Nursing students' expectations of their first clinical placement: A qualitative study

Effects of cooperative learning and situational simulation on nursing competence in clinical practice among nursing students: A quasi-experimental study

BACKGROUND

Appropriate cooperative learning and situational simulation designs can enhance mental health and nursing competence in clinical practice. This approach is crucial for cultivating the clinical nursing competence of nursing students.

AIM

To determine the effect of combining cooperative learning and situational simulation on nursing competence in clinical practice.

DESIGN

A quasi-experimental study.

SETTING AND PARTICIPANTS

This study was conducted with 142 second-year students in the nursing department of a university in Taiwan.

METHODS

The experimental group received cooperative learning combined with situational simulation methods, while the control group used only cooperative learning methods. Data were collected using the Clinical Practice Stress Scale and the Fundamental Nursing Competence Scale. Percentiles and frequency distributions were used to analyze the data, and independent t-tests were conducted to compare differences between the groups.

RESULTS

There were no significant differences in descriptive characteristics between the groups (p > .05). Post-test measurements of nursing technical performance, total score on the fundamental nursing competence scale and six sub-dimensional scores of the students in the experimental group were significantly improved compared to the control group (p < .001). However, there were no significant differences in total clinical practice stress scale scores between the groups (p > .05). Interestingly, the knowledge score of the control group was significantly higher than that of the experimental group (p < .05).

CONCLUSION

The combined methods of cooperative learning and situational simulation have been shown to positively impact students' academic and nursing technical performance. The results indicate improvements in nursing competence in clinical practice, with signs of a reduction in clinical practice-related stress. Nurse educators can apply these strategies in clinical nursing education to achieve better outcomes.

Effects of governmental support on clinical nurse educators in South Korea: A repeated cross-sectional study

AIM

To assess the effectiveness of the Clinical Nurse Educator Support Project and offer valuable insights for supporting nursing education.

BACKGROUND

Allocating clinical nursing educators is crucial for supporting novice nurses' transition into the clinical setting and improving their performance.

INTRODUCTION

In 2019, the Ministry of Health and Welfare in South Korea implemented the Clinical Nurse Educator Support Project, which involves governmental financial support for the employment of clinical nurse educators.

METHODS

This study employed a repeated cross-sectional design to assess the project outcomes. Following the framework of the Kirkpatrick Evaluation Model, secondary data from annual self-program evaluation reports were analyzed to assess program satisfaction, clinical adaptation, and turnover rates of novice nurses. The "Strengthening the Reporting of Observational Studies in Epidemiology checklist" guided the reporting of the study.

RESULTS

The project played a pivotal role in enhancing the quality of nursing education. Novice nurses' program satisfaction and clinical adaptation consistently remained high or exhibited an increase. The project led to a decrease in turnover rate among novice nurses, while the coronavirus 2019 pandemic resulted in increased turnover rates due to limited clinical practice opportunities for nursing students.

CONCLUSION

Government support for clinical nurse educators has positively impacted the institutionalization of nursing education. The pressing need is to prioritize not only the enhancement of nursing education quality and the improvement of nurses' working conditions but also the development of healthcare policies and programs to effectively respond to unforeseen challenges and crises.

IMPLICATIONS FOR NURSING POLICY

Government and healthcare institutions must collaborate to strengthen clinical education, crucial for novice nurses' clinical adaptation. Prioritizing the improvement of nursing education quality and nurses' working conditions is essential. Continuous research and evaluation of the Clinical Nurse Educator Support Project is imperative to assess its impact and make necessary adjustments.

Cognitive Flexibility and Professional Identity in Nursing Students: The Modeling Role

BACKGROUND

Students' professional identity is essential to build nursing competence. Cognitive flexibility plays a crucial role in developing professional identity, as well as clinical supervisors and academic teachers through role modeling. This study analyzed the role of internship and theoretical modeling in the link between cognitive flexibility and professional identity.

METHOD

Participants were first-, second-, and third-year nursing students (n = 284) at a university in northern Italy. Participants completed an online survey, and multigroup analysis was performed.

