Indicators of undergraduate nursing students' satisfaction with their learning journey: An integrative review

Professional identity and preparedness for hospital practice among undergraduate nursing students: A cross-sectional study

BACKGROUND

Professional identity is a crucial characteristic that undergraduate nursing students must possess to ensure effective and safe clinical practice. It has been identified as a factor influencing nursing student retention and their intention to remain in the nursing profession. However, the influential factors that impact the development of professional identity among nursing students currently are not well known.

OBJECTIVES

To identify factors determining professional identity among undergraduate nursing students and to confirm the relationship between nursing students' professional identity and their preparedness for hospital practice.

DESIGN

A cross-sectional study.

SETTINGS

The largest public nursing college in Oman.

PARTICIPANTS

180 full-time undergraduate nursing students in their third and fourth years who had completed at least one clinical course.

METHODS

Students completed validated, self-administered paper questionnaires through convenience sampling, including professional identity and preparedness for hospital practice scales.

RESULTS

The mean total score for professional identity was 63.3 (SD = 10.5), indicating a moderate level of professional identity. The findings showed a low level of preparedness for hospital practice among nursing students, with, a mean total score of 165.8 out of 246 (SD = 30.4). We found a significant positive association between professional identity and preparedness for hospital practice (r = 0.43, p < 0.001), the number of clinical courses taken (r = 0.15, p = 0.041), enrolment in fourth-year clinical courses (H (4) = 19.9, p = 0.001), grade (H (3) = 7.8, p = 0.049) and the selection of nursing profession as the first choice (H (3) = 28.0, p = 0.05).

CONCLUSIONS

The study has implications for identifying students with lower readiness for hospital practice and providing them with the necessary training. Nursing educators should prioritize reinforcing professional identity among students who have chosen nursing as a secondary option or have a lower grade. This can be achieved by promoting a positive nursing image and fostering a supportive clinical learning environment.

Predictors of nursing student satisfaction as a key quality indicator of tertiary students' education experience: An integrative review

INTRODUCTION

Student satisfaction is an important quality indicator in higher education, impacting student retention and institutional rankings. Healthcare education literature lacks factors related to student satisfaction. Reporting these elements might assist educators in curriculum design that helps to retain students. This is imperative for nursing education with the current global need for graduates.

OBJECTIVES

To explore, synthesize and report available evidence on conceptual elements underlying the formation of higher education students' satisfaction, with a focus on nursing education.

DESIGN

Integrative review.

DATA SOURCES

Six databases were searched for learner experiences of satisfaction: MEDLINE, Academic Search Complete, CINAHL Complete, ERIC, APA PsychArticles, PsychInfo. Articles were screened, assessed for quality and 12 nursing student studies and 10 conceptual studies of mixed student cohorts were reviewed.

REVIEW METHODS

Peer-reviewed literature in English during the period 2012 to 2022 was reviewed using methods documented for an integrative review.

RESULTS

Twenty-two included studies were mostly quasi-experimental, based on statistical analysis of higher education student surveys. Antecedent elements affecting satisfaction in mixed student cohorts were Service Quality, Institutional Image and perceived Value. These studies identified up to seven dimensions underlying student satisfaction. Nursing studies were focused on the quality of service delivery related to teaching and confirmed five elements: Faculty, Learning environment, Curriculum, Social interaction and Development. Conceptual studies also reported 'consequent' elements, high satisfaction resulting in positive student behavioural intent, loyalty and positive word of mouth. The details of antecedent and consequent elements that underlie student satisfaction are described.

CONCLUSION

Conceptual studies of mixed student cohorts identified nine elements that inform student satisfaction with learning experiences. Nursing student studies tested fewer variables and confirmed up to five elements forming student satisfaction. There is a need to investigate the impact of additional key elements in nursing students - perceptions of value, institutional image and administrative support.

Stressors inherent to clinical practices and their relationship with emotional intelligence in nursing students: A cross sectional study

BACKGROUND

There is a wide body of knowledge about Emotional Intelligence and its benefits in health care, generating better productivity, clinical performance and communication with work teams, patients and families. Its relationship with stress and with performance of clinical practices has also been studied, although the results are not conclusive or up-to-date.

OBJECTIVES

To study and correlate the perception of Emotional Intelligence and the stressors inherent to Nursing students' clinical practices.

DESIGN

A multicenter and observational study was carried out through cross-sectional surveys with Nursing students during the 2021/2022 academic year.

PARTICIPANTS

377 students were included in the study, recruited through non-probabilistic sampling in four Spanish universities.

METHODS

Sociodemographic and academic variables were collected, as well as the following main variables: perceived Emotional Intelligence and stressors in clinical practices.

RESULTS

The study sample consisted of 377 students (89.1 % women; mean age of 23.15 ± 5.50). The perception of Emotional Intelligence obtained adequate ranges. The stressors that generate most concern are being attacked by the patients, lack of competence, and impotence and uncertainty. There are statistically significant differences in Emotional Intelligence by gender and university, as well as in stressors between each other. The Emotional Intelligence dimensions are weakly correlated with the stressors, although with statistical significance.

CONCLUSIONS

This study shows that Emotional Intelligence slightly influences the stressors inherent to clinical practices, so that EI can help cope with the difficulties of clinical work. Specifically, emotional clarity has an inverse relationship with some stressors. However, the attention and repair dimensions do not present such a clear relationship in our study or in previous ones. This shows the need to include Emotional Intelligence training in Nursing training curricula.

Nursing students' achievement emotions in association with clinical practicums and alternative learning

OBJECTIVES

This study aimed to identify and compare nursing students' achievement emotions associated with clinical practicums and alternative learning during the COVID-19 pandemic.

