directors (n = 3), a camp nurse (n = 1), and the clinical educator (n = 1). Data collection involved semi-structured interviews and a focus group. Interpretive description methodology was used to identify themes and patterns related to overarching research questions.

FINDINGS

Students met the outcomes and overall participant perceptions and experiences were positive. However, some participants shared constructive critiques for future consideration.

CONCLUSIONS

Nursing students who completed a young families clinical placement at summer camps met course outcomes, and those involved reported both positive experiences and constructive critiques for future consideration.

Defining sense of belonging in nursing - An evolutionary concept analysis

OBJECTIVES

The purpose of this analysis is to develop the concept of sense of belonging in nursing. The secondary purpose is to identify the antithesis or direct opposite beyond the negative consequences related to a lack of belonging in nursing.

DESIGN

Rodgers' evolutionary method guided the analysis and advancement of sense of belonging in nursing.

DATA SOURCES

Following PRISMA guidelines, peer-reviewed English articles and dissertations were reviewed from PubMed, ERIC, CINAHL, and PsychINFO. Forty-seven articles describing sense of belonging in the nursing profession, both academic and workforce, were included.

REVIEW METHODS

Inductive thematic analysis was used to determine recurring themes of the antecedents, attributes, consequences, and antithesis of belonging in nursing.

RESULTS

A welcoming, positive atmosphere encouraging a culture of mentorship is key to developing an environment of belonging. The attributes of belonging include being trusted, valued, and an accepted part of the team, and encouraging a connection to the community. Nurses and nursing students have improved confidence, self-esteem, and motivation to learn when a sense of belonging is present. They feel supported and respected in the environment. However, historically minoritized students and nurses report discrimination, bias, and condescension resulting in feeling invisible, isolated, excluded, and neglected. Nurses and nursing students feel invisible, isolated, excluded, and neglected without a sense of belonging.

CONCLUSION

Developing a sense of belonging in nurses and nursing students is critical to our profession. Further research is essential to develop interventions and strategies for cultivating a sense of belonging in nursing.

Preregistration nursing students' motivation for speaking up for patient safety: An integrated literature review

AIM

The aim of this review was to uncover what motivates preregistration nursing students to speak up for patient safety during work integrated learning (WIL) and to develop an evidence-based safety motivation framework for use by educators, clinicians, and preregistration nursing students.

DESIGN

This study used an integrative literature review design guided by Whittemore and Knafl's methodological framework.

DATA SOURCES

Five research databases, CINAHL, MEDLINE, PubMed, Scopus, and Web of Science, were searched for relevant peer reviewed research literature published in English between January 2011 and January 2024. The use of MeSH terms "undergraduate nursing student," or "preregistration nursing student" and "speaking up," "patient safety," and "motivation," resulted in 489 search returns. Following application of filters and inclusion criteria fifty-four (n = 54) studies were identified as being relevant to the research aim.

REVIEW METHODS

The fifty-four (n = 54) research studies were reviewed using the JBI Critical Appraisal tool relevant to the study methodology. The JBI critical appraisal tools are checklists used to determine research quality, validity, results, and meaning. Following appraisal, 27 studies were included in the integrative literature review.

RESULTS

Authentic learning, view of self as a nurse, and positive work integrated learning experiences were found to be the primary motivators for preregistration nursing students to speak up for patient safety during work integrated learning. These three motivators provided the foundation for an evidence-based framework, underpinned by self-determination theory, that can be used to enhance preregistration nursing students' motivation to speak up for patient safety.

CONCLUSIONS

The integrative review design enabled the development of the evidence-based Safety Motivation Framework to support preregistration nursing students' during work integrated learning however missing from the literature was information about the lived experience of this group of students when speaking up for patient safety.

Relationship between emotional intelligence and academic support perception among nursing interns: The moderating role of bullying behaviors in nursing education

AIM

This study aims to investigate the status of academic support perception among nursing interns and explore the correlation between academic support perception, emotional intelligence, and bullying behaviors in nursing education, especially the moderating role of bullying behavior on the relationship between emotional intelligence and academic support perception.

BACKGROUND

Academic support perception is closely related to the nursing interns' mental health and academic performance. To some extent, it can reflect nursing interns' satisfaction and happiness during their internship, affecting their motivation to continue their studies. However, little is known about the nursing interns' academic support perception in China.

METHODS

A total of 1020 nursing interns participated in this study. A sociodemographic information questionnaire, Bullying Behaviors in Nursing Education Scale, Wong and Law's Emotional Intelligence Scale, and Academic Support in the Practicum Scale were used to collect data.

FINDINGS

Bullying behaviors and emotional intelligence were significantly associated with nursing interns' academic support perception. In addition, bullying behaviors in nursing education moderated the association between emotional intelligence and academic support perception.

DISCUSSION

Nursing interns who possess high emotional intelligence and experience less bullying in nursing education tend to perceive higher academic support in clinical practice. The positive effects of emotional intelligence on nursing interns' academic support perceptions are contingent on the level of bullying behavior experienced in nursing education. Less bullying behaviors in nursing education enhance the impact of emotional intelligence on academic support perception.

CONCLUSION AND IMPLICATIONS FOR NURSING

Strategies should be created to promote emotional intelligence and decrease bullying behaviors in nursing education to improve the perception of academic support among nursing interns.

Fostering belonging and social connectedness in nursing: Evidence-based strategies: A discussion paper for nurse students, faculty, leaders, and clinical nurses

BACKGROUND

The phenomenon of loneliness among healthcare providers, particularly nurses, has garnered increasing attention due to its detrimental effects on individual well-being and professional retention. The isolation experienced by nurses has been linked to heightened turnover rates and intentions to leave the profession, posing significant challenges to healthcare systems globally. Recognizing loneliness as an epidemic in 2023, the U.S. Surgeon General highlighted the urgency of addressing this issue within the healthcare workforce.

PURPOSE

This paper explores evidence-based strategies to mitigate loneliness and promote social connectedness among nurses, drawing insights from various stakeholders. It aims to offer actionable recommendations to enhance the nursing experience and retain professionals in the field.

DISCUSSION

Strategies include peer support programs, mentorship initiatives, wellness activities, and fostering open communication. Leveraging technology for virtual connections is also highlighted, especially in remote work scenarios.

CONCLUSION

A holistic approach is vital, combining individual, interpersonal, and systemic interventions to combat nurse loneliness. Prioritizing social connectedness fosters a supportive work environment, benefiting both nurses and patient care quality.