RESULTS

Internship modeling was positively associated with professional identity but not for second-year students. Theoretical modeling was not significantly associated with professional identity and cognitive flexibility. Theoretical modeling did not mediate the relationship between cognitive flexibility and professional identity. Clinical internship modeling mediated the relationship between cognitive flexibility and professional identity but not for second-year students.

CONCLUSION

Internship modeling helps students give sense and coherence to learning, which contributes to their professional identity. [J Nurs Educ. 2024;63(11):764-772.].

Bridging the experience-complexity gap with longitudinal clinical placements

BACKGROUND

Clinical learning is a critical element to prepare nursing students for the profession. There is limited evidence on the experience-complexity gap among novice nursing students entering the workforce.

PURPOSE

This study aimed to implement a novel longitudinal clinical experience program and examined readiness for practice for undergraduate nursing students.

METHODS

We used a prospective cohort design using the Casey-Fink Readiness for Practice survey.

FINDINGS

There have been 2,004 clinical placements filled since the start of the program. Repeated exposure at one organization provided consistency and continuity while allowing students to develop relationships with patients and staff in a variety of settings. The medical-surgical two clinical experience was a pivotal course that influenced students' perception to enter the nursing workforce.

DISCUSSION

Clinical and academic partners must collaborate to provide the necessary competencies required to enter the workforce. Longitudinal clinical programs may improve nursing students readiness for practice.

CONCLUSION

The continous and immersive nature of the longitudinal clinical experience program facilitated the development of critical thinking skills and clinical competence, suggesting that longitudinal clinical placements can bridge the experience-complexity gap in nursing education.

Preparedness for a first clinical placement in nursing: a descriptive qualitative study

BACKGROUND

A first clinical placement for nursing students is a challenging period involving translation of theoretical knowledge and development of an identity within the healthcare setting; it is often a time of emotional vulnerability. It can be a pivotal moment for ambivalent nursing students to decide whether to continue their professional training. To date, student expectations prior to their first clinical placement have been explored in advance of the experience or gathered following the placement experience. However, there is a significant gap in understanding how nursing students' perspectives about their first clinical placement might change or remain consistent following their placement experiences. Thus, the study aimed to explore first-year nursing students' emotional responses towards and perceptions of their preparedness for their first clinical placement and to examine whether initial perceptions remain consistent or change during the placement experience.

METHODS

The research utilised a pre-post qualitative descriptive design. Six focus groups were undertaken before the first clinical placement (with up to four participants in each group) and follow-up individual interviews (n = 10) were undertaken towards the end of the first clinical placement with first-year entry-to-practice postgraduate nursing students. Data were analysed thematically.

RESULTS

Three main themes emerged: (1) adjusting and managing a raft of feelings, encapsulating participants' feelings about learning in a new environment and progressing from academia to clinical practice; (2) sinking or swimming, comprising students' expectations before their first clinical placement and how these perceptions are altered through their clinical placement experience; and (3) navigating placement, describing relationships between healthcare staff, patients, and peers.

CONCLUSIONS

This unique study of first-year postgraduate entry-to-practice nursing students' perspectives of their first clinical placement adds to the extant knowledge. By examining student experience prior to and during their first clinical placement experience, it is possible to explore the consistency and change in students' narratives over the course of an impactful experience. Researching the narratives of nursing students embarking on their first clinical placement provides tertiary education institutions with insights into preparing students for this critical experience.

Barriers and facilitators to the formation of professional identity among nursing students: A four-year longitudinal qualitative study

BACKGROUND

Nursing professional identity (NPI) is essential for nurses to develop their nursing profession. It reflects the competencies consistent with the professional practices of nurses and contributes to them providing better healthcare and public health. The formation process of NPI started with undergraduate nursing education and continued throughout the nursing career.

OBJECTIVE

To explore nursing students' perceptions of facilitators and barriers to the formation of NPI during their study.