METHODS

This cross-sectional, descriptive study enrolled 236 nursing students. Participants completed a web-based, self-administered survey regarding achievement emotions. Wilcoxon signed-rank tests were used to calculate mean differences in achievement emotions associated with clinical practicums and alternative learning.

RESULTS

Nursing students who undertook e-learning reported higher negative achievement emotions than those who experienced other alternative learning modalities. Higher achievement emotions were associated with clinical practicums than with alternative learning. The most frequently reported negative emotions were anxiety associated with clinical practicums and boredom with alternative learning.

CONCLUSIONS

Nurse educators should design and implement supportive clinical learning experiences to engender productive achievement emotions. Implications for an international audience: Nurse educators should play roles in providing well-designed and supportive clinical learning environments to help nursing students regulate achievement emotions.

Nursing student learning of biosciences through movies and concept maps: A mixed study

BACKGROUND

acquisition of bioscience knowledge is challenging for nursing students. This calls for teaching methodologies that allow them to acquire this knowledge and add value in the nursing context.

OBJECTIVE

to evaluate a teaching experience using a movie clip and the collaborative use of C-Maps in first-year bioscience learning in nursing students.

DESIGN

embedded mixed methods study.

PARTICIPANTS

143 students.

METHODS

data were collected in two phases: first, collecting quantitative data through a questionnaire on utility, satisfaction and perceived competency development, and collecting qualitative data on learning, teaching materials and developed competencies through an open-question instrument. The second phase consisted of a focus group to explore in greater depth learning experience.

RESULTS

six themes emerged from the qualitative analysis: using C-Maps as a learning process; developing group competencies; knowledge integration and transfer; teacher-student relationship; art as a didactic support; and difficulties encountered and proposals for improvement. Regarding utility, the students highlighted learning and relating concepts. Elements of satisfaction were working in small groups and having the teacher as a guide. Finally, the competencies most developed were teamwork and learning ability.

CONCLUSION

the combination of a movie clip and a C-Map is an innovative strategy motivating and valuable for learning biosciences.

Emotional Impact of COVID-19 Pandemic on Nursing Students Receiving Distance Learning: An Explorative Study

Social restrictions have a significant impact on higher education, especially on nursing students. The main goal of our study was to assess the emotional state of nursing students who received e-learning during the second wave of the COVID-19 pandemic. The secondary objective was instead to measure the usability and acceptability of distance learning systems. A cross-sectional survey design was used to assess the psychological effects of the COVID-19 pandemic on 1st-, 2nd-, and 3rd-year undergraduate nursing students attending the University of Messina, Italy, using an anonymous online questionnaire. The data of 522 nursing students were examined. All participants completed the online questionnaire, declaring the good usability of e-learning education (SUS mean 68.53 ds: 16.76). Moreover, we found that high levels of satisfaction in the use of the means of distance learning (based on the SUS score) were positively correlated with low levels of stress, anxiety, depression, and mental distress. In conclusion, the present study provided relevant information on usability and mental distress related to e-learning and use in a sample of nursing students. It was found that students generally found this method to be good for use. Although e-learning can be a valuable and usable teaching tool, the study suggests that students prefer a blended or presence modality, based on their perception of learning. So teaching nursing students in the future could integrate the two ways to enhance learning. Further studies are needed to evaluate this aspect.

Fourth year intellectual disability student nurses' journey and future work intention: a qualitative study

BACKGROUND

The aim of this qualitative study is to explore the views and experiences of final year BSc intellectual disability nursing students' journey, future work plans and examine factors influencing their migration intentions following graduation.

METHODS

A qualitative component of a mixed methods study where a focus group interview was conducted with final year BSc intellectual disability nursing students (n = 10) from one University in Ireland in June 2019. A topic guide was utilised, and participant's were interviewed about their programme, future work plans and migration intentions. An inductive approach was utilised, and data were analysed using a pre-existing framework for initial coding and thematic development. Duffy's conceptual model of identity transformation provided a structure to analyse the data and map themes onto the conceptual framework.

RESULTS

The findings were mapped onto the five stages of Duffy's (2013) conceptual model of identity transformation: Pre-Entry; Reaffirming; Surmounting; Stabilising and Actualising. Findings indicate that further work is required to promote intellectual disability nursing and address professional esteem issues, support for education and professional development, such as providing career guidance opportunities prior to course completion, development of clinical skills within their education programme and support for the professional development of new graduates. Participant's identified uncertainty about career opportunities and saw scope for future professional development opportunities particularly in community-based work.

CONCLUSION

This study has identified that final year intellectual disability nursing students are uncertain about career options and opportunities for intellectual disability nurses in other country's. There is an urgent need for the intellectual disability nursing profession to articulate their practice and advocate for their role and contribution to the care of people with intellectual disability. This study identified a clear need for direction and information regarding intellectual disability nursing roles and career opportunities.

A team approach to delivery of contextually relevant bioscience: encouraging student connections between tacit knowledge and new content acquisition

BACKGROUND

Bioscience is essential knowledge for nursing practice and is an important component of undergraduate nursing education, however students commonly feel anxious about studying the subject. The purpose of this study was to develop appropriately scoped contextually relevant bioscience lesson resources to enhance student engagement and performance and reduce attrition and unit failures over a sustained period.

METHODS

Participants included students enrolled in the core bioscience unit for an undergraduate Bachelor of Nursing degree from a central campus and a widening participation (WP) campus. From 2016 to 2018, unit learning resources were progressively revised to include a structured learning and teaching manual, signposted lectures, and digital resources. Online surveys and formal institutional data collection metrics were used to assess the impact of the changes to unit learning resources.

RESULTS

Student attrition rates and failure rates for the unit were reduced over a two-year period across a diverse student cohort.

CONCLUSIONS

Scaffolded and diverse learning materials support the success of undergraduate bioscience students by improving student engagement and reducing cognitive load.