The role of extended reality in optometry education: a narrative review

The evolution of digitally based pedagogies, such as extended reality (XR) - a group of simulated learning environments that include virtual simulation, virtual reality, and augmented reality - has prompted optometry educators to seek evidence to guide the implementation of these teaching and learning activities within their curricula. Looking more broadly across the medical and allied health fields, there is a wealth of evidence to guide the incorporation of XR, as it is increasingly being integrated into the curricula of other select health professions disciplines. Educators from these disciplines continue to explore and embed XR in practice. This narrative review summarises the findings and appraises the literature on the use of XR in optometry education. It identifies the learning domains in which XR has been implemented in optometry education and proposes areas for further investigation. The review questions the technology-focused approach that has driven the literature within the review and calls for richer pedagogical foundations with suggestions for future research agendas. As such, this narrative review provides optometry educators with new ways of understanding XR and its relationship with the curriculum.

Nursing students' stressors and coping strategies during their first clinical training: a qualitative study in the United Arab Emirates

BACKGROUND

Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses' sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study.

METHODS

A qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes.

RESULTS

During their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students' clinical experiences. We extracted three main themes that described students' stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies.

CONCLUSIONS

This qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum.

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.

Trajectory of change in perceived stress, coping strategies and clinical competence among undergraduate nursing students during clinical practicum: a longitudinal cohort study

BACKGROUND

Clinical practicum is crucial for strengthening nursing students' clinical competence. However, nursing students often experience considerable stress during clinical practicum, and so they employ coping strategies to alleviate it. There is almost no empirical evidence on the change trajectory of perceived stress, coping strategies, and clinical competence among nursing students during a one-year clinical practicum. This study aimed to investigate the trajectory of change in perceived stress, coping strategies, and clinical competence among undergraduate nursing students during a one-year clinical practicum.

METHODS

This study used a longitudinal cohort design. Undergraduate nursing students were recruited from a science and technology university in Taiwan to participate from February 2021 to January 2022. Perceived stress, coping strategies, and clinical competence among students in basic training practicum (T1), advanced training practicum (T2), and comprehensive clinical nursing practicum (T3) were surveyed by using the Perceived Stress Scale (PSS), Coping Behaviour Inventory (CBI), and Clinical Competence Scale (CCS). PSS, CBI, and CCS in T1, T2, and T3 were compared using a generalized estimating equation (GEE) to deal with correlated data. The level of statistical significance was set at α = 0.05.

RESULTS

A total of 315 undergraduate nursing students completed the questionnaire. The study results show that the overall perceived stress of the students is the highest in T2 and the lowest in T3. The main source of stress of the students is 'taking care of patients' at T1 and 'lack of professional knowledge and skills' at T2 and T3. Students' perceived stress in 'taking care of patients' gradually decreases over time. The four coping strategies of CBI, which are 'stay optimistic', 'problem-solving', 'transference' and 'avoidance' in this order, remain the same ranking in three surveys.The main stress coping strategy used by students is 'stay optimistic', while the coping strategy 'avoidance' is used more frequently in T2 than in T1 and T3. Students' mean scores of the overall clinical competence and in the 'general nursing' and 'management' subscales in T3 are higher than those in T1 and T2. However, their mean scores in 'self-growth' and 'positivity' subscales are the highest in T1 and the lowest in T2.

CONCLUSIONS

The results show that through experiential learning in clinical practicum at different stages time after time, students' overall perceived stress is the lowest and their overall clinical competence is the highest in T3. The main coping strategy used when students managed stress is 'stay optimistic'. According to the results, we suggest that clinical educators provide students with appropriate guidance strategies at different stages of stress and continue to follow up the clinical competence and retention rates of these nursing students in the workplace in the future.

Cultural adaptation and validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for Brazil

OBJECTIVES

to carry out the cultural adaptation and evaluation of validity evidence of the Student Nurse Stressor-15 (SNS-15) Scale for use in Brazil.

METHODS

psychometric study, conducted from the stages of translation, synthesis, back-translation, review by a committee of seven experts, pre-test and evaluation of measurement properties with 32 and 238 nursing students, respectively. Descriptive statistics, Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) were performed. The reliability of the instrument was estimated using McDonald's Omega (ω).

RESULTS

EFA subsidized the distribution of the fifteen SNS-15 items into four factors. Using AFC, satisfactory fit indices were achieved (Comparative Fit Index = 0.94; Tucker-Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Square Residual = 0.16) and ω = 0.86.

CONCLUSIONS

the Brazilian version of the SNS-15 presents evidence that confirms its validity and reliability.

Enhancing sense of belonging in nursing student clinical placements to advance learning and identity development

Clinical placements are considered one of the "hallmarks" of nursing education. In these settings, students can build upon their theoretical learning by applying knowledge, practicing skills, connecting with nurses and other medical professionals, and creating opportunities to work with diverse populations. As a result, students begin to hone their nurse identity, and build confidence and self-esteem. Importantly, the development of a nursing identity through clinical placement work is improved by integrating opportunities that increase belongingness. Campus climate plays a significant role in creating the environment necessary for belongingness to flourish and leads to enhanced student learning. Taking the role of positive campus climate into consideration, this article argues that instructors supervising undergraduate nursing students in clinical learning environments must create inclusive climates for their students to increase positive educational outcomes. Specific recommendations for creating inclusive clinical learning environments are provided.

Modifiable factors contributing to belongingness of undergraduate nursing students in the clinical learning environment: An exploratory study

BACKGROUND

Belongingness has been tied to positive personal and educational outcomes in undergraduate nursing students in the clinical learning environment, but there is limited literature on specific factors that promote these important feelings of acceptance and value alignment.

OBJECTIVES

This study aimed to assess demographic characteristics, program/clinical structure factors, and modifiable clinical setting factors that may impact feelings of belongingness in U.S. undergraduate nursing students in the clinical learning environment.

DESIGN

A cross-sectional survey design was used to assess the relationship between demographics, program/clinical structure factors, and modifiable clinical setting factors and levels of belongingness using the U.S. version of the Belongingness Scale - Clinical Placement Experience.

SETTING

A national study was conducted via the National Student Nurses Association database from December 2022 to January 2023.

PARTICIPANTS

759 volunteer undergraduate nursing students in the U.S. who had completed at least one clinical course.

METHODS

An online survey was disseminated to assess demographic factors, program/clinical structure factors, students' perceptions on the frequency of occurrence and perceived value of modifiable clinical setting factors (including clinical format, clinical site, relationship and interpersonal, and miscellaneous factors), and to measure levels of belongingness experienced.

RESULTS

Bivariate analyses revealed one statistically significant program/clinical structure factor (p <.001) and 10 statistically significant modifiable clinical setting factors (p <.001) that contribute to belongingness. The findings also support the use of the U.S. version of the BES-CPE as a reliable and valid instrument.

CONCLUSIONS

Results demonstrate the importance of fostering belongingness in undergraduate nursing students in the clinical learning environment and, for the first time, extrapolate qualitative findings from the literature into the identification of factors that contribute to these critical feelings of inclusion. There are immediate implications for nursing educators and a rich foundation for future intervention research is proposed.

Psychometric evaluation of the Persian version of the Sense of Belonging in Nursing School (SBNS): a quantitative and cross-sectional design

BACKGROUND

This study aimed to evaluate the psychometric indicators of the Persian version of the Sense of Belonging in Nursing School scale (SBNS).

