Dreams and disappointments regarding nursing: Student nurses' reasons for attrition and retention. A qualitative study design

Exploring the motivations, expectations, and experience of graduate-entry nursing students: A qualitative research study

Current research demonstrates a sparsity of United Kingdom-focused research into graduate-entry nursing programmes, as well as a need for further research into motivations and expectations of graduate-entry nursing students. The aim of this study was to explore a graduate-entry nursing programme from a student perspective, with a specific focus on a) motivations for enrolling, b) expectations of the programme, and c) experience of the programme to date. A qualitative descriptive design was utilised. Three focus groups and one interview were conducted with students from two cohorts at a British university at multiple points during the two years of the programme. Qualitative data were analysed thematically, and findings presented back to participants. It was found that student motivations were consistent with previous research and key stressors were identified relating to both academic and placement elements of the programme. It is proposed that the underlying cause of stress amongst graduate-entry nursing students was a lack of perceived control over their experience. This finding is supported by Karasek's (1979) Job Demand-Control Model. It is suggested that increasing students' perceived control could decrease student stress, therefore improving retention and enhancing the student experience.

Effects of gamification on academic motivation and confidence of undergraduate nursing students: A systematic review and meta-analysis

OBJECTIVES

This review aimed to evaluate the effects of gamification on academic motivation and confidence among undergraduate nursing students and identify the game design elements contributing to these effects.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Comprehensive systematic searches were conducted to retrieve randomized controlled trials (RCTs) and quasi-experimental studies (QES) with control groups published in English and Korean from inception to January 31, 2024, using PubMed, Embase, CINAHL Plus, ERIC, ProQuest Central, Cochrane Library, and RISS.

REVIEW METHODS

Eligible studies, including grey literature, were selected. The quality of the selected studies was evaluated using the Joanna Briggs Institute Critical Tool. Meta-analyses based on a random-effects model were conducted to estimate the standardized pooled effects (SMD). Subgroup analyses were conducted to identify the effect size moderators and game design elements that contributed to the effect size. The grading of recommendations, assessment, development, and evaluation approach (GRADE) was used to evaluate the certainty of evidence.

RESULTS

A total of 22 studies were selected for the systematic review, and 18 studies were included in the meta-analysis. The SMD for academic motivation (SMD of RCTs = 0.86, 95 % CI [0.27, 1.45]; SMD of QES = 1.22, 95 % CI [0.17, 2.26]) and confidence (SMD of RCTs = 1.11, 95 % CI [0.54, 1.68]; SMD of QES = 0.79, 95 % CI [0.40, 1.19]) revealed moderate-to-large effects. The subgroup analysis revealed significant differences in effect sizes across academic years, measurement scales, study areas, study quality, game duration, and game design elements. GRADE assessments for academic motivation and confidence were rated as moderate and low, respectively.

CONCLUSION

This review provides convincing evidence for the positive effects of gamification interventions on academic motivation and confidence among undergraduate nursing students. However, the limited number of RCTs and moderate-to-low certainty of the evidence underscore the need for additional research.

Exploring the relationship between grit scores and academic potential in baccalaureate nursing students

BACKGROUND

An ongoing nursing shortage poses significant challenges to the healthcare industry, prompting nursing education programs to find ways to increase nurse graduates. Unfortunately, the problem of attrition in nursing education is significant. Despite many years of attrition research, educators still seek to find answers to determine what factors cause some students to succeed and others to fail in nursing programs. Noncognitive variables, like grit, have been largely overlooked as potential solutions to the problem of attrition.

PURPOSE

The purpose of this study was to explore the extent to which grit predicts academic potential in baccalaureate nursing students.

METHODS

This cross-sectional study included a total of 63 baccalaureate nursing students in their first semester of a four-semester nursing program at a mid-sized public university in East Texas. Participants took an electronic survey reporting demographic information, completing the Short Grit Scale (Grit-S), and consenting to release of their pre-admission science grade point average (sGPA), ATI Test of Essential Academic Skills (TEAS) exam scores, and first-semester nursing GPA (nGPA).

RESULTS

When added to sGPA and TEAS scores, grit scores were not a statistically significant predictor of nGPA. Students with high grit scores were just as likely to experience attrition as those with low scores, and grit did not statistically significantly predict first-semester attrition.

CONCLUSIONS

Nurse educators are encouraged to pursue strategies to address attrition in nursing education. Traditional selection criteria of sGPA and TEAS exam scores were shown to be predictors of nGPA. Additional research is warranted to explore the relationship between noncognitive variables, especially grit, and nursing student academic potential.

Caring for nursing students is caring for patients: A multicentre cross-sectional study on the relationship between nursing students' caring and the perception of instructors' caring

BACKGROUND

Caring in nursing is a fundamental aspect, yet teaching and fostering caring behaviours in nursing students remain challenging. Clinical instructors play a crucial role in this process.

OBJECTIVES

The aims of this study were a) to describe nursing students' caring behaviours and perceptions of instructor caring, b) to assess sex-related and year of course differences in students' caring behaviours and perceptions of nursing caring, and c) to investigate the association between nursing students' caring and their perception of instructors' caring.

DESIGN

A multi-centre, cross-sectional observational study was conducted.

SETTING

The study involved undergraduate nursing students from four teaching hospitals of a university in Northern Italy.

PARTICIPANTS

A total of 316 nursing undergraduate students participated in the study (83.9 % female, 16.1 % male, 23.1 % 1st year, 48.1 % 2nd year, 28.8 % 3rd year).

METHODS

Participants completed online self-reported surveys assessing caring behaviours, empathy, burnout, and perceptions of instructor caring. Caring behaviours, expressive and instrumental caring, were measured using the Caring Behaviour Inventory (CBI), and perceptions of instructor caring were assessed using the Nursing Students' Perceptions of Instructor Caring (NSPIC) questionnaire.

RESULTS

Students' caring behaviours were positively associated with their perceptions of instructor caring, particularly in relation to a supportive learning climate and instructor flexibility. Female students displayed higher scores in expressive caring, while students in their second and third years demonstrated increased instrumental caring behaviours. Responding to Individual Needs was significantly lower in third-years students, compared to first- and second-year ones.

CONCLUSIONS

This study emphasizes the crucial role of clinical instructors in shaping nursing students' caring attributes. However, the influence of sex on caring behaviours remains unclear, necessitating further investigation. These findings underscore the significance of nurturing caring behaviours in nursing education and offer insights for selecting, training, and supporting clinical instructors, to foster more compassionate and competent nurses.

International graduate entry nursing students: A qualitative study on engagement

AIM

This study aims to elicit graduate entry nursing students' views on factors that enable and constrain their learning engagement.