Availability and use of technology for e-learning: to what extent do these impact Bangladeshi university students? A cross-sectional study

Background: E-learning is making education globally and conveniently attainable with the deliverance of advanced technology. However, this mode of academia is still not commonly practiced locally. Thus, the study aimed to investigate technological availability, usability, and association to university students' perceived stress due to e-learning curriculum.

Methods: A cross-sectional study commenced among Bangladeshi university students enrolled in the e-learning curriculum. A total of 1162 university students were included. The main explanatory variables were related to the availability of technology and the use of technology. The outcome variable was perceived e-learning stress. In statistical analysis, p-value < 0.05 was considered statistically significant with a 95% confidence interval.

Results: In this study, lack of technological availability and usability were associated with higher level of perceived e-learning stress. Being female, living in rural areas, and outside of Dhaka division were found the associated factors in the lack of technological availability and usability.

Conclusions: A significant association between the availability and usability of technology with perceived e-learning stress was observed. Thus, measures should be taken to initialize e-learning adaptivity by increasing technological growth across the nation, considering educational preparedness for future catastrophes.

First and second cycle nursing students' perceptions of the clinical learning environment in acute care settings - A comparative crossectional study using the CLES+T scale

BACKGROUND

Research has shown that the clinical learning environment can both facilitate and hinder students' learning. Students' perceptions need to be evaluated, preferably using nationally and internationally validated instruments. In Sweden, there is a lack of research about students' evaluation in acute care settings and from the perspectives of different levels of students.

OBJECTIVES

The aim was to explore and compare perceptions of the clinical learning environment of first- and second-cycle nursing students in an acute care setting using the Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T).

DESIGN

The design involves cross-sectional data collection with comparisons between groups.

SETTING AND PARTICIPANTS

Data were collected from a convenience sample of first- and second-cycle students at the end of their clinical placements in an acute care setting at a university hospital.

METHODS

A paper version and a web version of the culturally adapted version of CLES+T was filled out by the students. An independent t-test was used to explore the differences between CLES+T scores and distribution methods and educational level. Internal consistency was evaluated using Cronbach's alpha.

RESULTS

Overall, the students (N = 179) were satisfied with the clinical learning environment. There was no significant difference in the total score (m = 4.31, SD = 0.63) between first- and second-cycle students except for the subscale of "Premises of nursing on the ward" and the individual items "The ward's nursing philosophy was clearly defined" and "Patients received individual nursing care", showing that the first-cycle students were more satisfied compared to the second-cycle students. The scale demonstrated high internal consistency (α = 0.97 vs. 0.96) for the paper survey and the web survey, respectively.

CONCLUSIONS

Our findings provide initial support for the CLES+T as a useful instrument to evaluate the clinical learning environment at different levels of education and in different contexts regardless of distribution method.

Antecedents of perceived value-in-use by university students

Purpose

This study aims to analyze factors that may influence the value-in-use perceived by undergraduate students from the built environment, teaching care and hedonic value.

Design/methodology/approach

The authors conducted a survey with 900 students from a university in southern Brazil. The main results evidenced that the built environment positively and significantly influences teaching care, hedonic value and value-in-use.

Findings

The hedonic value, teaching care and built environment explain 67.8% of value-in-use; the built environment and teaching care explain 45.1% of hedonic value; and the built environment explains 45.1% of the teaching care. Based on the results, it was possible to identify the value that the built environment and the teaching care represent for university students. Therefore, universities should invest in these dimensions, considering the time and cost students spend on this service to increase their satisfaction and retention.

Originality/value

This study analyzes antecedents of value-in-use perceived by undergraduate students from the built environment, teaching care and hedonic value.

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.

Nursing Students' Perceptions of Faculty Caring as a Predictor of Students' Caring Behaviors

This cross-sectional, descriptive survey study aimed to examine the relationships among nursing students' perceptions of faculty caring, students' caring behaviors, and their confidence, satisfaction, and empathy in an undergraduate nursing program. The instruments included the Caring Behaviors Inventory-16 Student Version, Nursing Students' Perceptions of Instructor Caring, and students' confidence, satisfaction, and empathy. There were significant pair-wise relationships among students' perceptions of faculty caring, students' caring behaviors, satisfaction, confidence, and empathy. Students' perceptions of faculty caring were a significant predictor for students' caring behaviors. These findings are significant in future designing and implementing interventions to enhance students' learning experiences.

A literature review of emotional intelligence and nursing education

AIM

The purpose of this study is to investigate the current state of knowledge about emotional intelligence (EI) in nursing education BACKGROUND: Human relationships and emotions are an integral part of nursing care and contribute to care quality. This part of the profession must be addressed in nursing education to prepare students and deal with their emotions and the patients's. Research on emotional intelligence (EI) in nursing has been particularly developed recently. A broad understanding of many benefits of EI is crucial to include EI in this training program.

DESIGN

Systematic literature review METHODS: Undertaken using electronic database (Cairn; PubMed; Science Direct; Wiley online library) and specific search terms. This research covered articles published in English and French between 2007 and 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA) directed the systematic review process.

RESULTS

57 articles are included in this systematic review. The literature focuses on EI and nursing education. The findings categorized into four themes: EI and performances; EI and Physical and mental health; EI and Social Relationship; and EI program.

CONCLUSIONS

This literature review reveals that EI has many benefits in nursing students. Several training programs aimed at developing this concept have proven to be effective in nursing education. We believe that a synthesis of this knowledge will then allow us to better understand the benefits of EI for a further implementation in nursing education. Perspectives and recommendations will also be formulated to enable the implementation of emotional skill development programs in such training.

