Developing trends of initial nursing education in China from 2006 to 2017: A descriptive analysis based on national-level data

Development and validation of a core competency scale for nursing internship supervisors

BACKGROUND

Clinical practicums are a crucial part of nursing education wherein nursing internship supervisors (NIS) play a vital role in facilitating hands-on experience. However, many NIS start their teaching roles without adequate educational training, despite the importance of this task. Therefore, the aim of this study was to develop and validate a reliable and credible core competency scale for NIS.

METHODS

We used the framework from the Academy of Medical Educators for the training of NIS in healthcare. We combined a literature review, theory-based inquiry, qualitative interviews, and expert consultation to create the initial scale. The final scale underwent comprehensive evaluation by 653 NIS and 653 nursing internship students from three leading hospitals in Luzhou, Sichuan Province, resulting in a total of 1306 participants.

RESULTS

The study produced the Core Competency Scale for NIS, a refined instrument covering six dimensions (professional socialized mentoring capacity, clinical teaching competencies, student counseling communication and coordination skills, nursing process competencies, curriculum design capacity, clinical problem-solving skills) and 39 items. The scale showed a content validity index of 0.98 and strong criterion-related validity, with a correlation coefficient of r = 0.73 (p < 0.01) against the Clinical Teaching Effectiveness Instrument scale. Cronbach's alpha ranged from 0.973 to 0.990, indicating high reliability and validity.

CONCLUSION

The Core Competency Scale for NIS demonstrates robust reliability and validity, serving as a valuable tool for assessing the core competencies of nursing instructors. It provides a strong foundation for the development and application of training programs tailored to enhance the skills of nursing faculty in the clinical setting.

Association of hospital safety climate and compliance with occupational safety practices among nurse interns: A cross-sectional study using canonical correlation analysis

Background and Aims

Nurse interns may be at a similar or higher risk than registered nurses. The key elements and mechanisms involved in the effects of safety climate on safety performance are not well understood. This study explores the relationship between the perceived hospital safety climate and compliance with occupational safety practices among nurse interns.

Methods

A cross-sectional study was conducted among 178 nurse interns in three tertiary university hospitals in Chongqing city, China. The Chinese version of the Hospital Safety Climate Scale (HSCS) was used to measure the perceived hospital safety climate of nurse interns. Compliance behavior was measured using the Compliance with Occupational Safety Practice Scale (COSPS). Canonical correlation analysis and multiple linear regression modeling were used to examine their relationship.

Results

Total scores for the HSCS and COSPS were 92 (80,100) and 185 (175,185) [M (P25, P75)], respectively. Canonical correlation coefficients for canonical variates 1 and 2 were 0.636 (p < 0.001) and 0.414 (p < 0.001), respectively. Nurse interns' compliance with occupational safety practices was mainly influenced by management support, feedback/training, personal protective and engineering control equipment availability, and absence of job hindrance. Multiple linear regression showed that management support of HSCS accounted for 37.1% of the variance in compliance (β = 0.283, p = 0.039).

Conclusion

Nurse interns reported high levels of perceived hospital safety climate and compliance with occupational safety practices. Younger nurse interns reported a lower level of perceived hospital safety climate. Nurse educators can improve interns' compliance by promoting better management support, feedback/training, personal protective and engineering control equipment availability, and fewer job hindrance.

Internship and postgraduate entrance examination: A qualitative study on the psychological experience of undergraduate nursing students under dual pressure in China

Background

With the development of nursing positions and nursing disciplines in China's tertiary hospitals, the number of people applying for the master's degree in nursing is also increasing year by year. Postgraduate examinations are held during internship, so nursing students face the dual pressure of testing and internship, which brings varying degrees of negative experiences and emotional fluctuations.

Objective

To explore the psychological experiences and influencing factors of undergraduate nursing students under the dual pressures of clinical nursing internships and postgraduate examination preparations.

Design

Descriptive qualitative study.

Method

Purposeful sampling was used to recruit 18 participants from eight tertiary hospitals in China between October and December 2023. Semi-structured in-depth interviews were conducted, with interview recordings transcribed verbatim. Thematic analysis was then applied to the data.

Results

Four themes were identified: negative experiences under dual pressures, coping mechanisms for negative experiences, motivational effects under dual pressures, and evaluations of significant individuals. Nursing students improved their overall abilities through internships and exam preparations, gaining a clear understanding of themselves and certain hospital roles. However, at this stage, students also experienced adverse psychological experiences for various reasons. Thus, they employed several methods to alleviate their psychological stress, aiming for a better state to face internships and exam preparations.