BACKGROUND

Learning engagement has been associated with student retention/attrition and the achievement of learning confidence and success. While all students are subject to challenges that affect their learning engagement, those experienced by international students who are learning in a foreign and unfamiliar context are of particular concern to academics. An understanding of international graduate entry nursing students' perspectives on factors that enable and constrain their engagement can inform development of learning and teaching strategies that are more responsive to the needs of this group of students and can support their learning achievement.

DESIGN

A qualitative descriptive design conducted in one Australian multi campus university School of Nursing. Participants included first and second-year international students enrolled in a graduate entry Master of Nursing course.

METHODS

Data, including demographic information, was collected via a theoretically informed online survey consisting of a Likert scale and open- ended questions. This study reports participant responses to open ended questions included in the survey. A thematic analysis was used to interpret findings.

FINDINGS

Analysis identified participants' perspectives on factors that influenced their learning engagement in four theme areas: 1) Availability of study support resources, 2) Opportunities for social interaction, 3) Opportunities to build a sense of belonging, and 4) Constraints on development of a sense of engagement. Opportunities for social engagement emerged as a dominant finding across all themes.

CONCLUSION

This research, which focused on international students' perspectives on learning engagement, contributed to existing knowledge on student engagement in higher education graduate entry nursing courses. Opportunities for social interaction within and beyond formal course learning experiences were valued by students and identified as key to their learning engagement. These findings have implications for academics and student support services who together, can influence the context of students learning to better meet their engagement needs.

Nursing Students' Perceptions About the Culture of Nursing: A Focused Ethnography Study

AIM

The aim of this study was to gain students' perspectives on the culture of nursing and their enculturation to this professional culture.

BACKGROUND

Newly graduated registered nurses (NGRNs) experience identity shock when transitioning to practice, at great costs to themselves and health care organizations. Understanding how nursing students view their professional culture and the enculturation process can foster professional identity formation and ameliorate NGRN identity shock.

METHOD

This focused ethnography study used focus groups for data collection and Leininger's method of data analysis.

RESULTS

Two themes emerged: 1) descriptors of the culture of nursing and 2) influence of formal and informal learning.

CONCLUSION

Nursing students struggle to define the culture of nursing, contributing to challenges with the enculturation process and leading to identity shock. Intentionally addressing these challenges can help decrease identity shock, promote stronger professional nursing identity formation, and improve the transition to nursing practice.

Improving success and retention of undergraduate nursing students from rural and remote Australia: A multimethod study protocol

AIM

The aim of the proposed research is to develop, pilot and evaluate a novel, bespoke intervention with in-built consideration of the factors influencing attrition and barriers to retention for rural and remote undergraduate nursing students.

BACKGROUND

There are high rates of attrition in nursing students with rural and remote backgrounds in Australia. However, there is a lack of understanding of what enables or impedes these students to progress in their studies and the strategies available to support them to become part of the nursing workforce. Addressing these gaps is critical to informing the efforts of those involved in nursing education, training and workforce planning.

DESIGN

A multi-methods study.

METHOD

A project involving a multi-methods approach will be undertaken at an Australian higher education institution. In the first exploratory study, interviews and student cohort data will be used to understand attrition and retention, influencing factors and barriers to retention among rural and remote undergraduate nursing students. Findings from this study will be used to guide the development and implementation of a novel tailored student support service targeted to increase retention for this cohort. In the final evaluation study, the attrition and retention outcomes of participating students will be examined via interviews, surveys and existing cohort retention data.

EXPECTED RESULTS

The study will provide insights into the factors that can shape the retention experiences of rural and remote undergraduate nursing students and generate much needed evidence concerning what Higher Education Institutions can do to support the retention for this specific student cohort.

Perceptions of nursing staff and students regarding attrition: a qualitative study

OBJECTIVES

This research aims to explore the perceptions of nursing students and directors of bachelor of nursing degree courses regarding reasons for attrition amongst nursing students.

METHODS

A qualitative descriptive study was conducted using inductive thematic analysis. The study included a purposeful sample of 12 students and 4 directors of bachelor of nursing degree courses.

RESULTS

As reasons for attrition, the directors highlighted a lack of preparation for nursing studies and students' limited awareness of possibilities for support and learning. The students emphasized insufficient support from academic staff and poor course organization. Economic and family issues and a misunderstanding of the professional role of a nurse were cited as reasons by both directors and students.

CONCLUSIONS

The findings provide important insight into attrition in the nursing programme. Further research is warranted, particularly in other contexts. Addressing student attrition requires a comprehensive approach that includes the provision of adequate support systems, mentorship, and resources for students.

The effect of digitalization on the career intentions of nursing students: A cross-sectional study

AIM

We investigate how the confirmation of expectations about digital technology in the workplace affects the career intentions of nursing students. We also explore the role of task fit in mediating (1) digital technology satisfaction and job satisfaction and (2) digital technology satisfaction and career intentions.

BACKGROUND

The turnover of graduating geriatric nursing students is very high and rising. To support the work of nursing staff, elderly care institutions are beginning to adopt digital technologies that aid in nursing tasks. However, it is unclear whether students' perceptions of those digital technologies have an impact on their career intentions.

DESIGN

This is a cross-sectional study.

METHODS

We recruited 549 geriatric nursing students. Data were collected from December 2022 to March 2023. The questionnaire included seven sections: expectation confirmation, perceived usefulness, perceived safety, digital technology satisfaction, task fit, job satisfaction and career intentions. The validity and reliability of the model were confirmed.

RESULTS

The results show that the confirmation of students' expectations for the digital technology used in elderly care services has a positive impact on their career intentions. However, the results do not confirm the impact of perceived security on digital technology satisfaction, or the effect of job satisfaction on career intentions.

CONCLUSION

Elderly care institutions and educators should monitor the current state of the digital work environment to ensure that it can adequately support students in their work. They should ensure the use of advanced and appropriate technology tools in teaching and clinical environments to provide a richer and more vivid learning experience. These initiatives can support nursing students in their transition from school to practice and increase their willingness to stay in the profession.

Perceptions of being a registered nurse (PRN): development and validation of a survey tool

BACKGROUND

Nursing students enter nursing programs with idealistic perceptions of what it is to be a nurse. Upon graduation, many find these perceptions mismatched with the actual nurse's role. This can lead to discontentment in their chosen career. These issues highlight the importance of nursing students developing an understanding of the nurse's role during their undergraduate nursing education. One way to accomplish this is to assess perceptions and address them accordingly during the nursing program. Survey tools assessing perceptions of nursing exist but lack contemporary and multicultural foci.