Development and psychometric testing of a Learning Behaviour Questionnaire among Chinese undergraduate nursing students

OBJECTIVE

This study aimed to develop and validate a new Learning Behaviour Questionnaire (LBQ) for the undergraduate nursing students.

STUDY DESIGN

This study was performed in two phases. Phase 1 of the study focused on questionnaire development to create a pool of items, while phase 2 focused on validity and reliability testing.

METHODS

Semistructured interviews were used to explore nursing undergraduates' perception of learning behaviour. A two-round modified Delphi method was used to test content validity and quantify the degree of consistency in questionnaire items. An item analysis, an exploratory factor analysis (EFA), a confirmatory factor analysis (CFA) and an internal consistency reliability check were conducted. Criterion-related validity was demonstrated through correlations with Self-Regulated Learning Scale for Undergraduates (SRLS-U). A sample of 114 nursing students was evaluated in test-retest reliability to confirm stability.

RESULTS

The final LBQ consisted of four factors for the 19-item questionnaire with a 5-point rating from '1' (Fully disagree) to '5' (fully agree). The content validity was 0.890. EFA revealed the presence of four factors, including 'strategy', 'attitude', 'motivation' and 'degree of satisfaction'. The CFA indicated good fit indexes for the proposed model (χ²/df=1.866, root mean square residual=0.037, comparative fit index =0.950, goodness-of-fit index =0.929, Tucker-Lewis index=0.941, adjusted goodness-of-fit index=0.907 and root mean square error of approximation=0.049). The LBQ correlated significantly with SRLS-U subscales (r=0.742-0.837, p<0.01). The Cronbach's alpha coefficient of the whole questionnaire was 0.936, while the Cronbach's alphas of the four factors were 0.828, 0.826, 0.804 and 0.805, respectively. The test-retest reliabilities of the four factors were 0.886, 0.904, 0.852 and 0.875, respectively.

CONCLUSION

The validity and reliability of the LBQ were satisfying. The LBQ is a short, well-developed questionnaire that can serve as a generic assessment tool for measuring learning behaviour for Chinese undergraduate nursing students.Cite Now.

Influence of psychological stress and coping styles in the professional identity of undergraduate nursing students after the outbreak of COVID-19: A cross-sectional study in China

Aim

To investigate the influencing factors in professional identity of undergraduate nursing students after the outbreak of COVID‐19.

Design

Cross‐sectional study.

Methods

The study covered 2,999 nursing students in six undergraduate nursing schools. Several self‐report questionnaires were used to collect the general information, psychological stress, coping styles and professional identity of the undergraduate nursing students.

Results

The overall average score of the professional identity of nursing students (3.67 ± 0.51) has increased significantly after the outbreak of COVID‐19. The professional identity of the undergraduate nursing students was negatively correlated with psychological stress (r = −0.23, p < .001), expectation (r = −0.12, p < .001) and avoidance (r = −0.16, p < .001), but was positively correlated with solving problems (r = 0.18, p < .001) and seeking support (r = 0.12, p < .001). Academic performance, positions, grades, reasons for choosing a nursing profession, parents or relatives engaged in nursing work and the risk degree of residence were the factors influencing the professional identity score of undergraduate nursing students' (p < .001).

Nursing and Midwifery Students' Satisfaction with Their Clinical Rotation Experience: The Role of the Clinical Learning Environment

BACKGROUND

The clinical learning environment and clinical rotation experience of students are integral to nursing curriculum and are a crucial component of nursing education which helps transform theoretical knowledge to clinical practical skills.

OBJECTIVE

This study was aimed at assessing the role of the clinical learning environment on undergraduate nursing and midwifery students' satisfaction with their clinical rotation experience.

METHOD

The study employed a quantitative cross-sectional survey design. Data was collected from a sample of 240 undergraduate nursing and midwifery students of the University for Development Studies, Tamale, Ghana, using a structured questionnaire. Ethical approval was obtained from the University of Cape Coast Ethics Review Board. Descriptive analysis was displayed as frequencies and percentages. Inferentially, Fisher's exact test, linear regression, and Spearman's correlation tests were used to test for and quantify associations between independent and dependent variables at p ≤ 0.05.

RESULTS

The level of students' satisfaction with both clinical rotation experience and the clinical learning environment was high (65.6% and 63.5%, respectively). A statistically significant association of the students' satisfaction with their clinical rotation experience was found. There was a statistically significant relationship between the clinical learning environment (χ 2 (9, N = 224) = 80.665, p < 0.001), pedagogical atmosphere in the clinical area (r s  = 0.379, p < 0.001), the leadership style of the ward manager (r s  = 0.340, p < 0.001), the premises of nursing in the ward environment (r s  = 0.501, p < 0.001), and the students' satisfaction with their clinical rotation experience.

CONCLUSION

These findings provide nurse educators and clinicians with meaningful understanding about areas to prioritise when planning clinical learning opportunities in such a way that skills learning and practice of nursing skills are successful and satisfactory for undergraduate student nurses and midwives.

Applying the social cognitive model of well-being in the nursing clinical practicum: A structural equation modeling analysis with a Spanish student's sample

BACKGROUND

Clinical education, understanding as practicum, plays a key role in nursing education but has been identified as the most challenging and stressful experience for nursing students. Promoting student satisfaction and well-being during clinical practice has a significant effect on learning outcomes, retention and attrition.

OBJECTIVES

To examine the predictive power of a social cognitive model of wellbeing when applied to explain academic satisfaction in the clinical practicum and overall life satisfaction of Spanish nursing students.

DESIGN/PARTICIPANTS

A cross-sectional correlational study was conducted at four Spanish nursing schools in a 586 student's sample.

METHODS

Data were collected through a self-reported questionnaire that included measures of academic support, self-efficacy, goal progress, academic satisfaction, life satisfaction and trait positive affect. The research model was evaluated through structural equation modeling.