Conclusion

Schools and hospitals should pay more attention to the needs of nursing students under dual pressures, monitoring their emotional states, and providing psychological support to enhance their stress-coping abilities. It is important to ensure the overall well-being of students while strengthening the motivational effects of internships and learning experiences.

A questionnaire on the current situation of resignation intention of nurses in intensive care units in China - A descriptive quantitative study

AIM

This study analysed and summarized the correlation between various indicators of ICU nurses' personal lives, hospital work situation, social opinion, psychological assessment, and their intention to resign.

DESIGN

A descriptive quantitative study.

METHODS

This study was a multicentre questionnaire on factors influencing intensive care unit (ICU) nurses' intention to resign. This study was completed through the Critical Care E Institute (CCEI) and China Calm Therapy Research Group Academic Organization (CNCSG) by contacting ICU nurses in three hospitals in 34 provinces in China. The questionnaire was in the form of a cell phone WeChat scan code. The survey included 22 indicators, including basic information about nurses (marital and child status, personal income, etc.), hospital work (weekly working hours, night shift, hospital environment, etc.), and psychological symptoms.

RESULTS

A total of 1904 nurses were included in this study. Among them, 1060 (55.67%) had the intention to resign. In this study, among the 22 indicators involved, 16 factors, including hospital work hours, job title, satisfaction with current income, having children, and evaluation of the hospital, significantly impact nurses' intentions to resign (all p < 0.05). Logistic regression analysis showed that six indicators influenced nurses' choice of resignation intention (all p < 0.05), including hospital work time, professional title, income satisfaction, hospital work pride, satisfaction of nurses with the compassion and care given to them by their hospitals, and career vision score. The ROC curve showed that all six indicators were <0.70, but the model receiver operating characteristic (ROC) curve constructed for the indicators was 0.756. In China, increasing the income of ICU nurses, fostering pride in hospital work, reducing working hours, ensuring smooth promotion processes, and enhancing career prospects can all decrease their likelihood of choosing to resign. Absorbing practical nursing management and work experience from other countries will help decrease the intention to resign within this group.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Effect of Tronclass combined with team-based learning on nursing students' self-directed learning and academic performance: a pretest-posttest study

BACKGROUND

Self-directed learning ability is crucial for lifelong learning. The inadequate self-directed learning ability of nursing students in China may be due to their deficiency in self-management or learning initiative.

OBJECTIVE

To explore the effect of online learning platform (Tronclass) combined with team-based learning on nursing students' self-directed learning and academic performance.

DESIGN

Pretest-posttest design.

PARTICIPANTS

From March to July 2023, 69 undergraduate third-year nursing students from a university in Hunan Province were selected through a whole-group sampling method.

METHODS

This study used Tronclass to carry out team-based learning in the teaching process of pediatric nursing courses. It compared the self-directed learning ability nursing students before and after courses, and juxtaposed their academic performance with those of their counterparts who graduated in previous years.

RESULTS

When comparing compare motivation, self-management, teamwork and information literacy, which are four subscale aspects of the self-directed Learning Ability Scale, the post-survey scores for these four dimensions are greater than the pre-survey results. The results of the study showed a statistically significant difference (P < 0.05), in the students who engaged in Tronclass combined with team-based learning. Specifically, these students received higher midterm and final grades than to those who had already graduated and did not participate in these activities. (P < 0.05).

CONCLUSION

Combining Tronclass with team-based learning enhances nursing students' ability to engage in self-directed learning and improves their performance in midterms and finals, thereby fostering the development of comprehensive competence.

Translation and psychometric validation of the Chinese version of the metacognitive awareness scale among nursing students

Objective

This study endeavors to translate and psycho-metrically validate the metacognitive awareness inventory scale (MAS) for nursing students in China.

Method

A total of 592 nursing students were enlisted from four universities situated in the eastern, southern, western, and northern regions of China. Content validity and reliability were evaluated using the content validity index and item-total correlation coefficient, and Cronbach's alpha coefficients, respectively. Convergent validity examined the goodness of fit among sub-scales through the average extracted variance and composite reliability.

Results

Exploratory factor analysis confirmed the first-order and second-order factor models, contributing to a cumulative variance of 89.4 and 59.5%, respectively. The Cronbach's alpha values were 0.963 and 0.801, respectively. Confirmatory factor analysis outcomes indicated an excellent overall fit index for the model, satisfying the convergent validity criteria and achieving a target coefficient of 96.0%, which is consistent with the original scale structure.

Conclusion

The Chinese version of the MAS (C-MAS) is a reliable and valid instrument for assessing metacognitive awareness among Chinese nursing students. Further research should consider a broader sample of nursing students across China to reinforce the scale's applicability.