METHODS

The study conducted in Shahroud and Semnan schools of nursing and midwifery in Iran examined nursing students using a cross-sectional approach by convenience sampling method from 3/6/2023 to 24/8/2023. To assess the SBNS scale, the forward-backward procedure was used to translate it into Persian. Face and content validity were evaluated, and exploratory and confirmatory factor analyses were conducted with sample sizes of 200 and 182, respectively. Reliability was assessed using Cronbach's alpha coefficient, MacDonald's omega, and intra-class correlation coefficient.

RESULTS

The exploratory factor analysis resulted in the exclusion of four items, leaving a final selection of 15 items. These items were categorized into three factors: classmates, clinical staff, and inclusive educational environment, which accounted for 49.16% of the overall variance. The confirmatory factor analysis indicated that the model was a good fit for the observed data, and the subscales had high internal consistency (Cronbach's alpha coefficient was 0.752 to 0.880) and stability (intra-class correlation coefficient was 0.889 to 0.968).

CONCLUSION

According to the results, it can be concluded that the Persian version of the SBNS scale demonstrates sufficient validity and reliability in assessing students' sense of belonging to the nursing school.

Compassion fatigue and psychological resilience levels of nursing final students: A descriptive, cross-sectional, and relational study

OBJECTIVES

Nursing students often encounter real-life trauma situations during their clinical experience and similar workplace environment and climate as professional nurses. This research was carried out to determine the reflections of the compassion fatigue levels of nursing final year students on their psychological resilience levels.

METHODS

This research was conducted as descriptive and cross-sectional. The sample of the study consists of 250 final year nursing students. Data were collected using Personal Information Form, Compassion Fatigue Scale, and Resilience Scale. It was determined that the compassion fatigue and psychological resilience levels of nursing final year students were moderate.

RESULTS

It was determined that as the levels of compassion fatigue increased, psychological resilience decreased. A highly negative and significant correlation was found between the total and sub-dimension mean scores of compassion fatigue and psychological resilience (p = 0.001).

SIGNIFICANCE OF RESULTS

It was found that there was a negative and high level relationship between nursing students' compassion fatigue levels and all its sub-dimensions and psychological resilience. Resilience can improve psychosocial functioning and professional performance, including for nursing students facing stressful clinical experiences. It is important to determine the compassion fatigue and psychological resilience levels of nursing students, to determine the existing problems, and to take initiatives for this.

Modeling the social determinants of resilience in health professions students: impact on psychological adjustment

Stressors inherent to training and stemming from the learning environment are associated with high rates of burnout, depression, and mental health problems in health professions students (HPS). There is evidence that disadvantaged or stigmatized groups are particularly affected. These problems not only impact students after graduation but may also have detrimental effects on patient outcomes. Resilience, conceptualized as the process of adapting well in the face of adversity, has inspired an increasing number of interventions aimed at addressing those problems in HPS. These interventions have mostly targeted individual students and their psychological traits while ignoring social and structural factors that may enhance or undermine individual resilience. To address this gap in the literature, the authors reviewed the evidence for psychosocial determinants of resilience and proposed a model inspired by the social determinants of health literature and the "upstream-downstream" metaphor. In this theoretical paper, the authors propose that upstream determinants such adverse childhood experiences and socioeconomic and sociodemographic markers of disadvantage have a direct effect on psychological adjustment and an indirect effect mediated by resilience. Additionally, the authors propose that the institutional downstream drivers of learning environment, social support, and sense of belonging moderate the direct and indirect effects of the upstream determinants on psychological adjustment. Future research should test these hypotheses and gather evidence that may guide the development of interventions. The authors present their model as part of a comprehensive response to recent calls to action to address diversity, equity and inclusion in health professions education.

Student nurses as a future general practice nursing workforce. Implementing collaborative learning in practice: implications for placement learning and patient access. A mixed methods study

BACKGROUND

There is a global shortage of nurses, with particularly acute shortfall in General Practice Nursing in the United Kingdom estimated at as high as 50% vacancy rate by 2031 by some sources. There has previously been reluctance for General Practices to host student nurses on placement, but it has become imperative to increase placement capacity if practices are to be able to recruit a future workforce. Collaborative Learning in Practice is a means of organising placement learning for student nurses using a coaching model, that allows for leadership development, peer support and earlier engagement in patient care, and increases placement capacity.

METHODS

This was a mixed methods study using qualitative data from focus groups to evaluate the implementation of Collaborative Learning in Practice, and routinely collected audit data on numbers of clinic appointments to investigate the potential impact an increased capacity of student nurses might have on patient access to services. The aims of this study were: to implement and evaluate Collaborative Learning in Practice in General Practice Nursing settings; to explore issues of interprofessional learning; to explore patient access to services related to increased student nurse capacity.

RESULTS

Our qualitative data indicated the following themes as important to students and staff: Peer Support; Interprofessional Learning; and the Importance of 'own clinics' for students to see patients. The audit data indicated that having students leading their own clinics increased the clinic numbers available by approximately 20% compared to when students were not in placement.

CONCLUSIONS

This study shows that student nurses increased clinic capacity and improved access for patients. Students valued their placement, felt that they were more 'part of the team' than in other placements and consequently had a greater sense of belonging. This was multifaceted, coming in part from the welcoming practice staff, in part from the opportunities for peer support engendered by the collaborative learning in practice model, and in part from the interprofessional learning opportunities available. General Practice Nursing placements for students are important for future workforce recruitment and can help meet Quality and Outcomes Framework targets for General Practices.

The relationship between perceived stress and emotional intelligence in Moroccan nursing students

BACKGROUND

Nursing students are subjected to many stressors during their clinical practicums. Emotional intelligence (EI) could act as a real stress regulator. In this perspective, we sought to study the relationship between stress and EI in a sample of Moroccan nursing students.

MATERIALS AND METHODS

This study was conducted using the descriptive correlational method. The statistical population consisted of the nursing students of the Higher Institute of Nursing Professions and Health Techniques of Tetouan in Morocco during the academic year 2021-2022. Among them, 146 participants were selected on the basis of simple random sampling. Participants completed a self-administered questionnaire addressing sociodemographic factors, perceived stress (the Perceived Stress in Clinical Practice Scale), and emotional intelligence (Wong and Law Emotional Intelligence Scale test). Descriptive statistics were used and Pearson's correlation coefficient was applied to assess the correlation between stress and EI, and to compare them according to socio-demographic characteristics. A linear regression analysis was calculated to analyze the effect of independent variables on perceived stress and EI. For the analysis, a level of 0.05 was chosen.

RESULTS

The overall mean age of the students was 20.02 ± 1.12 years. Participants had moderate levels of perceived stress (M = 2.42 ± 0.77) and high levels of EI (M = 3.79 ± 1.09). A significant positive correlation between perceived stress and EI was found (r = 0.741, P < 0,05). The regression model shows that EI, education level, and clinical practice setting can explain changes in perceived stress levels and are effective and significant factors (P < 0,001).