AIM

To develop a feasible, valid, and reliable survey tool to identify nursing students' perceptions of being a nurse.

DESIGN/METHODS

In Phase 1, a literature review and Nominal Group Technique meetings were used to generate primary survey items. Phase 2 included a pre-pilot and online pilot testing of the Perceptions of being a Registered Nurse (PRN) survey tool with 797 nursing students across all year levels at three Australian Universities.

RESULTS

The 34-item PRN survey tool uses a five-point Likert scale to measure nursing students' perceptions of nursing, including factors influencing a nurse's well-being, attributes and qualities of nurses, the role of the nurse, and nursing professionalism. The Item-Content validity index was high (> 0.78), and the inter-item correlation validity was identified by Pearson's product-moment coefficient of r = .712. Internal reliability was confirmed with a Cronbach's alpha = 0.83. Based upon the participation completion rate, the survey tool was deemed applicable and feasible. The majority of respondents believed that nurses have altruistic attributes; however, perceptions of nursing varied significantly when rating factors influencing the physical, emotional, and social well-being of a nurse. In later stages of training, respondents were more likely to agree that nursing is physically and emotionally demanding and that nurses experience social isolation due to shift work, finding it difficult to achieve a work-life balance.

CONCLUSIONS

The PRN survey tool was found to be valid, reliable, and feasible. Future use and outcomes from PRN assessments may lead to changes to nursing curricula that enhance nursing students' perceptions of nursing.

Exploration of nursing students' views on the theory-practice gap in surgical nursing education and its relationship with attitudes towards the profession and evidence-based practice

AIM

The aim of this study was to explore nursing students' views on the theory-practice gap in surgical nursing education and determine its relationship with attitudes towards the profession and evidence-based practice.

BACKGROUND

In nursing education, the discrepancy between the theoretical knowledge and clinical practices is known as the "theory-practice gap". Although this problem was defined many years ago, scientific information on the subject is very limited in terms of surgical nursing.

METHOD

This descriptive-analytical and cross-sectional study was carried out in three different universities in the Black Sea Region of Türkiye. The sample consisted of 389 nursing students. The data collection was carried out in May-July 2022 through the use of the following tools: The Attitude Scale for the Nursing Profession (ASNP), the Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice (KABQ-EBP) and the researchers made form to determine students' views on the theory-practice gap. The data were analysed with Student's t-test, multiple linear regression analysis.

RESULTS

72.8% of the students stated that they thought there was a discrepancy between their theoretical surgical nursing courses and clinical practice. While the total ASNP score of students who thought that there was a discrepancy between theoretical education and clinical practice was lower than that of the other students (p = 0.002), no difference was found among the students in terms of the total KABQ-EBP score (p > 0.05). In the multiple linear regression analysis, it was determined that thinking about gap (β = -0.125, p = 0.009), gender (β = -0.134, p = 0.006), willingness to choose the profession (β = 0.150, p = 0.002) and KABQ-EBP score (β = 0.247, p < 0.001) had significant effects on nursing students' attitudes towards the profession. In the model, %12 of the total variance was explained by the variables.

CONCLUSION

The study shows that the gap between theory and practice for the surgical nursing course is a problem perceived by most students. Also, students who thought that there was a theory-practice gap for the surgical nursing course had a more negative attitude towards the profession, while their attitudes towards evidence-based nursing were not different from others. The results of this study encourage further research to gain a better understanding of the impact of the gap between theory and practice on nursing students.

Factors Influencing Retention among Regional, Rural and Remote Undergraduate Nursing Students in Australia: A Systematic Review of Current Research Evidence

BACKGROUND

This systematic review aimed to explore the factors influencing retention among regional, rural, and remote undergraduate nursing students who were enrolled in Australian universities.

METHODS

Mixed-methods systematic review. A+ Education, CINAHL, Education Resources Information Center (ERIC), Education Research Complete, JBI EBP database, Journals@Ovid, Medline, PsycINFO, PubMed, and Web of Science were systematically searched from September 2017 to September 2022 to identify eligible English-language studies. The methodological quality of the included studies was critically assessed using the Joanna Briggs Institute's critical appraisal tools. Descriptive analysis with a convergent segregated approach was conducted to synthesize and integrate the results from the included studies.

RESULTS

Two quantitative and four qualitative studies were included in this systematic review. Both the quantitative and qualitative findings demonstrated that additional academic and personal support was essential for improving retention among undergraduate nursing students from regional, rural, and remote areas in Australia. The qualitative synthesis also highlighted many internal (e.g., personal qualities, stress, ability to engage with classes and institutions, time management, lack of confidence, cultural well-being, and Indigenous identity) and external factors (e.g., technical difficulties, casual tutors, different competing demands, study facilities, and financial and logistical barriers) that influenced retention among undergraduate nursing students from regional, rural, and remote areas in Australia.

CONCLUSIONS

This systematic review demonstrates that identifying potentially modifiable factors could be the focus of retention support programs for undergraduate nursing students. The findings of this systematic review provide a direction for the development of retention support strategies and programs for undergraduate nursing students from regional, rural and remote areas in Australia.

Digital adaptability competency for healthcare professionals: a modified explorative e-Delphi study

AIM

To establish items of the digital adaptability competency for healthcare professionals.

BACKGROUND

While the application and deployment of eHealth has continued at a rapid pace, healthcare professionals are expected to keep up and join the digital evolution. The implementation of eHealth requires a change in the healthcare professionals' competencies of which the ability to adapt to technological change is fundamental. There's more needed than just ICT skills, overall competencies to be digitally adaptable between patientcare and the use of eHealth are needed. Today, a distinct and relevant list of items for healthcare professionals related to the competency of digital adaptability is missing.

DESIGN

An exploratory modified e-Delphi study.

METHODS

This study was conducted in Flanders, Belgium. An expert group (n = 12) consisting of 2 policymakers of the Belgian federal government, 3 eHealth managers of large organizations in the Belgian healthcare sector, 1 nurse, 1 midwife, 2 health service users and 3 researchers specialized in eHealth research. Through a literature review an initial list of items was developed, consisting of 67 statements. A two-round Delphi survey was performed where experts could rate the relevance of each item. The third round comprised an online meeting, where the expert group discussed the remaining items until agreement was reached to retain, modify, or eliminate the item.

RESULTS

In round 1, eleven items were included to the final document. In round 2, ten items were included. In round 3, the panel unanimously agreed to add six items, one item was modified into two separate items. In total, 29 items were included in the final document.

CONCLUSIONS

The rather abstract concept of digital adaptability is now transformed into a more pragmatic concept of 29 items, reflecting the practical competencies of healthcare professionals necessary to be digital adaptable.