METHODS

A 4-year longitudinal, qualitative research design with yearly semi-structured interviews undertaken from 2019 to 2022. The reflexive thematic analysis methodology was applied for the data analysis.

RESULTS

Ninety-three nursing students were recruited, joining a group or individual interview. The four-year nursing baccalaureate program revealed a dynamic formation process of NPI: "Outsider of nursing", "Entering the nursing courses", "Building nursing competence", and "Thinking and acting like a nurse". A total of 12 themes were identified to present the barriers and facilitators to the NPI formation at different stages. Specifically, the six barriers include conflict between their ideals and reality, sociocultural stereotypes about nursing, the negative impact of COVID-19, the pre-internship concerns, struggling to meet expectations, and potential danger and discrimination in the healthcare settings. The enablers were: self-motivation and inner belief towards the nursing profession, the power of role models, the improvement of nursing capacity, well integration into the healthcare professional teams, understanding of the clinical environment, and recognition and encouragement from others.

CONCLUSIONS

The formation of nursing students' NPI is an ever-changing process, with various intrinsic and extrinsic influences during their four-year study. Nursing educators are suggested to prepare and develop students' professional comportment in their theoretical and clinical practice to develop their professional identity as a nurse.

Students' evaluation of professional experience placement quality in a pre-registration nursing programme: A cross-sectional survey

AIM

To evaluate the quality of student nurses' experiences and overall satisfaction with professional experience placements at a regional Australian University.

BACKGROUND

Professional experience placements are a crucial component of pre-registration nursing programs. However, the absence of standardised approaches to assess placement quality has created uncertainty on what constitutes a high-quality placement from a student's perspective.

DESIGN

Cross-sectional survey.

METHODS

A descriptive cross-sectional survey was administered online to 800 second and third year undergraduate nursing students at an Australian university. The survey contains demographic questions (e.g., year of study, placement specialty, duration, setting and geographic location), a validated Placement Evaluation Tool and free-text comments. The Placement Evaluation Tool is a 20-item questionnaire that measures two key factors: clinical environment (factor 1), learning support (factor 2) and overall satisfaction of students' learning experiences during a professional experience placement. A descriptive analysis was conducted to evaluate the student's overall experience and satisfaction. Multivariate linear regression was used to assess the relationship between the quality of the student experience and demographics and presented as beta coefficient (β) and confidence interval (CI). Free-text comments were thematically analysed.

RESULTS

A total of 1104 survey responses were received (as students may rate more than one placement), with an estimated 71% response rate. Most responses (60.3%) were third-year students. Most students experienced high-quality placements, reflected in the overall positive placement experience (PET item 1-19 score: mean 85.9 out of 95) and high student satisfaction (PET item 20: mean 8.53 out of 10). Multiple linear regression analyses revealed that the third year of study and public facilities were independent predictors of positive student experiences (β: 2.61, 95% CI: 0.75, 4.47 and β: 3.72, CI: 0.90, 6.55, respectively). Further analysis of PET items related to factor 1 and factor 2 revealed that high positive experiences in public facilities may be due to the higher learning support (β: 2.54, CI: 0.80, 4.27). Three main themes were perceived to be important to students' professional experience: (i) staff and facilitator attitudes, (ii) learning opportunities and (iii) a team-based learning environment.

CONCLUSIONS

Most students reported high-quality placement experience and high satisfaction; however, a lack of learning support may contribute to less positive student experiences. This finding emphasises the importance of collaboration between clinical facilities and educational institutions to enhance the student's placement experience.

Do nursing students' attitudes to clinical practice training affect the levels of vocational motivation?

BACKGROUND

It is extremely important for nursing students to be professionally motivated to train qualified future professional nurses. Students' vocational motivation is affected by their experiences in clinical and academic learning environments.

OBJECTIVE

The aim of this study was to investigate the correlation between the vocational motivation levels of nursing students and their attitudes toward clinical practice.