CONCLUSION

EI has been shown to be a protective factor against stress in nursing students. Those with well-developed EI have lower levels of stress. Therefore, it is suggested that a mindfulness-based training program be incorporated into the nursing curriculum to develop emotional skills and combat stress in students.

The relationship between faculty interactions, sense of belonging, and academic stress: a comparative study of the post-COVID-19 college life of Korean and international graduate students in South Korea

Objective

Rapid changes in post-COVID-19 higher education have increased students' academic stress. This study focused on graduate students' academic stress in South Korea and compared the results for Korean graduate students and those for international graduate students.

Method

Using the online survey results, the study verified the relationships between faculty interactions, a sense of belonging, and academic stress among Korean and international graduate students using a mediating effects analysis and a multigroup path analysis.

Results

The results were as follows. First, Korean students experienced greater academic stress, faculty interactions, and a sense of belonging, but no statistically significant difference was observed. Second, a sense of belonging had a mediating effect on the relationship between faculty interactions and academic stress. Unlike in previous studies, all paths were found to be statistically significant. Faculty interactions had a negative effect on academic stress and a positive effect on a sense of belonging. A sense of belonging had a negative effect on academic stress. Third, the comparison of Korean and international graduate students showed that international students had a greater effect of faculty interactions on academic stress.

Conclusion

Through these results, we explored the post-COVID-19 academic lives of Korean and international graduate students in South Korea and built grounds for effective interventions for alleviating academic stress.

Collaborative clinical facilitation in selected nursing and midwifery colleges in Northern Ghana

Background

Collaborative clinical facilitation converges key players to guide students individually and within groups towards achieving clinical nursing competence. However, experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and nursing and midwifery students are often fragmented and have been largely unexplored in Ghana.

Aim

To describe the experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and final year nursing and midwifery students in Northern Ghana.

Setting

The study was conducted at two nursing and midwifery colleges and an academic hospital in Northern Ghana.

Methods

A qualitative, descriptive, exploratory design was utilized. Forty-six participants comprising 16 nurse educators, 10 clinical preceptors, 10 nursing students and 10 midwifery students were purposively sampled. Focus groups and in-depth interviews were used to gather data and analysed thematically.

Results

Three themes revealed facilitative experiences of collaborative clinical facilitation: team-based clinical mentorship and supervision, personalised preceptorship, and clinical conferences. Two themes emerged inhibitory to collaborative clinical facilitation: staff shortages and lack of timely communication.

Conclusion

This study found that team mentorship, preceptorship and conferences fostered collaborative clinical partnerships for students' clinical learning. However, failure to engage in timeous communication in the midst of staff shortages hampered its smooth practice. Orientation workshops need to be organised for key players to share relevant updates and explore ways to navigate the challenges often experienced within the clinical training environment.

Contribution

This paper provides insight into the collaborative nature of clinical facilitation; and highlights the need for coordinated clinical placements to enhance students' clinical learning.

DEVELOPMENT AND PSYCHOMETRIC TESTING OF THE SENSE OF BELONGING IN NURSING SCHOOL SCALE

Background and Purpose: While sense of belonging is essential for human motivation, impaired belonging among nurses can impact the care and safety of patients. This article reports the development and psychometric testing of the Sense of Belonging in Nursing School (SBNS) scale to assess nursing students' sense of belonging in three different environments: Clinical, classroom, and among the student cohort. Method: Principal component exploratory factor analysis with varimax rotation was used to determine the construct validity on the 36-item SBNS scale with a sample of 110 undergraduate nursing students. Cronbach's alpha was used to determine the scale's internal consistency. Results: The scale was reduced to 19-items with high internal consistency (α = 0.914). Principal component analysis then identified four factors (sub-scales) with high internal consistency: Clinical staff (α = 0.904), clinical instructor (α = 0.926), classroom (α = 0.902), and classmates/cohort (α = 0.952). Conclusion: The SBNS scale is a reliable and valid tool to measure sense of belonging across three environments among nursing students. Further research is needed to determine the scale's predictive validity.

An exploration of the impact of working in pairs on the dental clinical learning environment: Students' views

INTRODUCTION

The aims of this study were to explore the undergraduate dental clinical students' experiences and perspectives of paired working in the clinical learning environment.

MATERIALS AND METHODS

An interpretivist methodological approach with a socio-cultural lens was used. A stratified purposeful sampling strategy was chosen. Students digitally recorded three audio-diaries using Gibbs' cycle to guide reflection on collaborating clinically with a peer. 1:1 semi-structured interviews were held using a topic guide. Inductive thematic data analysis was undertaken.

RESULTS

Eight participants were recruited. Main themes related to individual characteristics (motivation, professionalism, knowledge and experience) and relational features (feeling safe, attaching value, positive working relationships) that contributed to effective collaborative partnerships. The social setting is important for learning in the dental clinical environment. Benchmarking is used by students to motivate and reassure. Students learnt from their peers, particularly when they felt safe and supported and had developed good relationships. A lesser quality learning experience was highlighted in the assistant role.

CONCLUSION

Paired working for clinical training was viewed mostly positively. Working with a variety of peers was beneficial and enabled development of interpersonal skills and professionalism. More effective collaborative learning partnerships were described when students felt they belonged and had affective support. Disadvantages of paired working were noted as reduced hands-on experience, particularly for senior students and when working in the assistant role. Ground rules and setting learning goals to change the mind-set about the assistant role were recommended. Emotional and practical support of students is needed in the clinical setting.

TouchPoint: Undergraduate Senior Immersion Activity

BACKGROUND

TouchPoint is an innovative approach to traditional clinical postconferences for prelicensure BSN students in an immersion experience. The aim of TouchPoint was to build relationships between faculty and students in an unscripted method of deep, meaningful, reflective sharing.

METHODS

TouchPoint sessions were a synthesis of stories told by nursing students. These sessions addressed relationships among patient, nurse, and families, and the importance of inter- and intraprofessional relationships. Faculty facilitators guided discussions.

RESULTS

TouchPoint sessions promoted psychological safety, built resiliency, and enhanced student awareness. The safe space created and opened a structured discussion of sensitive topics such as death, dying, gossip, loss, unsupported nursing staff, joy, and happiness, and the supportive nature of nurse mentors throughout these positive and negative experiences.

CONCLUSIONS

TouchPoint's success was in strengthening resilience practices for students by sharing lived experiences and adhering to an environment of trust, respect, and support.

Levels of motivation and basic psychological need satisfaction in nursing students: In perspective of self-determination theory

BACKGROUND

Motivation is the first and most important constituent element of learning behavior. One of the most important theories in this field is self-determination theory (SDT) which is a general theory of motivation. According to this theory, the satisfaction of basic psychological needs of autonomy, competence, and relatedness are effective in the internalization of incentive. Hence this theory can be a good foundation for reforming medical education programs.