RESULTS

The proposed model fit well in the full sample and accounted for substantial portions of the variance in academic (50%) and life satisfaction (21%). Most of the hypotheses formulated were verified. The model was invariant across academic year.

CONCLUSIONS

The results indicated global support for the social cognitive model of academic satisfaction as a guide for developing interventions to facilitate the positive adjustment and wellbeing of nursing students in the practicum.

Undergraduate nursing student academic resilience during medical surgical clinical practicum: A constructivist analysis of Taiwanese experience

BACKGROUND

Nursing students often experience a reality shock in the course of their practicums that can significantly impact their studies.

PURPOSE

This study aimed to explore the academic resilience of undergraduate nursing students during their Adulting Nursing practicums and identify protective factors to mitigate their impact.

METHODS

The constructivist grounded theory approach enabled us to explore nursing students' academic resilience in their practicums. Purposive and theoretical sampling was used to recruit 19 participants. Individual in-depth interviews were audio-recorded and transcribed verbatim. The constant comparative method directed theoretical sampling. The criteria of credibility, originality, resonance, and usefulness were considered to ensure the quality and trustworthiness of the study.

RESULTS

The main challenges were related to facilitators, the environment, and application of techniques. Students reported feelings of 'walking on thin ice' and doubts about their decision to pursue a nursing career. Academic resilience was identified as the ability to maintain optimism while facing challenges. Participants concluded that overcoming their ignorance through practical learning was an important outcome of the process of developing academic resilience.

CONCLUSION

The findings highlight the need for facilitators to re-examine their teaching strategies and provide supplementary support to help students to improve their academic resilience.

Examining nursing students' wellness and resilience: An exploratory study

Undergraduate nursing students report high levels of stress which can negatively impact their overall wellness, and their academic and clinical performance. Despite this knowledge, there are few studies that have examined the well-being of nursing students and their ability to demonstrate resilience. Therefore, the purpose of this exploratory study was to examine resilience and wellness, together with the key factors that promote a well-being in nursing students from mid-western Canadian university. The sample of 196 undergraduate nursing students completed an online Nursing Well-being and Resilience Survey. Findings indicated that most nursing students had good health; however, many presented with anxiety and/or depression and a decreased sense of wellness in the physical, spiritual, and emotional domain. Other significant findings included participants >26 years old having lower burnout scores, higher ego-resilience and well-being scores compared to students ages 20 to 25; and, 2) there were differences between campus locations in terms of Professional Quality of life (compassion satisfaction, burnout, and traumatic stress) and sense of well-being. Understanding how resilience and wellness are influenced throughout the nursing program is a first step in developing targeted wellness initiatives for different nursing student populations.

Magnet hospital attributes in nursing work environment and its relationship to nursing students' clinical learning environment and satisfaction

AIMS

To analyse nursing students' perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated.

DESIGN

This study had a cross-sectional, correlational, design.

METHODS

Data were collected using self-reported questionnaires from 180 nursing students at a university in southeast Spain between September-October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students' satisfaction with the work environment and with the clinical learning process were measured using a four-point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ² test, Mann-Whitney U test, Spearman and phi correlation were used to analyse the data.

RESULTS

Nursing students' perception of greater Magnet-like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22-0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02).

CONCLUSION

Magnet-like features at the work environment lead to superior clinical learning environment and higher students' satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation.

IMPACT

In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.

Development and Psychometric Assessment of Nursing Student's Satisfaction with First Clinical Practical Education Questionnaire: Modified Version

Background

The present study aimed to develop an instrument for assessing nursing students' satisfaction with First Clinical Practical Education (SFCPE), and then to test the validity and reliability of the instrument.

Materials and Methods

In this methodological research, the views of a panel of 15 clinical professors, in terms of the clinical nursing principles and skills training, were used to develop the instrument. The content validity of the instrument was evaluated quantitatively and qualitatively based on the panel's views. The data was collected from the questionnaire completed by 380 second- and third-semester nursing students in 15 medical universities of Iran. The Exploratory Factor Analysis (EFA) was later performed to determine the construct validity of the instrument. The reliability of the instrument and stability analysis were evaluated using the internal consistency test by calculating Cronbach's alpha and by the test-retest method, respectively.

Results

Throughout the development phase, 16 items were added to the SFCPE instrument, and a 42-item instrument was later developed. During the qualitative and quantitative content validity reviews, the number of added items decreased to 38 items. Finally, a 37-item instrument consisting of seven factors was developed. The Cronbach's alpha coefficients of 0.95 and 0.75-0.9 were obtained for the whole instrument and the factors, respectively. Pearson's correlation coefficient was within the normal range (0.71-1).

Conclusions

The developed SFCPE is a valid and reliable instrument that can be used for assessing the satisfaction of nursing students in terms of clinical nursing principles and skills.

Resilience, stress, and psychological well-being in nursing students: A systematic review

OBJECTIVE

Synthesize the evidence relating to the interaction of resilience, stress, and well-being in undergraduate nursing students across countries.

DESIGN

Systematic review DATA SOURCES: Peer reviewed studies published from 2008 to December 2018 were searched in CINAHL, Web of Science, Medline (OVID), PsycINFo and four biomedical databases originating from China (China National Knowledge Infrastructure, WanFang Data, VIP and CMB).

REVIEW METHODS

Adhering to the preferred reporting items for Systematic Reviews and Meta-analyses guidelines, eight databases were searched. Twelve studies, which met the inclusion criteria, were extracted, and subject to quality appraisal by two researchers.

RESULTS

In total, 12 papers were included. Outcome analysis revealed the level of resilience as moderate; stress levels were high and the incidence of negative psychological health accounts for a proportion of nursing students. The interaction between resilience and stress and well-being was high. Resilience and low stress were found to better predict well-being. All the studies cited recommendations to inform educational policy and practice in relation to resilience, well-being, and stress among undergraduate nursing students.