The effect of occupational coping self-efficacy on presenteeism among ICU nurses in Chinese public hospitals: a cross-sectional study

Background

Nurses are the largest occupational group in the health field, with inestimable value in realizing universal health coverage, and nurses' physical and mental health has become an ordinary global reality. Compared with explicit absence, nurses' presenteeism has a more lasting impact and significant harm and loss. It has become an essential factor affecting nurses' physical and mental health, declining quality of healthcare services, and elevated healthcare-related risks. There is a lack of research exploring whether occupational coping self-efficacy influences nurses' presenteeism behavior, especially in less-developed regions of China.

Objective

This study aimed to investigate the current status of ICU nurses' occupational coping self-efficacy and presenteeism in public hospitals in western China and to explore the impact of ICU nurses' occupational coping self-efficacy on presenteeism.

Methods

A cross-sectional research design selected 722 ICU nurses in western China from January to February 2023 as survey respondents. A general information questionnaire, Occupational Coping Self-Efficacy Scale (OCSE-N), and Stanford Presenteeism Scale (SPS-6) were used. SPSS 21.0 software was used for statistical analysis. Pearson correlation analysis and multivariate hierarchical regression were used to explore the influence of ICU nurses' occupational coping self-efficacy on presenteeism.

Results

A total of 722 ICU nurses completed the questionnaire. The OCSE-N score of ICU nurses was (22.24 ± 6.15), and the SPS-6 score was (16.83 ± 4.24). The high presenteeism was 67.23%. Correlation analysis showed that in ICU nurses, OCSE-N total score was negatively correlated with SPS-6 total score (r = -0.421, p < 0.05), indicating that the higher the level of occupational coping self-efficacy, the lower the presenteeism. Multiple hierarchical regression analysis showed that occupational coping self-efficacy strongly predicted presenteeism, accounting for approximately 18.35% of the total variance.

Conclusion

There is a correlation between ICU nurses' occupational coping self-efficacy and presenteeism, and nurses' occupational coping self-efficacy affects presenteeism differently. Managers should pay attention to nurses' occupational coping self-efficacy to promote nurses' presenteeism reduction.

The association between perfectionism and academic procrastination among undergraduate nursing students: The role of self-efficacy and resilience

AIMS

This study aimed to investigate the associations between perfectionism and undergraduate nursing students' academic procrastination, the mediating effects of self-efficacy and the moderating role of resilience.

DESIGN

A cross-sectional survey.

METHODS

The survey was conducted from March to May 2022 with a sample of 587 undergraduate nursing students in two undergraduate universities in China. A descriptive statistical approach, Pearson's correlation analysis and the Hayes' PROCESS Macro model 4 and 14 were used to analyse the available data.

RESULTS

Adaptive perfectionism and maladaptive perfectionism negatively and positively predicted academic procrastination in nursing undergraduates, respectively. Self-efficacy played a partially mediating role in the association between adaptive perfectionism and academic procrastination. Furthermore, resilience played a moderating role in the association between adaptive perfectionism and academic procrastination.

CONCLUSIONS

Maladaptive perfectionism and low levels of resilience and self-efficacy may increase the risk of academic procrastination among nursing undergraduates. Nursing educators can take measures to decrease the risk of academic procrastination among nursing undergraduate students by guiding them to cultivate adaptive perfectionism tendencies and improve their self-efficacy and resilience.

IMPACT

The findings of this study can be used to develop targeted coping and prevention measures for nursing educators to reduce the incidence of academic procrastination among nursing undergraduates.

PATIENT OR PUBLIC CONTRIBUTION

Five hundred eighty-seven undergraduate nursing students from two undergraduate universities participated in the study and responded to questions on perfectionism and academic procrastination, etc.

The contribution of perceived death competence in determining the professional quality of life of novice oncology nurses: A multicentre study

PURPOSE

Novice nurses find it challenging to cope with patient dying and death, especially in a death taboo cultural context, such as mainland China. By taking the example of Chinese novice oncology nurses, this study aimed to explore the contribution of their perceived death competence in determining their professional quality of life.

METHOD

A multicentre, cross-sectional study was conducted in six tertiary cancer hospitals in mainland China involving 506 novice oncology nurses. Measurements were the Coping with Death Scale-Chinese version, the Professional Quality of Life Questionnaire, and the Coping Style Questionnaire. Hierarchical multiple regression analyses were used to analyse the data.