OBJECTIVE

The aim of this study was determining the basic psychological need and the effect of it on level of motivation and self-determined motivation of nursing student in the field.

METHODS

This is a cross-sectional, descriptive-analytical study done through a census on 243 nursing students of Guilan University of Medical Sciences. Data gathering tool was demographic information, motivation level, and basic psychological needs questionnaire. Data were analyzed using independent t-test, Spearman and Pearson correlation, Man-Whitney, backward regression considering P < 0.05.

RESULTS

The findings showed that the majority of students (51.9 %) were female and, the mean age was 21 years. Statistical tests indicated a significant relationship between levels of motivation, basic psychological needs, and demographic variables. However, the regression coefficients indicated that the need for competence and relatedness could be a suitable predictor for internal motivation.

CONCLUSION

Basic psychological needs satisfaction, especially needs of competence and relatedness in the clinical field by instructors can lead to internalization of their incentive and positive outcomes.

The effect of home visit simulation on emotional intelligence, self-efficacy, empowerment, and stress in nursing students. A single group pre-post intervention study

BACKGROUND

Clinical simulation, the teaching methodology used in the Nursing Degree, helps students to acquire certain skills. Home visiting is a complex scenario in community care that requires certain critical skills in order to function successfully.

OBJECTIVES

The aim of this study was to analyze the improvement of self-efficacy, empowerment, management of emotions and perceived stress of nursing students through clinical simulation during home visits.

DESIGN

A quasi-experimental study was carried out.

PARTICIPANTS

A sample of Students of the 2nd year of the Nursing Degree.

METHODS

A high-fidelity simulation programme was implemented in two sessions. The variables that were measured were: self-efficacy (General Self-efficacy Scale), empowerment (Spreitzer Psychological Empowerment Scale), emotional intelligence (Trait Meta-Mood Scale-24), and perceived stress (Perceived Stress Scale).

RESULTS

170 students with a mean age of 22.2 years took part. An increase in general self-efficacy, self-determination, impact, empowerment (total score), and emotional clarity was observed after the intervention.

CONCLUSIONS

Clinical simulation as a teaching methodology allows the development of skills and competencies that are necessary for nursing students to be able to function in community settings such as home care. Therefore, this teaching methodology should be integrated into University Community Nursing training programmes.

Belongingness in undergraduate/pre-licensure nursing students in the clinical learning environment: A scoping review

AIM

The aim of this scoping review was to map the literature investigating belongingness in undergraduate/pre-licensure nursing students in the clinical learning environment.

BACKGROUND

The concept of belongingness, which encompasses feelings of acceptance, connection and value alignment, has been tied to positive outcomes in undergraduate/pre-licensure nursing students including increased learning, participation, confidence and professional socialization. It is critical for educators and clinical staff to foster a sense of belongingness for nursing students to promote positive and effective clinical learning experiences.

DESIGN

The scoping review strategy established by the Joanna Briggs Institute was followed. The databases searched were CINAHL Complete (EBSCO), Education Source, Medline Complete (EBSCO), APA PsycINFO (EBSCO) and Epistemonikos.

METHODS

Following a search of the five databases, studies were screened by title and abstract by two independent reviewers for inclusion. Data including population, concept, context, methods and key findings relevant to the review question were extracted and synthesized using an instrument developed by the reviewers.

RESULTS

A total of 47 articles with varying methodologies were critically appraised. Three overarching focus areas emerged: outcomes resulting from feelings of belongingness versus alienation, factors that contribute to a sense of belongingness in the clinical learning environment and interventions to promote a sense of belongingness while students are immersed in the clinical learning environment.

CONCLUSIONS

Belongingness in the clinical learning environment is an important concept that lends itself to positive learning experiences and increased satisfaction of undergraduate/pre-licensure nursing students. Environmental, relational and experiential factors can be maximized and specific interventions employed to promote belongingness. This review identifies a lack of evidence on measured interventional effectiveness at the student, school and clinical unit level. Future research to address these gaps is recommended.

TWEETABLE ABSTRACT

Scoping review suggests environmental, relational and experiential factors promote positive outcomes in belongingness of nursing students.

Comparison of the effectiveness of the electronic portfolio and online discussion forum methods in teaching professional belonging and ethical behaviors to nursing students: a randomized controlled trial

BACKGROUND

Nursing is a profession that has had many ethical aspects and understanding professional belonging and ethics as a deep and complex process is one of the basic concepts in this field. This study aimed to compare the effectiveness of training professional belonging and ethical behaviors in two methods: electronic portfolio and online discussion forum in nursing students.

METHODS

This study is a single-blinded randomized-controlled trial (RCT) with two parallel intervention groups and a third control group. The sample size was 90 selected by block randomization method. The educational contents of professional belonging and ethical behaviors were presented to the participants in two ways: electronic portfolio and online discussion forum. Demographic information form, professional belonging questionnaire, and ethical behaviors questionnaire were applied to collect data. Data were analyzed using SPSS version 24 software. Respectively mean, standard deviation and repeated measured, analysis of variance tests was used in descriptive and analytic statistic. (P value < 0.05).

RESULTS

Comparison of the mean score of professional belonging and ethical behavior in the three stages of pretest, immediately after the test and four weeks after the test in all three groups was significant (P < 0.001). The control group had a higher mean score of professional belonging immediately after the test (108.18 ± 48.9) compared to the other two groups. Also, the online discussion forum group had a higher mean score on ethical behavior in four weeks after the test (104.2 ± 0.8) compared to the other two groups.

CONCLUSION

Training based on two methods of the electronic portfolio and online discussion forum increases and enhances the level of ethical behaviors in students. Therefore, the implementation of such methods of training can be useful in improving, promoting, and learning ethical behaviors in nursing students. On the other hand, training based on the two methods had a negative impact on professional belonging. Therefore, it is suggested that future studies be conducted with a greater focus on areas of professional belonging.

TRIAL REGISTRATION

This research has been registered in Iranian Clinical Trial Registration Center (IRCT) with registration number "IRCT20180612040063N1" and registration date "16/07/2018".

The Influence of Physical Distancing, Sense of Belonging, and Resilience of Nursing Students on Their Viral Anxiety During the COVID-19 Era

OBJECTIVE

We aimed to explore how nursing students' adherence to physical distancing, sense of belonging, or resilience may be associated with viral anxiety during the coronavirus disease (COVID-19) era in South Korea.

METHODS

We conducted an online survey among nursing students from December 8-10, 2021. The survey gathered participants' age, sex, grades, living area, and responses to questions on COVID-19. In addition, responses to Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), adherence to physical distancing, Sense of Belonging Instrument, Calling and Vocation Questionnaire, Patient Health Questionnaire-9 items (PHQ-9), and Connor-Davidson Resilience Scale-2 (CD-RISC2) items were gathered.