CONCLUSIONS

This was the first systematic review to synthesize the evidence relating to the interaction of resilience, stress, and well-being in undergraduate nursing students across cultural settings. Evidence confirms the importance of resilience in nursing students influencing stress and psychosocial morbidity. Nursing educational strategies that foster and enhance resilience is recommended.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.

Quality Assurance in Nursing Education: A Qualitative Study Involving Students and Newly Graduated Nurses

Background: Assuring quality training for future nursing professionals is essential to preserving population health and socio-economic development. Quality assurance in the European Higher Education Area places students in a leading role to transform and improve higher education programs. Therefore, an innovative way of reviewing strengths and weaknesses of the nursing education program of a Spanish university has been developed. Objectives: The aim of this paper was to explore the perceptions and opinions of nursing students and newly-qualified nurses regarding the contents of the nursing curriculum in order to improve its quality. Methods: Descriptive and exploratory qualitative research was carried out involving 12 newly-qualified nurses and 12 student nurses. Semi-structured interviews and focus groups were performed. Results: Based on the thematic analysis, two themes emerged: improving clinical practices and reviewing the theoretical curriculum. Conclusions: Among the improvements suggested by the participants, the most relevant ones were establishing a clear structure of learning contents in the practicum, and redistributing the European Credit Transfer and Accumulation System ECTS credits in various courses of the study program. However, additional evidence is needed prior to proceeding with any changes.

Students' perceptions of teaching factors that demotivate their learning in lectures and laboratory-based skills practice

Objectives

The objective of this paper is to report students' perceptions of factors that demotivated their learning in lectures and laboratory-based skills practice settings.

Methods

A total of 23 students were recruited from the Bachelor of Nursing courses at three Japanese universities, using purposive sampling. A semi-structured interview was conducted with each participant between November 2017 and January 2018 to elicit their perceptions about which aspects of the teaching context demotivated their engagement in learning. The results were analyzed using thematic analysis.

Results

Three themes were generated: a restrictive environment, discouraging attitudes and discouraging teaching approaches.

Conclusions

To prevent students from experiencing demotivation, teachers in the nursing faculty need to manage learning resources more effectively, create a quiet and focused atmosphere to allow students to concentrate, and be enthusiastic about teaching. They also need to add value to their classes, help students to follow lectures, and ensure that the workload they give their students is appropriate.

Impact of educational games on academic outcomes of students in the Degree in Nursing

Objective

The aim of using the game-based tool Kahoot! was to evaluate and reinforce the contents taught in the subject of Management and Administration of Nursing, Ethics and Health Legislation Services included in the Degree in Nursing, during the 2016–2017 academic year.

Methods

A prospective quasi-experimental study was carried out on a sample of 116 students. 10 multiple-choice questions were designed, with only one possible correct answer and a 20-second-limited response time for each of the questions. Four of these questions previously answered in the classroom using this game were chosen (20% of the exam). Each one of them corresponded to one unit of the topics taught in the subject.

In order to participate in the educational game, students needed their smartphones or electronic devices. After completing the game, the students’ satisfaction level derived from its use was assessed.

Results

The correct answer rate in the educational game was greater than 50% for all questions except for one, in which the rate was 28.8% (P<0.05). Response time as related to score presented statistically significant differences, and higher scores for those questions with lower response time (P<0.001).

The questions included in the final test which had been previously answered using Kahoot! showed a significantly higher difficulty index than the rest of the final exam questions (P<0.05). Question 3 was the easiest, while being the one in which the highest-scoring students obtained more wrong answers.

For the students this tool was easy to use (89.6%) and they positively valued the content acquisition and comprehension, as well as the teacher-student interaction (P<0.05).

Conclusion

The implementation of educational games which consider response time and correct answers favors competitiveness and motivates students to actively participate in their learning process.

Student perceptions, experiences and support within their current Bachelor of Nursing

BACKGROUND

This study was developed to assist academics and curriculum designers to understand the perspectives and expectations of students when designing a program of study and inclusive of students as partners. The purpose of this qualitative study was to explore the perceptions and experiences of students enrolled in the Bachelor of Nursing (BN).

SETTINGS, PARTICIPANTS, METHODS

The setting is a multi-campus university in Australia. Participants were currently enrolled and recruited from the Bachelor of Nursing, Bachelor of Nursing Advanced and Bachelor of Nursing Graduate Entry. Semi-structured focus group interviews and thematic analysis was used to collect and analyse the data.

RESULTS

Three major themes were identified from the focus group interviews: 1. Expectations; 2. Interesting and stimulating; and 3. Preparedness for study and clinical practice.

CONCLUSION

Students held strong personal reasons for pursuing a nursing degree. The geographic location and international rankings were factors for choosing the university in this study. Student's perceptions and experiences of the curriculum and support identified that their BN program was interesting and adequately prepared them for clinical practice. Some areas for improvement were more detail during program orientation related to clinical practice requirements and more assistance with engaging with learning and teaching technologies.

Nursing students' perceptions of a clinical learning assessment activity: 'Linking the puzzle pieces of theory to practice'

The nursing profession struggles with providing a bridge to close the theory to practice gap for students. Students are expected to graduate with competencies that promote their safe and comprehensive nursing care provision in accordance with professional standards. This paper reports on students' a simulated clinical educational intervention embedded into a second-year nursing student clinical topic offering experiential learning opportunities for a large cohort. Feedback was analysed using Braun and Clarke's (2006) thematic qualitative process to investigate student-learning experiences and present student perceptions of this experience. Three key themes were identified: support promoted learning, focus on the bigger picture and practice clarifies puzzle pieces. Students perceived the simulated clinical experience as beneficial to their confidence, learning and ability to develop their professional practice. Promotion of learning outcomes facilitated by the structured, supportive and educational approach was important for students. Nurse educators have a responsibility to develop learning experiences that enable student's ability to link theory to practice in context. Ongoing exploration and evaluation of this intervention is required however, such an approach appears to support student's knowledge development for transference across situations and within large student cohorts.