Correlates of resilience among university students in Oman: a cross-sectional study

BACKGROUND

Resilience has a paramount role in dealing with different life stressors and has a great impact on mental health.

AIM

To assess the level of resilience among university students and explore the relation between resilience and a number of variables including psychological well-being, self-esteem and physical health.

METHODS

A cross-sectional design was utilized. Data was collected from 676 university students. Students were required to complete a demographic sheet, Brief Resilience Scale, World Health Organization Well-Being Index, Rosenberg Self-Esteem Scale and a physical health survey.

RESULTS

Overall, less than half of the participants have reported low levels of resilience (45.3%; n = 306). Regular sleep, perceived stress, WHO well-being index, self-esteem, and having a cumulative GPA of more than two, were factors that significantly predicted positive resilience in multivariate analysis.

CONCLUSION

Resilience is a necessary skill among university students that requires more academic attention. Factors predicting positive resilience should be considered when implementing mental health promotion programs.

Resilience in nursing education: an evolutionary concept analysis

OBJECTIVES

Resilience is a complex concept that is extensively drawn upon in higher education, nursing included. The objective is to examine the concept of resilience and its use within nursing education.

METHODS

Rodgers' evolutionary concept analysis was used to explore this concept.

RESULTS

The current focus on fostering resilience in undergraduate nursing education predominantly focuses on educational interventions to support one's ability to self-care continues to be pervasive within the nursing literature. More recent dialogue encourages a more holistic approach that examine interventions from both individual and structural perspectives.

CONCLUSIONS

Recommendations for future research are to examine the synergy between individual, contextual, and structural factors to support resilience in nursing students.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Based on the concept analysis, resilience is contextual. Therefore, nurse educators may support and foster nursing students' resilience by having increased awareness of both individual and structural perspectives of resilience.

Expectations of learner nurses in sampled clinical areas of the Limpopo province, South Africa

BACKGROUND

Nurse training in South Africa requires placing learner nurses in real-life setting for them to gain practical experience. To complete their training and be competent practitioners, learner nurses must have expectations and aspirations when they go for practice.

AIM

This study sought to understand learner nurses' expectations at clinical learning areas during placement.

SETTING

Four clinical learning areas in the Limpopo province were purposely sampled. Tertiary, regional and district hospitals were sampled to obtain information from different levels of care.

METHODS

A qualitative, descriptive and contextual design was used to explore the expectations of learner nurses during clinical placements. Permission to conduct the study was obtained from various bodies and ethical considerations were ensured. Nonprobability purposive sampling was used, and six focus groups were formed. Each focus group discussion (FGD) had six to eight participants. The FGDs were according to level of study, with the third and fourth levels each having two FGDs because of the number of participants.

RESULTS

The following three themes emerged: milieu in the clinical learning areas, learning in the clinical areas and self-actualisation.

CONCLUSION

The clinical learning areas are institutions of promoting learning through practice. They should promote learning and offer support to learners so that learners meet their expectations, which may prevent discouragement and attrition.

CONTRIBUTION

This study adds to the body of knowledge in nursing education and practice because when students' expectations are met, their training outcome might be positive leading to competent professional nurses.

Underrepresented Ethnic Minority Nursing Students' Perceptions of Factors That Enhanced or Hindered Their Self-Efficacy

Self-efficacy is the perceived confidence of students in their ability to learn new skills and knowledge. This study examined underrepresented ethnic minority students' perceptions of the factors that enhanced/hindered their self-efficacy in a bachelor of science in nursing program. Qualitative analysis revealed three themes: 1) doing it, 2) connecting with clinical faculty, and 3) dealing with multiple stressors. Students described clinical faculty's teaching strategies that enhanced their nursing self-efficacy as they managed multiple stressors in their lives.

The lived experience of nursing students who were unsuccessful in an undergraduate nursing program-A narrative inquiry

BACKGROUND

Historically, attrition rates among nursing students in the United States have been a significant problem. However, beyond academic struggles, little is known about the unsuccessful experiences of nursing students. A glimpse into unsuccessful nursing students' perceptions and stressors, other than academic requirements, provides a framework for nurse educators to develop an identification system for at-risk students.

DESIGN

This study aimed to focus on the student perception of failure, beyond academic results. A phenomenological study using narrative inquiry methodology was used for the study.

PARTICIPANTS

The purposive sampling approach included thirty-seven students who were unsuccessful in a baccalaureate nursing program. All students were interviewed and analysis was completed.

METHODS

Our analysis revealed both intrinsic and extrinsic motivators presented as an important factor for each student's success. Although each participant had unique circumstances, common themes emerged. These findings support the need for support that goes beyond support with academic studies.

RESULTS

Holistic admissions processes need to be utilized, ensuring the best candidates, are admitted to nursing programs. Admission criteria should expand beyond grade point average requirements, and possibly include some form of stress management evaluation, or consideration of extrinsic influences.

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.

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.

Undergraduate nursing students' experiences of becoming a professional nurse: a longitudinal study

Background

During education it is essential for nursing students to develop professionalism in nursing. Nurses are placed in situations based on trust, and it is crucial that their patients have confidence in them to provide professional and safe care. A key period in nursing students’ development of a professionalism occurs during training when students gain knowledge and skills that separate nurses as professional healthcare workers from laypeople. The purpose of this study was to investigate nursing students’ experiences of professional competence development during education.

Methods

A longitudinal study was carried out using qualitative content analysis with a manifest inductive approach. Thirty-four students enrolled in a Swedish three-year nursing program, from August 2015 to January 2017 were interviewed on four occasions.

Results

The results revealed that students’ professional role developed gradually. The students’ started their education with dreams and a naive understanding of the profession, but their understanding of the complexity of the nursing profession gradually evolved. Students became theoretically equipped at the university and developed clinical skills through practice. Students’ focus went from mastering medical technology to a more holistic approach. Before graduating, students felt ready but not fully trained.

Conclusions

Our findings indicate a discrepancy between the content of the theoretical education and the clinical settings since students identified a lack of evidence-based practice. A solid theoretical education before entering clinical training offered students possibilities for reflecting on evidence-based practice and the clinical settings. The realization that there is always potential for professional improvement can be interpreted as an emerging awareness, and development of professionalism. It is clear that students could benefit from increased collaborative work between clinical supervisors and faculty staff at the university.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01002-0.