RESULTS

The SAVE-6 score was significantly correlated with adherence to physical distancing (r=0.29), PHQ-9 (r=0.26), and CD-RISC2 (r=-0.34, all p<0.01) similar to partial correlation analysis adjusting participants' group (freshmen and sophomores vs. juniors and seniors). A linear regression analysis revealed that viral anxiety of nursing students was predicted by sex (female, β=0.20, p=0.001), adherence to physical distancing (β=0.25, p<0.001), sense of belonging (β=0.16, p=0.014), and CD-RISC2 score (β=-0.32, p<0.001) (adjusted R2=0.24, F=10.01, p<0.001).

CONCLUSION

We observed that adherence to physical distancing, sense of belonging, and their resilience influenced nursing student's viral anxiety. An appropriate support system to manage viral anxiety is needed for nursing students during the COVID-19 pandemic.

Dual Collegiate Roles-The Lived Experience of Nursing Student Athletes

BACKGROUND

Teamwork and communication, characteristics learned through playing college sports, can precipitate a sense of wonder in the lived experiences of nursing students who played a college sport.

METHOD

A phenomenological study was conducted to understand the meaning of the collegiate roles of the nursing student and the student athlete. These roles carry different sets of responsibilities, social contacts, and physical and emotional demands. Thirteen practicing nurses who played a college sport during their nursing program were interviewed.

RESULTS

Data analysis revealed four essential themes that described the meaning of their experience: athletic identity, perseverance, advocates and adversaries, and belongingness. Results suggest participation in college sports creates a sense of belonging that assists in the transition into college.

CONCLUSION

Although nursing students may be deterred from coordinating academics and athletics, this study indicates it is possible and may even have benefits, both academically and during students' transition into practice. [J Nurs Educ. 2022;61(3):117-122.].

Stress and coping styles among nursing students during the initial period of the clinical practicum: A cross-section study

Objectives

This study aimed to explore the level of stress, types of stressors, type of coping styles, and factors influencing stress levels and coping styles among nursing students during the initial period of the clinical practicum.

Methods

A cross-sectional survey design was used. In September 2017, participants were recruited from a tertiary hospital in Zhejiang Province, China, using a convenience sampling method. A demographic characteristics questionnaire, the Intern Nursing Student Stressor Scale, and the Simple Coping Style Questionnaire were used to collect data. Data were analyzed using descriptive analysis, independent sample t-tests, one-way analysis of variance, Pearson’s correlation analysis, and multiple linear regression analysis.

Results

A total of 158 nursing students were recruited, most of whom were female, undergraduates, and from rural areas. The nursing students perceived a moderate level of stress during the initial period of the clinical practicum. The need for knowledge and skills was the most common source of stress. Positive coping styles were most commonly adopted. Nursing students who were undergraduates, only children, and chose nursing major involuntarily experienced higher stress levels than those who were junior college students, not only children, and chose nursing major voluntarily. Nursing undergraduates were more likely to use positive coping styles than junior college students. Male nursing students and those experiencing higher stress levels related to the “environment and equipment of the wards” and the “nature and content of the work” were more likely to use negative coping styles.

Conclusion

Nursing educators should offer targeted guidance based on the stress reported during the clinical practicum and the demographic characteristics of the nursing students. Guidance should be provided to encourage nursing students to adopt effective coping strategies and reduce stress.

Cross-sectional Study of the Relationship between Experiences of Incivility from Staff Nurses and Undergraduate Nursing Students’ Sense of Belonging to the Nursing Profession

AIM

This study examined the frequency of incivility for undergraduate nursing students and the relationship between staff nurse incivility and nursing students' sense of belonging. Factors between program semester and students' body mass index (BMI) to staff nurse incivility and students' sense of belonging were assessed.

BACKGROUND

Sense of belonging enhances belonging development to the profession. However, no studies address the relationship between incivility and nursing students' sense of belonging.

METHODS

A cross-sectional design assessed the relationship between staff nurse incivility and undergraduate nursing students' sense of belonging to the nursing profession. An online survey was administered to 123 pre-licensure junior and senior undergraduate nursing students from February 1, 2021, to May 5, 2021. Correlation coefficient, descriptive statistics, Fisher r-to-z transformation, 95% confidence intervals were calculated.

RESULTS

Staff nurse incivility inversely correlated with undergraduate nursing students' sense of belonging (rs=-.358; p <.001). American Indian or Alaskan Native students reported the highest mean frequency of incivility (1.25 ± .421). There were no significant differences in correlations based on semester or BMI.

CONCLUSION

Staff nurse incivility is inversely associated with sense of belonging in students. Further research is needed to test interventions mitigating the effects of incivility on belonging.

Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students

BACKGROUND

Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being.

PURPOSE

The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students.

METHODS

A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress.

RESULTS

More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being.

CONCLUSIONS

Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.

Profiling Attached Residents in an Urban Community in the U.S.: An Empirical Study of Social–Landscape Interactions within a Park

Community attachment has been studied predominantly in terms of the social dimensions of community life, which explains what makes residents feel connected to a locality. Following a more recent trend within the community attachment literature, this study examined the role of communities’ physical dimensions in fostering sentiments of rootedness and connections to communities. More specifically, the study sought to better understand the role that urban parks play in predicting community attachment using a discriminant analysis technique to profile attached residents. We selected Discovery Green Park in Houston, Texas, as the study site, where we administered 606 total surveys to park visitors inquiring about their interactions with the park itself, emotional connections to it, and social interactions within the park. We found that strongly attached residents tend to be older, have a greater reliance on the park service and programs, and have meaningful interactions with new people in the park and frequently visit the park in groups to socialize and relax. Additionally, those who are strongly attached to the community attribute greater symbolic meanings to Discovery Green and more strongly identify with the park. The profile of residents attached to the community, given their interactions with the park and its visitors, provides important knowledge to both park managers and community leaders; they can use this information to create conditions, fostering more strongly attached residents who tend to be active agents of positive change in the community.

The relationship of learned resourcefulness with self-leadership skills: A study with nurse and midwife students

BACKGROUND

It is important for the professionalism that students at the university use their coping skills to solve the problems that may arise before starting the profession, control their behaviours by directing themselves, and motivate themselves in case they face negative situations.

OBJECTIVES

This study was carried out to determine the relationship between the selfleadership skills of students studying in nursing and midwifery departments and their learned resourcefulness skills.

DESIGN

The study a descriptive, correlational and cross-sectional pattern.

SETTINGS

The sample of the study consisted of 380 students studying at the Nursing and Midwifery Department of the Faculty of Health Sciences of a foundation university in Istanbul.

METHODS

The research data were collected using the information form, the Revised Self-Leadership Questionnaire, and the Rosenbaum Learned Resourcefulness Scale. In the analysis of the data descriptive analysis, parametric or non-parametric comparative analyzes and correlational analyzes were used.