Using a Continuing Multimedia Case Study to Develop Critical Thinking and Empathy

BACKGROUND

Critical thinking and empathy are essential elements in attaining competencies expected of Bachelor of Science in Nursing graduates. Our purpose is to describe the use of a continuing multimedia case study in a large online course, including the pedagogical framework, implementation, and impact on student learning.

METHOD

We adapted qualitative analysis strategies to thematically analyze data from course assignments to demonstrate evidence of the development of critical thinking and empathy.

RESULTS

Students reported a variety of critical thinking skills acquired through continuous examination of patient problems and completion of case study-based tasks. Students described changes in their emotions and attitudes toward the older adult patient in the case study and the population represented with empathy as the dominant emotion.

CONCLUSION

The use of a continuing multimedia case study provided a successful platform for enhancing the learning of didactic content and the development of critical thinking and empathy. [J Nurs Educ. 2019;58(3):169-172.].

Characteristics of nursing students with high levels of academic resilience: A cross-sectional study

BACKGROUND

Academic resilience is an important characteristic that helps nursing students, who must engage in intensive learning and clinical practice, to overcome academic stress and adapt to their school and the clinical field.

OBJECTIVES

To determine the characteristics of nursing students with high academic resilience.

DESIGN

This study used a cross-sectional design.

SETTING

Three universities in South Korea.

SUBJECTS

We recruited a convenience sample of 254 nursing students.

METHODS

Academic resilience, general characteristics, clinical practice stress, clinical practice satisfaction, and social-affective capability were assessed via self-reported questionnaires. The collected data were analyzed using descriptive statistics, chi-squared test, and analysis of variance with Tukey's post hoc test.

RESULTS

The mean academic resilience score was 3.79. A greater proportion of respondents with high levels of academic resilience had good interpersonal relationships (χ² = 35.175, p < .001), high academic grades (χ² = 30.968, p < .001), a role model (χ² = 9.770, p = .033), and high satisfaction with their major (χ² = 20.214, p = .001). Significant differences in the subscale scores for clinical practice stress, including burden of clinical tasks (F = 4.727, p = .010), conflict of interpersonal relations (F = 4.889, p = .008), and conflict with patients (F = 7.023, p = .001), were found among the academic resilience groups. We also observed differences in the subscale scores of clinical practice satisfaction, including practice content (F = 4.894, p = .008) and practice environment (F = 8.301, p < .001). Respondents in the high resilience group had higher social-affective capability scores than did those with lower resilience (F = 43.994, p < .001).

CONCLUSION

Based on our results, students with high academic resilience are more likely to continue their studies and benefit from programs that strengthen their social-affective capability. We therefore propose that nursing school curriculum focus on enhancing social-affective capability.

Promoting emotional intelligence and resilience in undergraduate nursing students: An integrative review

OBJECTIVE

To synthesize the evidence that explored resilience and emotional intelligence in undergraduate nursing students.

BACKGROUND

Nursing is a demanding profession that offers unique challenges. Emotional intelligence and resilience are traits that can allow nursing students to effectively respond to challenges in professional placements and future practice.

DESIGN

An integrative review incorporating both quantitative and qualitative research designs.

DATA SOURCE

Studies in the English language were identified through a systematic search in electronic databases: CINAHL, PubMed, ERIC, Scopus and PsycINFO. No restriction dates were used and the search was up until November 1, 2017.

REVIEW METHODS

Methodological quality was assessed using the Critical Appraisal Skills Programme checklist for qualitative research and the Newcastle-Ottawa Quality Assessment Scale for quantitative research. Data analysis was conducted based on the integrative review method.

RESULTS

Fourteen articles were included. A positive relationship was found between resilience and performance in undergraduate studies including professional experience placements. While some studies observed an important role for emotional intelligence for nursing students, there is currently insufficient evidence to conclude that emotional intelligence improves nursing students' communication, academic success and retention.

CONCLUSION

Developing skills, such as resilience, as part of nursing programs allows students to be better prepared to deal with the unique challenges in nursing practice.

Student-related factors affecting academic engagement: A qualitative study exploring the experiences of Iranian undergraduate nursing students

Background and aim

Academic engagement is an important indicator of quality of higher education. This study aimed to explain the experiences of undergraduate nursing students in terms of student-related factors affecting academic engagement.

Methods

This qualitative study was conducted in 2017 at Mashhad University of Medical Sciences in Iran. Data were collected using semi-structured interviews and focus groups with 7 and 16 undergraduate nursing students at Mashhad School of Nursing and Midwifery; respectively. Undergraduate nursing students of both genders who enrolled in different academic semesters with various academic achievements were selected. Data were analyzed using conventional content analysis approach proposed by Graneheim and Lundman, with the support of MAXQDA software.

Results

After analyzing the data, 374 initial codes were extracted, which ultimately conceptualized within six main categories including: “learning motivation”, “interest in learning”, “student participation in extracurricular scientific programs”, “self-directedness”, “mental concentration”, and “demonstration of emotions”.

Conclusion

The findings of this study indicated that student-related factors such as individual motivation and interest, mental concentration, participation in extracurricular activities, and self-directedness in learning, as well as students’ sense of satisfaction with learning could play important roles in the creation of academic engagement in undergraduate nursing students that need to be of interest to nursing educators and planners.