METHODS

292 nursing students participated in the cross-sectional, descriptive study. The Student Information Form, Nursing Students' Attitudes Towards Clinical Practices Scale, Motivation Sources and Problems Scale (MSPS) were used to gather the data.

RESULTS

The average score for students' attitudes toward clinical practice was 107.08±18.13, while the total score for MSPS stood at 3.80±0.63. A positive correlation was identified between the attitude toward clinical practice and vocational motivation levels (r = 0.367; p < 0.001). There were positive correlations between the intrinsic motivation (r = 0.572; p < 0.001) and extrinsic motivation (r = 0.58; p < 0.001), and negative correlations were observed between the negative motivation (r = -0.324; p < 0.001) and the attitude toward clinical practice scale. There were positive correlations between belief and expectation (r = 0.492; p < 0.001) and positive approach (r = 0.532; p < 0.001) with the MSPS. In the multiple regression analysis, intrinsic motivation, extrinsic motivation, satisfaction with studying nursing, and participation in vocational courses were determined as effective predictors of attitudes towards clinical practice and explained 60.4% of the variance.

CONCLUSIONS

The study concluded that nursing students' attitudes toward clinical practices affect vocational motivation. Clinical learning environments should be arranged in a way to increase the motivation level of students towards professional learning.

Employment intention and career planning of male nursing students in different levels of colleges and universities: A qualitative study

AIM

To explore the employment intention and career planning of male nursing students at different levels of colleges and universities and provide references for formulating individualized training content.

DESIGN

Phenomenological research method in qualitative research.

METHODS

Using a phenomenological research method, 15 male nursing students from three levels of colleges and universities were interviewed in a one-to-half structure, and the data were analysed using NVivo12.0 software and the Colaizzi seven-step analysis method.

RESULTS

Four themes and 10 sub-themes were extracted. The four themes included professional identity experience, nursing learning experience, career expectation and planning and educational needs. The 10 sub-themes included the negative effects of traditional impressions, the gradual establishment of professional identity, public health events promote professional identity, negative experiences in learning, positive growth from learning, varied career plans, career expectations and influencing factors, a reasonable schedule, diversity of content requirements and the positive effect of teaching teachers.

CONCLUSIONS

Influenced by many factors, the employment intention and career planning of male nursing students at different higher education levels are varied. Schools and clinical practice units should strengthen the training of employment intention and career planning and make reasonable time adjustments to the training content.

PUBLIC CONTRIBUTION

In total, 15 male interns accepted our interview request. We utilized their break time to conduct the interviews, resulting in significant contributions to the content of the article.

Clinical Instructors' Perspectives on the Assessment of Clinical Knowledge of Undergraduate Nursing Students: A Descriptive Phenomenological Approach

This study aimed to determine clinical instructors' perceptions of the assessments used to evaluate the clinical knowledge of undergraduate nursing students. This study uses a descriptive phenomenological approach. Purposive sampling was used to recruit sixteen clinical instructors for semi-structured interviews between August and December 2019. All interviews were audio recorded and transcribed verbatim. Data were analyzed using a modified Colaizzi's seven-step method. Four criteria were used to ensure the study's validity: credibility, transferability, dependability, and confirmability. Three themes were identified in the clinical instructors' views on evaluating the clinical performance of student nurses: familiarity with students, patchwork clinical learning, and differing perceptions of the same scoring system. The study results suggest a need for a reliable, valid, and consistent approach to evaluating students' clinical knowledge. If the use of patchwork clinical internships for student nurses is unavoidable, a method for assessing student nurses' clinical performance that requires instructor consensus is necessary.

Nursing students' experiences and expectations of clinical learning: A qualitative study

BACKGROUND

Clinical learning is an important component of nursing education that can support the development of competence. Nursing students have expectations before clinical learning, however if these expectations are not matched with their experiences, then development can be hampered.

OBJECTIVE

To explore nursing students' expectations and experiences of their clinical learning experiences.

DESIGN

Qualitative descriptive design.

SETTINGS

The study was conducted at a large teaching hospital in Namibia.