RESULTS

In the study; 84.5% of the participants were female and whose mean age was 20.6-61.6% of the participants were studying in the nursing department. The total score the students got from the Revised Self-Leadership Questionnaire was 131.87 ± 23.49, and the total score that got from the Rosenbaum Learned Resourcefulness Scale was 120.81 ± 16.77. The students studying in the third-grade (124.16 ± 13.9) had higher self-control skills compared to the first (118.57 ± 18.8) and the second-grade (119.2 ± 16.7) students, that's, they frequently applied the coping strategies represented in the scale (p < 0.05). There was a positive linear relationship between two scale (p < 0.001).

CONCLUSION

Within the framework of the research results, gender, grade and the department studied are related to the level of self‑leadership. The level of learned resourcefulness was associated with classroom and stress training. Individuals' self‑leadership levels showed a positive relationship with their learned resourcefulness level.

Perceived Stress among School Students in Distance Learning During the COVID-19 Pandemic in the Gaza Strip, Palestine

The rapid outbreak of COVID-19 is a global health problem that has a significant effect on the educational systems. Therefore, students shifted to distance learning through the digital platform. Since COVID-19 has consequences on mental health, the present study examined the perceived stress level in school students in distance learning during the COVID-19 period. A cross-sectional study of a sample consisting of 385 school students evaluated the Perceived Stress Scale (PSS) and their concerns and emotions during the COVID-19 pandemic. The results showed that the mean value of the total PSS scores was 19.50 ± 9.28. About 48.6% of students had moderate stress, 28.8% had low stress, and 22.6% had high stress. Significant associations were found between the level of stress and demographic variables: age, gender, educational level, and place of residence. Female students were significantly higher than the male students in the mean score of perceived stress level (20.14 versus 18.13; p-value = 0.018). Females were more likely (53.4%) to have moderate stress than males (38.2%) (p = 0.019). The students aged 15–18 years were significantly higher than those aged 11–14 years in the mean score of perceived stress level (22.64 versus 17.24, respectively; p-value < 0.001). The students aged 15–18 years were also more likely (n = 536, 96.4%) to had high levels of stress than the younger students (p < 0.001). The results showed that secondary school students were significantly higher than primary school students in the mean score of perceived stress level (23.75 versus 16.76, respectively; p < 0.001). Secondary students were also more likely (43.0%) to have high stress than primary students (9.4%) (p < 0.001). Students who live in the Rafah governorate had a significantly lowest mean score of perceived stress level when compared to other counterparts (p-value = 0.005). Gender (β = − 0.282, P < 0.001), age (β = − 0.379, P = 0.004), place of residence (β = − 0.096, P = 0.034), and educational level (β = 0.845, P < 0.001) were predictors of perceived stress. The results revealed moderate to high levels of stress in school students in the Gaza Strip during schools closure due to the COVID-19 pandemic. The prevalence of psychological distress attributed to suddenly shifted from traditional learning to distance learning. The incorporation of stress management programs and online counselling will minimize stress and enhance the mental health of school students during distance learning.

What Helps, What Hinders? Undergraduate Nursing Students' Perceptions of Clinical Placements Based on a Thematic Synthesis of Literature

Introduction

Clinical placements are a mandatory component of nursing students’ education internationally. Despite clinical education being a key to nursing students’ achievement of nursing competencies, few studies have reviewed students’ narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys.

Methods

A systematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students’ experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research.

Results

Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as “Preparation,” “Welcomed and wanted” and “Supervision experiences”. A conceptual model of clinical placement elements conducive to nursing students’ learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed.

Conclusion

The conceptual model presents positive elements that influence students’ clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strategies to support students and supervisors alike, an important step forward in moving beyond the current clinical placement rhetoric.

Health-Related Quality of Life and Undergraduate Nursing Students: A Narrative Review

Background:

Undergraduate nursing students are vulnerable to stressful university learning environments and poor working conditions in clinical rotations. This can result in students leaving nursing programs or abandoning the profession following graduation. As a result, the health-related quality of life of nursing students is an important indicator to monitor student quality of life adequacy. Preventing premature student nurses' departure from the profession is necessary to reduce the nursing shortage.

Objective:

To describe the body of knowledge about the health-related quality of life for undergraduate nursing students during their qualification process.

Methods:

This was a narrative review through a six-database search, including Cochrane, CINAHL, Pubmed, Medline, PsycINFO and Livivio, from between January 1990 and June 2018, with updates in the search followed until November 2019. To assess study quality, the STROBE checklist was used.

Results:

Eight studies were included in a narrative synthesis. All studies were of cross-sectional design, and none included follow-up procedures. Most of the studies recruited participants from nursing courses and only one study recruited students from a national register. Sample sizes ranged from 110 individuals to 4,033 participants in the register-based study. Common health-related dimensions evaluated included stress, social support, mental health, fatigue, quality of life, and drug abuse. Stress, the most commonly studied dimension, was associated with clinical placements, final exams, and non-prescribed drugs. Social support networks were positively associated with coping abilities and self-esteem.

Conclusion:

There is low-quality evidence of the impact of nursing courses upon student health-related dimensions (stress, self-esteem, health-related behaviors). Nurse educators should be aware of these associations and support routine screening of students and their health-related dimensions. Interventions, such as consultation and study redesign, might increase the level of health-related dimensions. Nursing schools should further collaborate to investigate these associations and tailored interventions to positively affect health-related dimensions in nursing students.

Sources of Stress among Saudi Arabian Nursing Students: A Cross-Sectional Study

Introduction: Nursing students experience higher levels of stress than those in other health-related disciplines; however, there are limited data exploring stress among these students in a Saudi context. Aim: This study examines sources of stress among nursing students at an academic institution in Jeddah, Saudi Arabia, using a descriptive quantitative cross-sectional research design. Methods: Data were collected from a convenience sample of 500 undergraduate nursing students, with a response rate of 71.8%, using an adapted Stress in Nursing Students (SINS) questionnaire. Results: Nursing student sources of stress fell into three categories: academic concerns, clinical practice, and social factors. Discussion: The results demonstrate commonality between other countries’ sources of stress for nursing students but highlight cultural factors unique to Saudi Arabia. This study shows opportunities for cross-cultural learning and areas needing cultural tailoring to reduce stress among nursing students.

Baccalaureate occupational therapy students' development of social and emotional competencies

BACKGROUND

Academic life requiring students to meet academic and professional practice expectations can be stressful. Effective emotional and social competence can assist students in managing feelings, stressful situations and fostering relationships with educators, peers, and clients. Hence this is a helpful professional competence for health students to possess.

OBJECTIVE

To compare the emotional and social competence among the baccalaureate occupational therapy students across four academic year levels.

METHOD

A quantitative cross-sectional design was used. A total of 360 baccalaureate occupational therapy students completed the Emotional and Social Competency Inventory- University Edition. Regression analysis followed by contrast analysis examined the differences among first-, second-, third- and fourth-year levels.