Participation of clinical nurses in the practical education of undergraduate nursing students

OBJECTIVE

To evaluate the level of participation of clinical nurses from Castellón where Universitat JaumeI nursing students do their clinical clerkship. To identify the variables that may influence clinical nurses' participation in students' clinical mentorship.

METHOD

This observational, cross-sectional and descriptive study was conducted by applying the validated Involvement, Motivation, Satisfaction, Obstacles and Commitment (IMSOC) questionnaire. The variables collected were: age, work environment and previous training. The study was conducted between January and December 2014.

RESULTS

The sample included 117 nurses. The overall mean questionnaire score was 122.838 (standard deviation: ±18.692; interquartile range 95%: 119.415-126.26). The variable "previous training for mentorship students" was statistically significant in the overall score and for all dimensions (P<.05). Primary care nurses obtained better scores in the dimension Implication than professionals working at other care levels.

CONCLUSIONS

The level of participation of the clinical nurses from Castellón is adequate. The previous training that professionals receive for mentoring students improves both their level of participation and primary care level. Extending this research to other national and international environments is recommended.

Student perception of the educational environment in regular and bridging nursing programs in Saudi Arabia using the Dundee Ready Educational Environment Measure

BACKGROUND

Taibah University offers regular nursing (RNP) and nursing bridging (NBP) bachelor programs. We evaluated student perception of the learning environment as one means of quality assurance.

OBJECTIVES

To assess nursing student perception of their educational environment, to compare the perceptions of regular and bridging students, and to compare the perceptions of students in the old and new curricula.

DESIGN

Cross-sectional survey.

SETTING

College of Nursing at Taibah University, Madinah, Saudi Arabia.

PATIENTS AND METHODS

The Dundee Ready Educational Environment Measure (DREEM) instrument was distributed to over 714 nursing students to assess perception of the educational environment. Independent samples t test and Pearson's chi square were used to compare the programs and curricula.

MAIN OUTCOME MEASURE

The DREEM inventory score.

RESULTS

Of 714 students, 271 (38%) were RNP students and 443 (62%) were NBP students. The mean (standard deviation) DREEM score was 111 (25). No significant differences were observed between the programs except for the domain "academic self-perceptions" being higher in RNP students (P < .001). Higher mean DREEM scores were observed among students studying the new curriculum in the RNP (P < .001) and NBP (P > .05).

CONCLUSION

Nursing students generally perceived their learning environment as more positive than negative. Regular students were more positive than bridging students. Students who experienced the new curriculum were more positive towards learning.

LIMITATIONS

The cross-sectional design and unequal gender and study level distributions may limit generalizability of the results. Longitudinal, large-scale studies with more even distributions of participant characteristics are needed.

Expert patient illness narratives as a teaching methodology: A mixed method study of student nurses satisfaction

OBJECTIVE

To evaluate nursing students' satisfaction with Expert Patient Illness Narratives as a teaching and learning methodology based on patient involvement.

METHODS AND DESIGN

Mixed methods were used in this study: online survey with quantitative and qualitative items designed by researchers.

SETTINGS AND PARTICIPANTS

Sixty-four nursing students of the Universitat Autònoma de Barcelona, attending a Medical Anthropology elective course.

RESULTS

Women more frequently considered that the new learning methodology was useful in developing the competency "to reason to reason the presence of the triad Health-Illness-Care in all the groups, societies and historical moments" (p-value=0.02) and in that it was consolidated as a learning outcome (p-value=0.022). On the other hand, men considered that this methodology facilitated the development of critical thinking (p=0.01) and the ability to identify normalized or deviant care situations (p=0.007). Students recognized the value of Expert Patient Illness Narratives in their nursing training as a way to acquire new nursing skills and broaden previously acquired knowledge. This educational innovation improved nursing skills and provided a different and richer perspective of humanization of care.

CONCLUSIONS

The results of the present study demonstrate that nursing students found Expert Patient Illness Narratives satisfactory as a learning and teaching methodology, and reported improvement in different areas of their training and also the integration of new knowledge, meaning, theory applicability, as well las critical and reflective thinking. Involvement of patients as storytellers also provides a new humanizing perspective of care. Nonetheless, further studies of Expert Patient Illness Narratives are needed in order to improve its benefits as a teaching and learning methodology.

A structural equation model on the attributes of a skills enhancement program affecting clinical competence of pre-graduate nursing students

BACKGROUND

Clinical competence remains an issue in nursing and has received greater emphasis than academic competence. Although skill enhancement programs are recommended and beneficial, there is limited evidence on its influence on the clinical competence of pre-graduate nursing students.

OBJECTIVE

This study explored the attributes of a skills enhancement program that affect the perceived clinical competence of pre-graduate nursing students.

DESIGN AND SETTING

A cross-sectional study was conducted in a private higher education institution in the Philippines from April to May 2016.

PARTICIPANT AND METHODS

A total of 245 pre-graduate nursing students participated and completed a three-part survey composed of the respondent's robotfoto, the Skills Enhancement Program Questionnaire, and the Clinical Competence Questionnaire. Factor analysis explicated the attributes of the skills enhancement program while structural equation modeling and path analysis analyzed the variables' relationship.

RESULTS

Findings showed that a skills enhancement program has 4 attributes: supportive clinical instructor, comprehensive orientation, formative goals and objectives, and conducive learning environment. Although all attributes of the program positively affected clinical competence, a supportive clinical instructor had the strongest influence on all clinical competency dimensions.

CONCLUSION

A skills enhancement program that has a supportive clinical instructor, comprehensive orientation, formative goals and objectives, and conducive learning environment facilitates clinical competency development among pre-graduate nursing students. This knowledge provides momentum for nursing educators to review and refine their skills and the existing design of their skills enhancement program to further develop clinical competency among pre-graduate nursing students.