The perceptions of nursing students regarding coronavirus and occupation according to gender: A qualitative study

Outbreaks are experienced differently based on gender. In the context of the Covid-19 epidemic, students' perceptions of the nursing profession, their feelings related to themselves, their social circle, nursing, and the appropriateness of nursing practices are important. This study aimed to determine the perceptions of nursing students of the Coronavirus and their occupation according to gender. Twenty nursing students were interviewed using the semi-structured interview method. Content analysis and MAXQDA were performed. Five categories were identified: Visual perceptions regarding the nursing occupation and Covid-19, future nurses' occupational perceptions according to gender of pandemics such as the Coronavirus, the effect of the pandemic on occupational perception, perceptions of the people around them of their profession in relation to the pandemic, and the approach toward any pandemic in the future in terms of their profession as a nurse. Pandemics such as Covid-19 can affect the occupational perceptions of nursing students.

Isolation and Marginalization: Exploring Attrition of Men in Preregistration Nursing Programs

BACKGROUND

In Scotland, similar to other countries, male nursing students have a high attrition rate. This study examined the reasons for and ways to decrease the attrition rate.

METHOD

This four-phase collaborative study included four Scottish universities. Phase 1 involved three telephone interviews with men who had left a nursing program. Phases 2 through 4 used focus groups and interviews with 18 nursing students (13 men and 5 women) and 12 nurse lecturers. Thematic analysis followed a four-stage process.

RESULTS

Male nursing students in this study felt isolated and marginalized, were stereotyped regarding their masculinity and physical attributes, had difficulty communicating, and were reluctant to seek help. Financial pressures and access to learning opportunities also disproportionately affected male students. Resilience and maturity are required to cope with these challenges.

CONCLUSION

Proactive measures and visible role models in academic and clinical environments are needed to support male students in completing their nursing education. [J Nurs Educ. 2022;61(4):179-186.].

Exploring the experiences and perceptions of students in a graduate entry nursing programme: A qualitative meta-synthesis

BACKGROUND

Students commencing graduate entry fast-tracked nursing programmes leading to registration are highly motivated and characterised by rich life experiences. Given their unique motivations and characteristics, gaining insight into their experiences of graduate entry programmes will inform strategic directions in education.

OBJECTIVE

To synthesise graduate entry nursing students' self-reported experiences and perceptions of their accelerated programme.

DESIGN

Qualitative meta-synthesis.

DATA SOURCES

Databases included Cumulative Index of Nursing and Allied Health Literature, Emcare, Education Resources Information Centre, Medical Literature Analysis and Retrieval System Online, Psychological Information and Scopus. Qualitative studies published in English and reporting primary data analysis including experiences and perceptions of graduate entry nursing students were considered.

REVIEW METHODS

Qualitative studies were systematically identified and critically appraised. The meta-synthesis used an open card sort technique to organise data into a matrix of graduate entry nursing students' experiences and perceptions.

RESULTS

Fourteen studies were included. The analysis revealed three primary themes: what I bring and what I come with, developing a sense of self and nursing self, and what I need. Within these themes we found potential enablers of student success in learning; space, working together, and balancing work and life and learning to bridge two worlds. Students reflected on the benefits of academic support and shared their experiences of learning in clinical placement. In addition, students acknowledged the importance of clinical educators and preceptors who provided bridging that was further scaffolded by simulated learning experiences.

CONCLUSIONS

Findings indicate graduate entry nursing students have important needs and expectations of support in transition. The experiences and perceptions of graduate entry nursing students differentiated into what students arrived with, what support they need in their journey to become a nurse, alongside their experience of building a sense of self and their nursing self.

SYSTEMATIC REVIEW REGISTRATION NUMBER

CRD42020220201.

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.

Missed nursing care as experienced by undergraduate nursing students

Background: In clinical settings where missed nursing care prevails, nursing students' instructions, supervision and the joint reflection on clinical practice with mentors are also affected and nursing students become involved in dealing with missed nursing care.

AIM

To explore the experience of missed nursing care in clinical placements, its meaning for nursing students, and actions they considered or took.

METHODS

Qualitative study based on a content analysis of nursing students' written reports. Nursing students in three universities in Germany with experience of at least one clinical practice placement were invited to participate. Online, they answered three open questions concerning missed nursing care focusing on: (1) experiences of the phenomenon, (2) its meaning and (3) actions that had been considered or taken when dealing with missed nursing care. A content analysis was performed.

RESULTS

The recruitment criteria were met by 69 nursing students. Four main themes and 20 sub-themes were identified. The reports covered all forms of missed nursing care. Becoming involved led to intrapersonal conflicts and, feelings of powerlessness but also to learning opportunities. It challenged professional and ethical standards. Students identified a broad spectrum of actions to answer the challenge.

CONCLUSION

Dealing with missed nursing care creates opportunities and challenges for nursing students. To build up a well-trained and sustainable nursing workforce, learning environments for nursing students must reflect the challenges and counteract deficits.

The Rural Nursing Workforce Hierarchy of Needs: Decision-Making concerning Future Rural Healthcare Employment

Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career.

Nurses' Perceptions of the Factors Contributing to the Development of the Love of the Profession: A Qualitative Content Analysis

As a professional value, the love of the profession can significantly affect nurses’ professional practice, behaviors and commitment. Many different factors can affect the love of the profession. The exploration of nurses’ experiences of these factors can provide valuable data for development of the love of the profession. The aim of this study was to explore nurses’ perceptions of the factors contributing to the development of the love of the profession. This qualitative study was conducted in 2020–2021 using the conventional content analysis approach. The participants were thirteen nurses with different organizational positions purposively recruited from different settings in Iran. The data were collected via semi-structured interviews, and were analyzed via the conventional content analysis approach proposed by Graneheim and Lundman. The factors contributing to the development of the love of the profession were categorized into four main categories, namely the public perception of the profession (with three subcategories), educational variables (with two subcategories), the characteristics of the profession (with four subcategories), and nurses’ self-evaluation (with three subcategories). The love of the profession is affected by a wide range of personal, educational, professional and social factors. The manipulation of these factors would help to develop nurses’ and nursing students’ love of the profession, and encourage people to choose nursing as a career.

Academic dismissal from a baccalaureate nursing program: The student's perspective

BACKGROUND

The dismissal of a nursing student is distressing for the student and may be viewed as a failure of the admissions process or a lack of support by the school to ensure student success. While student dismissal is often associated with student characteristics such as academic performance prior to enrollment or during the nursing program, there was a dearth of studies that examined student dismissal from an in-depth analysis of the student's perspective.

PURPOSE

The purpose of this study was to describe and explore factors contributing to academic dismissal, particularly from the student's perspective.

METHOD

Using the lens of Critical Pedagogy, the investigator interviewed nine students dismissed from a baccalaureate nursing program. Students were asked to describe their experiences from the time they decided to pursue nursing school, during school, and after dismissal.