RESULTS

Students demonstrated "satisfactory" or above social and emotional competencies. For all students, the average Emotional and Social Competency Inventory subscale scores on teamwork, empathy and achievement orientation were the highest three competencies. The lowest average scores were systems thinking, inspirational leadership and coach and monitor skills. Fourth year students' emotional self-control (p = 0.03), positive outlook (p = 0.02), and influence (p = 0.02) were significantly lower than first-year students. No other significant differences were found between year levels on the other subscales.

CONCLUSION

Overall, students demonstrated good social and emotional competencies, with strengths in teamwork, empathy and achievement orientation competencies, which are fundamental in health service practice. However, fourth-year students demonstrated lower scores in emotional self-control, positive outlook, and influence competencies compared to their first-year peers. This indicates that fourth-year students have developed better self-awareness, can be more reflective and have a better perception of reality. It is recommended that targeted learning opportunities to develop students' emotional and social competencies to nurture final-year students' abilities and confidence be incorporated into the curriculum. Academic and practice education staff working with final year occupational therapy students need to consider the associated stress during this time when providing learning opportunities.

Modification, Translation, and Psychometric Testing of the Arabic Version of the Belongingness Scale-Clinical Placement Experience (BES-CPE)

BACKGROUND

This paper aimed to describe the modification, translation, and psychometric testing of the Arabic version of the Belongingness Scale-Clinical Placement Experience (BES-CPE).

METHODS

This study included the following phases: modification of the original BES-CPE based on the qualitative findings from a previous study; translation and back-translation of the scale; evaluation of the content validity by experts from Saudi Arabia; evaluation of the internal consistency reliability; and other psychometric properties of the Arabic BES-CPE.

RESULT

The results demonstrated acceptable psychometric properties. The Cronbach's alpha ranged from 0.68 to 0.92.

CONCLUSION

The Arabic BES-CPE is a promising tool that can be used to assess Saudi nursing students' sense of belonging. However, testing the tool with other undergraduate nursing students in a different context is recommended.

Cultivating inclusive learning environments that foster nursing education program resiliency during the Covid-19 pandemic

Nursing education programs faced multiple challenges to increase the size, diversity, and skill set of the nursing workforce while contending with shortage of clinical placement sites and retiring faculty. A program that is unable to be resilient in the face of crisis will fail in its mission to graduate resilient nurses. The purpose of this paper is to describe how nursing programs can respond to the challenge of creating a resilient program poised to graduate a diverse, inclusive, and resilient workforce. Utilizing resilience-oriented strategies to impact educational services solidified program relevancy, promoted student belonging, and enhanced student recruitment/retention. While programs have become accustomed to doing more with fewer resources, many of these programs may not survive these unprecedented times without incorporating a holistic approach for organizational well-being that promotes resilience through inclusivity.

Mental Resilience and Coping With Stress: A Comprehensive, Multi-level Model of Cognitive Processing, Decision Making, and Behavior

Aversive events can evoke strong emotions that trigger cerebral neuroactivity to facilitate behavioral and cognitive shifts to secure physiological stability. However, upon intense and/or chronic exposure to such events, the neural coping processes can be maladaptive and disrupt mental well-being. This maladaptation denotes a pivotal point when psychological stress occurs, which can trigger subconscious, "automatic" neuroreactivity as a defence mechanism to protect the individual from potential danger including overwhelming unpleasant feelings and disturbing or threatening thoughts.The outcomes of maladaptive neural activity are cognitive dysfunctions such as altered memory, decision making, and behavior that impose a risk for mental disorders. Although the neurocognitive phenomena associated with psychological stress are well documented, the complex neural activity and pathways related to stressor detection and stress coping have not been outlined in detail. Accordingly, we define acute and chronic stress-induced pathways, phases, and stages in relation to novel/unpredicted, uncontrollable, and ambiguous stressors. We offer a comprehensive model of the stress-induced alterations associated with multifaceted pathophysiology related to cognitive appraisal and executive functioning in stress.

Moral intelligence, clinical placement experience and professional behaviors among Iranian undergraduate nursing students in a baccalaureate nursing program: A descriptive correlational study

AIMS

This study was intended to examine the relationship of both moral intelligence (MI) and Clinical Placement Experience (CPE) with the level of nursing students' professional behaviors (PB).

BACKGROUND

The foundation of belief, belonging and ethical values develop PB as a meaningful attribute during the period students and caring for patients.

DESIGN

A descriptive correlational study was conducted.

METHODS

Descriptive data were derived from the Belongingness Scale-Clinical Placement Experience (BES-CPE), the Moral Intelligence Questionnaire (MIQ) and the Nursing Students Professional Behaviors Scale (NSPBS) including 200 students (response rate 94.5%).

RESULTS

We found a statistically strong positive correlation between NSPB, MI and CPE. The regression model accounted for 57.8% of the variance in NSPB; CPE and MI were significant explanatory variables of NSPB. Moreover, the non-employed dormitory students had a significant statistical difference in the scores of all three variables. Female students had significantly higher CPE and MI (p˂0.05).

CONCLUSIONS

According to our findings, preventive and mediation endeavors for nursing students can explicitly target their behavioral skills to reduce perceived rejection and improve morality. As a result, an optimal plan to improve the quality of professional training courses for students should be designed based on the comprehension of clinical belonging and moral intelligence.

Personal qualities needed by undergraduate nursing students for a successful work integrated learning (WIL) experience

BACKGROUND

International research has shown that during work integrated learning (WIL) undergraduate nursing students may experience stress, self-doubt, and coping issues, however personal qualities these students bring to their WIL journey or those needed to succeed during WIL remain unknown.

OBJECTIVE

To describe the views of students midway through their Bachelor of Nursing program regarding personal qualities they bring to and need for WIL success.

DESIGN

This article reports on a descriptive study that used an electronic questionnaire to collect the data.

SETTINGS AND PARTICIPANTS

Bachelor of nursing students (n = 421), who were studying fulltime or part time equivalent, at a regional university in Queensland Australia, were invited to complete the anonymous electronic questionnaire that was developed by the research team following an extensive review of literature. Inclusion criteria required participants to have completed at least one WIL experience and be midway through their three-year Bachelor of Nursing program.

METHODS

Data were collected during January and February 2017. The electronic questionnaire consisted of demographic, forced choice questions, and open-ended questions. This paper presents the qualitative analysis of responses to two of the open-ended questions that focused on personal strengths and work integrated learning experiences. Data were analysed using the inductive content analysis approach.

RESULTS

Six personal qualities were identified including: enthusiasm to succeed, commitment to learning, self-motivation, confidence, effective communication skills, and compassion.

CONCLUSIONS

Pre-entry screening of applicants to bachelor level nursing programs and the delivery of learning opportunities that encourages both reflection and debriefing may assist in describing personal qualities needed to succeed in WIL.