PARTICIPANTS

Fifteen first to fourth year undergraduate nursing students who were allocated to a teaching hospital in Namibia.

METHODS

The participants were purposively sampled among the teaching hospital's undergraduate nursing students. Data were collected between June to November 2021 through in-depth, semi-structured interviews that lasted between 35 and 45 min each. Data were analyzed using thematic analysis.

RESULTS

The data analysis identified four themes: clinical outlook and role, supporting/role modelling, clinical teaching and learning, and linking theory and practice.

CONCLUSION

The expectations and experiences of nursing students regarding the clinical environment were mixed. The findings demonstrated the need to moderate students' expectations, as well as to reorganize the clinical learning environment to enhance students' learning. Further studies should look at the standardization of student expectations based on the context of their clinical learning environment, and how this can improve learning experiences.

A concept analysis on the transfer climate in health sciences education

The transfer of learning is complex, with factors such as transfer climate influencing students' transfer of learning. This transfer climate will shape a student's experiences during work-integrated learning and can be modified to enhance the transfer of learning. However, studies on transfer climate are mainly reported from a human resource development context and the outcomes may not be transferable to health sciences education. Furthermore, there is no uniformity in defining and measuring transfer climate. Rodgers' evolutionary concept analysis approach was used to describe the antecedents, attributes, and consequences of a positive transfer climate. An information specialist assisted in developing a Boolean search string and searched 15 databases to identify relevant sources. In total, 156 relevant articles were selected from 1448 sources. Data were charted and thematically analyzed. Antecedents comprise interpersonal relationships and theory-practice correlation. The presence of student support, training programs, student characteristics, clinical facilitator characteristics and a well-resourced clinical environment are the attributes of a positive transfer climate and act as learning transfer mediators. Transfer climate consequently influences student, educational, and organizational performance. A conceptual definition for transfer climate was then proposed. It was subsequently concluded that developing competent healthcare professionals and providing support to students depend on the synergy and good working relationship between health services and educational institutions. The insights into modifiable elements to enhance transfer climate could benefit health sciences educators in reconsidering their clinical training models to ensure sufficient support during students' clinical placements to meet the demands for a better-qualified healthcare workforce.

Nursing students' expectations and career preferences before clinical placement in mainland China: A qualitative exploration

AIM

To explore nursing students' expectations and career preferences before their clinical placements.

BACKGROUND

Clinical placement is an important adaptation stage through which nursing students become nurses. Nursing students' expectations of clinical placement are not always met. There is a huge demand-supply gap in the nursing labor force and ensuring successful nursing placements could offset this gap.

DESIGN

This study adopted a descriptive qualitative design.

METHODS

Each participant was interviewed in the weeks before the start of their clinical placement. Interviews were semi-structured and audio recorded. Data were analyzed using Clarke and Braun's thematic analysis.

RESULTS

This study included 25 students (11 males and 14 females; age 20-21 years), which was sufficient to reach data saturation. We identified 138 codes and six themes emerged: a) expectations of role transition; b) expectations of self-enhancement; c) expectations of teaching styles; d) fears and worries; e) preliminary career preferences; and f) motivating and obstacle factors of engaging in a nursing career.

CONCLUSIONS

Nursing students had various expectations of their upcoming clinical placements alongside certain worries and fears. More predictive and targeted strategies need to be considered to ensure the success of clinical nursing placements. Further research should explore and verify strategies to meet nursing students' expectations and promote their preference for a nursing career.

Promoting academic resilience through peer support in a new pre-registration nursing programme

Nursing students can experience increased levels of stress while studying for their registration. It is acknowledged that higher education institutions should incorporate mechanisms to try to reduce these stress levels and build up resilience towards the difficult situations students may encounter during their studies. A bespoke method was created within a new part-time 4-year pre-registration nursing programme to support part-time junior (part 1) nursing students by implementing action learning sets within the programme. These sessions were delivered by part-time senior (part 3) nursing students who had already gone through similar experiences. Both the junior and senior students reported that they had gained benefits from this innovation, increasing their confidence and improving their ability to cope with some of the stressors of the programme. Building the resilience of nursing students within this pilot project was positively evaluated and could be developed further into other nursing programmes. This part-time programme was developed to retain nurses in Wales and was aimed at healthcare support workers with prior experience of providing the fundamentals of nursing care within local health boards.