RESULTS

Findings of this study suggest that intrinsic and extrinsic factors that contribute to a student's choice of pursuing nursing warrant consideration, including a student's social and cultural factors prior to admission.

CONCLUSION

Results from this study may inform those faculty and the admissions team reviewing potential students for admission into a baccalaureate nursing program of essential factors to consider prior to offering admission. A holistic evaluation of the student with consideration of social and cultural factors and readiness for entrance into a pre-licensure nursing program is the goal of the admissions process.

Psychosocial work characteristics associated with distress and intention to leave nursing education among students; A one-year follow-up study

BACKGROUND

Dropout in later years of the nursing degree programme involves lost investment and is a particular problem for both students and educators. Reasons for late dropout seem to be related to the work and learning environment of the clinical placement.

OBJECTIVES

The aim of this study was to investigate associations between psychosocial work characteristics and distress and intention to leave nursing education among third-year nursing students.

DESIGN

A prospective cohort study.

SETTING

A Bachelor of Nursing programme of a University of Applied Sciences in the Netherlands.

PARTICIPANTS

363 third-year nursing students.

METHODS

Baseline and one-year follow-up measurements were used from a prospective cohort study. Third-year nursing students were invited annually in May between 2016 and 2018. Psychosocial work characteristics were psychological demands, supervisor and co-worker support, and acts of offensive behaviour. Logistic regression analyses were used to build multivariate models.

RESULTS

Frequent exposure to violence (OR = 2.52, 95% CI: 1.29-4.92) was univariately associated with distress. In the multivariate model for distress, psychological demands (OR = 1.63, 95% CI: 1.05-2.52) and frequent exposure to violence (OR = 3.02, 95% CI: 1.48-6.19) were associated with distress. Supervisor support (OR = 0.54, 95% CI: 0.36-0.80) and co-worker support (OR = 0.41, 95% CI: 0.24-0.72) were negatively associated with intention to leave (i.e. were protective) in the univariate model. In the adjusted multivariate model, only co-worker support (OR = 0.50, 95% CI: 0.25-0.97) was a protective factor for an intention to leave.

CONCLUSION

Psychological demands and frequent exposure to violence are risk factors for distress, and co-worker support is a protective factor reducing the intention to leave nursing education in the last stage of the programme. Improving the psychosocial working climate of nursing students may reduce the intention to leave at a late stage in nursing education, and hence actual late dropout.

Students' perceptions of belonging in the School of Nursing at a regional university in Australia

BACKGROUND

Attrition in pre-registration nursing degrees is a global issue. Students' perceptions of belonging is a factor that influences attrition.

OBJECTIVE

The objective of this study was to evaluate students' perception of belonging to a School of Nursing, as well as their intention to complete the pre-registration Bachelor of Nursing (BN) program following implementation of the Initiatives for Retention (IR) intervention.

DESIGN

A prospective cross-sectional survey of student nurses was undertaken using an online questionnaire.

SETTING

A large regional university in Australia.

PARTICIPANTS

Pre-registration nursing students.

METHODS

Perceptions of Belonging were evaluated using the 24-item Belonging questionnaire comprising three subscales. Data were analysed using SPSS version 25. Pearson's correlation, Student's t-tests and one way ANOVA were used to assess associations and differences in belonging scores and student demographics, study status and participation in the Initiatives for Retention (IR) intervention.

RESULTS

A total of 201 students responded to the voluntary questionnaire. The mean score for overall Belonging was 70.5 (maximum obtainable 96), mean Scores for University affiliation, University support and acceptance, and staff relations with students were 34.7, 24.1 and 11.8 respectively. Female students, those who were studying at the university for less than a year and those who participated in the IR intervention activities reported significantly higher University Belonging scores compared to their contemporaries. Logistic regression revealed that students studying the BN course for more than 3 years (OR: 0.43 95% CI 0.20-0.93, p = 0.031), and those employed (OR: 0.435, 95% CI 0.16-0.16, p = 0.022) were significant predictors of not attending the IR sessions. There were no significant differences in overall University Belonging scores based on other demographic characteristics and, study status. The majority of the students (84%) stated that they plan to continue and complete the BN program.

CONCLUSIONS

Measures designed to develop student involvement may positively contribute a successful relationship between the institution and the student, increasing the students' sense of belonging and decreasing attrition among student nurses.

PRACTICE IMPLICATIONS

Initiatives for Retention (IR) facilitate a greater sense of belonging in nursing students hence Schools of Nursing should consider embedding such strategies.

Exploring the relationship between first-year nursing student self-esteem and dropout: A cohort study

AIM

To describe nursing student self-esteem prior to the influence of nursing education and to explore the relationship between self-esteem and dropout.

DESIGN

Cohort study.

METHODS

At the beginning of their first year of study, in October 2017, 464 nursing students completed a questionnaire that assessed their self-esteem level via Tafarodi & Swann Scale and self-esteem profile following Mruk's model, along with sociodemographic information, state anxiety, self-efficacy, intention to continue and social support. One year later, data on grades and re-enrolment were collected. Multivariate analyses explored the factors influencing self-esteem level (multiple regression), self-esteem profile (multinomial logistic regression) and dropout (binary logistic regression).

RESULTS/FINDINGS

The mean level of self-esteem was 50.8 (9.0), scale of 16 to 80. Forty-nine per cent of self-esteem profiles were classified as 'high', 20.1% as 'defensive acceptance based', 11.2% as 'defensive achievement based' and 19.6% as 'low'. State anxiety (p < 0.0001), self-efficacy about completion of the nursing programme (p < 0.0001) and self-efficacy about internship (p < 0.0001) were associated with self-esteem. The dropout rate was 21.5%. Self-esteem level (p = 0.039) and academic performance (p < 0.0001) were associated with dropout.

CONCLUSION

While nursing student self-esteem is often described as low, we know little about its baseline before entering the nursing programme and the factors that influence it. The dropout rate among first-year nursing students is high, but self-esteem is rarely explored as a possible explanation. We found that students had medium, and potentially fragile, self-esteem when starting their nursing education, and that self-esteem was associated with dropout.

IMPACT

Given that association and the impact of self-esteem on well-being and professional behaviour, educational institutions should foster self-esteem both generally and in students with anxiety or low self-efficacy. Future research should explore nursing student self-esteem using a longitudinal mixed methods approach. Society should value nurses and nursing students.

Effects of Simulation on Nursing Students' Dementia Knowledge and Empathy: A Mixed Method Study

The experience of living with dementia is multifaceted while unique to the individual. Dementia education must empower nursing students to recognize the complexity of the experience while also emphasizing the need for person centered care. Participation in Dementia Live^® provides nursing students a glimpse into the life of a person living with dementia incorporating common symptoms associated with dementia and time for reflection regarding the experience. The purpose of the study was to determine the effects of dementia simulation on nursing students' dementia knowledge and empathy for people living with dementia. This convergent mixed methods study involved a convenience sample of 65 undergraduate nursing students. A pretest/posttest design was used to collect quantitative data while thematic analysis of focus group discussions was used for qualitative data collection. Quantitative results reported a significant increase in empathy. Qualitative findings supported the quantitative findings with themes identifying four of the six components of empathy. This study adds to the understanding of teaching and learning about dementia care and highlights the contributions a seven-minute simulation made to improve empathy.

Prevalence and predictors for compassion fatigue and compassion satisfaction in nursing students during clinical placement

BACKGROUND

Compassion fatigue and compassion satisfaction affect clients' care satisfaction and nurses' well-being. However, little attention is paid to compassion fatigue and satisfaction in nursing students during clinical placement.

OBJECTIVES

To explore the relationships between social support, empathy, resilience, coping strategies, and compassion fatigue and satisfaction in nursing students during clinical placement in China.

DESIGN

A cross-sectional study was performed from May 1 to May 31, 2020.

SETTINGS

and participants: A total of 972 nursing students from 15 universities or colleges in Sichuan province, who received clinical training for at least 10 months were investigated.

METHODS

The instruments included Perceived Social Support Scale, Jefferson Scale of Empathy, Connor-Davidson Resilience Scale, Simple Coping Style Questionnaire and Professional Quality of Life Scale. Descriptive, correlation and regression analyses of these variables were conducted.

RESULTS

The prevalence of low, moderate and high risk of burnout were 1.3%, 97.8% and 0.9%, respectively. The prevalence of low, average and high levels of secondary traumatic stress were 43.6%, 55.3% and 1.1%. Moreover, 9 (0.9%), 316 (32.5%) and 647 (66.6%) respondents reported low, moderate and high levels of compassion satisfaction. Cognitive empathy and resilience were significant protectors from compassion fatigue, and significant contributors to compassion satisfaction. Less compassionate care and more passive coping were significant risk factors for compassion fatigue. Adaptive coping predicted burnout significantly and negatively, and predicted compassion satisfaction significantly and positively. Family support was a significant contributor to compassion satisfaction.

CONCLUSION

It is essential to develop strategies to increase empathy and resilience, avoid passive coping and enhance adaptive coping, and improve family support in order to reduce compassion fatigue and facilitate compassion satisfaction in nursing students during clinical clerkship.

The Professional Identity of Nursing Students and Their Intention to Leave the Nursing Profession During the Coronavirus Disease (COVID-19) Pandemic

BACKGROUND

The COVID-19 pandemic has affected China and other countries since December 2019. The effects of this pandemic on nursing students in terms of their professional identity, intention to leave the nursing profession, and perception of clinical nursing work remain unclear.

PURPOSE

The aims of this study were, first, to investigate nursing students' professional identity, intention to leave the nursing profession, and perception of clinical nursing work during the COVID-19 pandemic and, second, to explore factors influencing professional identity to help develop effective strategies to enrich and strengthen this factor in the future.

METHODS

This cross-sectional, descriptive survey study was conducted on 150 nursing students in China in February 2020.

RESULTS

The 14 (9.3%) participants who reported intending to leave the nursing profession earned lower scores for professional identity than their peers who reported intending to remain. The participants who believed that the COVID-19 pandemic had made them "more passionate about clinical nursing work" earned the highest scores, followed by those who believed the pandemic had "no effect." The lowest scores were earned by those who believed clinical nursing work to be "too dangerous to engage in." COVID-19 knowledge scores, the perceived effectiveness of preventive and control measures, the number of cases seen on the day the study survey was taken, and time spent daily on COVID-19 events were the variables found to influence professional identity.

CONCLUSIONS

COVID-19 outbreak is not merely a time of crisis but also an opportunity to reconstruct the professional identity of nursing students.

Motivations and Career Decisions in Occupational Therapy Course: A Qualitative Inquiry of Asia-Pacific International Students in Australia

PURPOSE

This study aims to understand the motivations of academic voyage and post-graduation career decisions of occupational therapy international students in Australia. The following two research questions guided this study: why do international students choose to study in Australia instead of ones in their own countries? And why do international students choose to study occupational therapy program(s) in Australia instead of ones in their own countries?

PATIENTS AND METHODS

A qualitative design with phenomenology was employed to recruit 20 participants for the data collection procedures, including interview sessions, focus group activity, and member checking interview. The participants were studying one of the accredited occupational therapy programs in Australia as international students.

RESULTS

Six themes were yielded. All participants expressed that due to the excellent education, reasonable tuition fees and living standard, and the positive career opportunities, almost all expressed their positive experiences of their Australian voyage as international students and tended to stay in Australia after they gained the registration career development. More importantly, the notions of contribution to Australian communities are captured as many considered Australia as an important place in their lives.

CONCLUSION

University leaders may wish to take action in upgrading their international students' services, particularly career development services. Government agencies may take this study as a blueprint for upgrading the current regulations for international students, particularly in establishing a targeted immigration visa for recent graduates who want to establish their own businesses or invest in Australia.

Mind the gap: The relationship between liminality, learning and leaving in pre-registration nurse education

Attrition refers to students leaving programmes of study before completion. This is an important topic area; there is a current global shortage of nurses, and it is widely reported that nursing is in crisis. Nurse education in the United Kingdom has changed substantially in the past fifty years, gradually moving from work-based apprentice style training to an 'all graduate entry' profession. There is a plethora of literature reporting attrition both in the UK and worldwide. It is clear that regardless of the education model, attrition from pre-registration programmes is a long-standing problem which has attracted much attention. The educative process of learning to be a nurse can be likened to a 'rite of passage', or perhaps a series of rites of passage. Rites of passage were first articulated by anthropologists, van Gennep and Turner. Van Gennep and Turner argued that as people make 'transitions', often via 'rites of passage' they pass through an in-between phase described as 'liminal'. This paper explores aspects of liminality in nurse education and examines the potential relationship with attrition. The paper concludes by suggesting that although liminality could be considered a risk factor for attrition, exploitation of the concept may offer opportunities to enhance learning.

Nurses and undergraduate student nurses' experiences in collaborative clinical placement programs in acute hospitals: An integrative literature review

OBJECTIVES

To identify, and critically review student, nurse clinician and clinical facilitator/educator experiences of collaborative clinical placement models in acute hospitals.

DESIGN

An integrative review that followed Whittemore and Knafl's (2005) framework.