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.

Nursing students' perceptions on motivation strategies to enhance academic achievement through blended learning: A qualitative study

Students who are motivated to learn novel knowledge and skills are needed to provide high-quality nursing services. Student nurses increasingly lose motivation as their program progresses due to various factors, especially in light of the recent academic situation with online education. As a result, the purpose of this study is to elucidate ways for improving academic motivation among Saudi nursing people who enrolled in blended learning. This study used a qualitative exploratory study design based on the phenomenological exploration, with 20 nursing students from a prominent Saudi institution. The qualitative analysis of the verbatim conveyed by the student nurses has yielded in the emergence of two main themes; “Extrinsic Motivation” and “Intrinsic Motivation”. Under the first theme the following subthemes emerged; “University support through policy”, “Instructor skills and communication”, “Curricular organization”, “Quality clinical experiences”, and “Conducive blended environment”, while under “Intrinsic Motivation”, the thematic analysis resulted in, “Coping with blended environment” and “Control over learning process”. Educators, students, academic staff, and clinical training are all identified as areas where academic motivation can be improved. In principle, boosting educational quality and instilling a good attitude among nursing students boost academic motivation.

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One of the most difficult challenges confronting today's instructors is motivation.

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The employment of BL in the nursing curriculum has expanded dramatically in current years.

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Students and nurses require immediate motivation in order to carry out health-related obligations in a new complex system.

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Saudi nursing students indicated the need for university and instructor academic support to increase motivation.

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Saudi nursing students expressed the importance of quality clinical education in enhancing motivation.

Escape Room vs. Traditional Assessment in Physiotherapy Students' Anxiety, Stress and Gaming Experience: A Comparative Study

Escape Rooms can serve multiple academic and educational purposes and can be used as part of the evaluation of a learning program. The aim of this study was to analyze the levels of anxiety and stress perceived in the evaluation using the Escape Room compared to the traditional evaluation, as well as to analyze the gaming experience. Methods: A comparative study was carried out in students of the Degree in Physiotherapy, with a total of 56 participants who underwent 2 evaluation processes. The variables analyzed were the State—Trait Anxiety Inventory, the Perceived Stress Questionnaire, and the Gaming Experience Scale. A comparative analysis was performed between the groups using the Mann Whitney U test and Student’s T test. Results: The levels of state-anxiety and trait-anxiety were higher in the traditional assessment group. Although no differences were found in the qualification obtained by the students, statistically significant differences were found between the two evaluation systems in terms of the overload factor, the energy factor, and the fear-anxiety factor of the perceived stress questionnaire. Conclusions: The Escape Room can be considered as an alternative to the traditional evaluation in Physiotherapy Degree students due to its lower levels of anxiety and perceived stress.

Understanding the Expectations of Nursing Students Following the First Clinical Internship: A Qualitative Study

The objective of this study was to describe how nursing students' expectations are achieved after the first clinical internship. A longitudinal qualitative study using purposive sampling was used in a public nursing school in Barcelona, Spain. Fifteen nursing students attending their internship for the first time. Data were collected in 2019 using semi-structured interviews until data saturation was reached. Interviews were conducted before and after the completion of the first clinical internship. The data were analyzed using the thematic analysis method. The students experienced some negative issues they did not think about, such as excessive homework, feeling a worker, not a student, loneliness, and learnings influenced by chance. Positive assessments of the accessibility of the placement location and the experience of the clinical instructor have a powerful influence on the student, allowing for the assessment and integration of the student in the health team. The practical learning is mediated by chance in terms of center, service, teacher, and clinical instructor assigned. It is crucial to establish consensual measures among all the actors involved to facilitate the objectivity of teaching and learning.