DATA SOURCES

Studies published between 2009 and 2019 were identified via a comprehensive search of the following databases: CINAHL, OVID Medline, EMBASE, EMCARE, PsychINFO, Johanna Briggs Institute, ERIC and SCOPUS.

REVIEW METHODS

The initial search located 2309 Articles. After screening and checking for eligibility 14 articles were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers, the McMaster's Critical Review Form for quantitative papers and MMAT Appraisal tool for mixed method papers. The papers were then analysed thematically.

RESULTS

Thirteen studies met the inclusion criteria for the review (four quantitative, six mixed method, three qualitative). We identified an overarching central theme of sense of belonging and acceptance along with the following four sub themes: familiarity and continuity, confidence and competence, preparedness and lastly supervising relationships and faculty support.

CONCLUSION

This review indicates collaborative clinical placement programs have a positive impact on the student experience. Further research is needed regarding experiences of clinical nurses, health organisation leaders and Faculty to better understand what will improve support of students in collaborative clinical placement programs as there were few research findings found related to these non-student participant groups. Exploring student placement experiences that include both traditional and Collaborative models would provide greater insight into the value of these programs.

Nursing students' perspectives on observed weight bias in healthcare settings: A qualitative study

BACKGROUND

Weight bias continues to be problematic within the healthcare setting among practicing healthcare providers (HCPs). These HCPs serve as influential role models for nursing students when immersed in the clinical environment. However, if HCPs are demonstrating bias toward patients with obesity, this may influence nursing students' beliefs and practices.

AIMS

This study aimed to explore nursing students' reflections of observed weight bias within the healthcare setting.

MATERIALS & METHODS

A descriptive qualitative study design was used involving reflective journaling and qualitative content analysis. Two cohorts of third-year baccalaureate nursing students (n = 197) participated in weight sensitivity training and submitted reflective journals over one academic semester.

RESULTS

Reports of weight bias were categorized into three themes-(1) Direct Impact: Observed Implicit and Explicit Provider Weight Bias; (2) Indirect Impact: Weight Bias Due to Skills, Equipment, or Staffing/Environmental Deficits; and (3) Reactions toward HCP Weight Bias: Conflict Between Weight Bias Training and Real-World Healthcare Experiences.

DISCUSSION

Weight bias was observed in some HCPs within the healthcare setting. Student reflections explored weight bias and the opposing messages between weight sensitivity training and real-world practices.

CONCLUSION

Preventing bias through continuing education for HCPs is crucial to provide compassionate care and instill ethical values in the next generation nurses.

Peer mentoring experiences of nursing students based on the caring perspective: A qualitative study

BACKGROUND

Care competency is a critical aspect required of nursing students who want to become nurses. Peer mentoring is a useful way to experience the natural care process.

OBJECTIVES

This study aimed to explore from the caring perspective the experiences of nursing students who have participated in peer mentoring as mentors and mentees.

DESIGN

This was a qualitative study; individual interviews were conducted and content analysis was performed to explore and describe peer mentoring experiences.

SETTINGS

This study was conducted in the department of nursing at a university in the Republic of Korea.

PARTICIPANTS

The participants were nine students in their second to fourth year who participated as mentors and mentees in the peer mentoring program organized by the department of nursing.

METHODS

Data on participants' experiences of mentoring were collected through individual interviews. The transcribed content was analyzed using content analysis, and the categorized content was reorganized through the framework of the theory of caring.

RESULTS

The results of the content analysis revealed five categories that formed a sequential process of caring, which became the cycle of another process of care.

CONCLUSIONS

This study's findings regarding peer mentoring experiences of nursing college students indicate that the program can be effective in improving care competencies related to nursing. Peer mentoring in nursing education could be a useful method to develop students' professional competencies.

Graduate entry to nursing: An exploration of the demographic characteristics of New Zealand students

This paper describes the characteristics of student enrolled in New Zealand's first Graduate Entry to Practice (GEN) programme. Data were collected from students enrolled in the first five cohorts of the programme from 2014 to 2018 (n = 93). In total 69 students responded to an on-line, self-report survey, resulting in a 74% return rate. The majority of respondents were female (87%, n = 60), aged 21-30 (68%, n = 47) and New Zealand European (77%, n = 53). The educational background of respondents ranged from theology, to marine biology and more commonly science based degrees. Their motivation for entering nursing was to work in a diverse and caring profession with many wanting to eventually move to advanced practice roles. A key finding was that the students considered that the primary role of the nurse was the provision of holistic care to both the patient and their family. The majority wish to start their nursing careers in the acute hospital based areas of care provision.

The Relationship between the COVID-19 Pandemic and Nursing Students' Sense of Belonging: The Experiences and Nursing Education Management of Pre-Service Nursing Professionals

The COVID-19 pandemic has changed the orders and structures of societies, particularly in the fields of medical and nursing professions. The researcher aims to understand the experiences, sense of belonging, and decision-making processes about Japanese pre-service nursing students and how the COVID-19 pandemic, social distancing, and lockdown has influenced their understanding as pre-service nursing professionals in Japan. As this study focuses on the issues of pre-service nursing students, the researcher invited forty-nine pre-service nursing students for a virtual interview due to the recommendation of social distancing. To increase the coverage of the population, the researcher employed snowball sampling to recruit participants from all over Japan. Although the COVID-19 pandemic influenced the overall performance of the medical and nursing professions, all participants showed a sense of belonging as Japanese citizens and nursing professionals due to the natural disaster of their country. More importantly, all expressed their desires and missions to upgrade and improve the overall performance of the public health system due to the influence of the COVID-19 pandemic. The results discovered that many Japanese nursing students advocated that Japan's national development, the benefits and advantages of their country, were of a greater importance than their own personal development and goals.

Despite Challenges: Nursing Student Persistence

BACKGROUND

Seeking to improve nursing student retention in their small university, faculty conducted a literature review on attrition in nursing education and discovered it to be a significant global problem with nearly one third of qualified students discontinuing. Improved nursing student persistence could stem the growing worldwide nursing shortage. The existing research on retention indicates multi-faceted challenges and impacts but offers scant solutions or insight into student perspectives.

METHOD

The nursing faculty piloted a bridge course for the freshman cohort to develop intrinsic strengths for student persistence and begin soliciting student feedback using a mixed-methods phenomenological approach.

RESULTS

Faculty describe the bridge course framework and activities and present initial student responses.

CONCLUSION

The pilot bridge course serves as one step toward identifying challenges and interventions from students' perspectives to support persistence as a means of meeting nursing shortage demands. [J Nurs Educ. 2019;58(7):427-430.].

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.