RESULTS

Death competence was significantly associated with compassion satisfaction (r = 0.509, P < 0.001), burnout (r = -0.441, P < 0.001) and secondary traumatic stress (r = -0.154, P < 0.001) which are the three dimensions of professional quality of life. The results of hierarchical multiple regression analyses demonstrated that death competence positively predicted compassion satisfaction and negatively predicted burnout (P < 0.01), but had no significant impact on secondary traumatic stress after coping style was entered into the model (P > 0.05).

CONCLUSIONS

Novice oncology nurses who perceive themselves to be incompetent in dealing with patient dying and death are more likely to experience poor professional quality of life in the death taboo cultural context. Cultural-sensitive interventions and a supportive work environment are important to enhance these nurses' death competence, increasing their professional quality of life and ultimately contributing to better end-of-life cancer care management.

The mediating effects of coping style and resilience on the relationship between parenting style and academic procrastination among Chinese undergraduate nursing students: a cross-sectional study

BACKGROUND

How to kindle the learning enthusiasm of nursing students and reduce the incidence of academic procrastination is an important factor in reducing student attrition and improving the quality of nursing education.

OBJECTIVES

To investigate the mediating role of coping style and resilience on the association between parenting styles and academic procrastination among nursing undergraduates.

METHODS

A cross-sectional study of 683 nursing undergraduates was conducted in China from March to May 2022. Parenting styles, coping style, resilience, and academic procrastination were measured using questionnaires. Descriptive analysis, Pearson's correlation analysis and Hayes' PROCESS Macro in SPSS 25.0 were used to test the model.

RESULTS

Positive parenting style had a significantly direct effect on academic procrastination and through three significantly indirect pathways: (1) through positive coping style (B =  - 0.048, 95% CI: - 0.074 to - 0.025), accounting for 14.71% of the total effect; (2) through negative coping style (B =  - 0.044, 95% CI: - 0.071 to - 0.021), accounting for 13.64% of the total effect; and (3) through resilience (B =  - 0.074, 95% CI: - 0.107 to - 0.044), accounting for 22.82% of the total effect. Moreover, negative parenting style had a significantly direct effect on academic procrastination and through two significantly indirect pathways: (1) through negative coping style (B = 0.056, 95% CI: 0.032 to 0.086), accounting for 21.73% of the total effect, and (2) through resilience (B = 0.028, 95% CI: 0.004 to 0.055), accounting for 10.93% of the total effect.

CONCLUSIONS

Intervention measures to reduce the academic procrastination of nursing undergraduates should include the evaluations of coping styles and resilience of nursing students and cultivation strategies to promote their positive coping styles and resilience.

Resilience and positive coping style affect the relationship between maladaptive perfectionism and academic procrastination among Chinese undergraduate nursing students

Background

Previous studies have not investigated the role of resilience and coping style on the association between maladaptive perfectionism and academic procrastination among nursing undergraduates. However, how to mobilize the learning enthusiasm of nursing students and reduce the incidence of academic procrastination is an important factor to reduce nursing loss and improve nursing quality.

Objectives

To investigate the influence of maladaptive perfectionism, resilience and coping style on academic procrastination among Chinese undergraduate nursing students.

Methods

A cross-sectional study was conducted. A convenience sampling method was used to select 665 nursing undergraduates from March to May 2022 in China. Maladaptive perfectionism, coping style, resilience, and academic procrastination were measured using questionnaires. The descriptive analysis, Pearson’s correlation analysis and the Hayes’ PROCESS Macro in SPSS 25.0 were used to test the model.

Results

The results showed that nursing undergraduates’ maladaptive perfectionism, resilience, positive coping style and academic procrastination were significantly correlated between every two variables, with coefficients ranging between −0.290 and 0.584. In addition, resilience played a partial mediating role in maladaptive perfectionism and academic procrastination, accounting for 15.70% of the total effect; in the meantime, this process was moderated by positive coping style.

Conclusion

Maladaptive perfectionism positively predicted nursing undergraduates’ academic procrastination; as a mediating mechanism with moderating, resilience and positive coping style further explained how maladaptive perfectionism promoted the academic procrastination of nursing undergraduates. Understanding this mechanism is of great significance for nursing educators to reduce the risk of academic procrastination in nursing undergraduates.

Impacts of COVID-19 pandemic on professional identity development of intern nursing students in China: A scoping review

PURPOSE

Clinical experience plays a vital role in the development of the professional identity (PI) of nursing students. China has applied a strict zero- COVID health policy in combating the COVID-19 pandemic since December 2019 and studies have been conducted in different places of China to explore PI development of nursing students during the pandemic time among the intern nursing students who are on clinical practices. This review study aims to synthesize the previous studies and provide a comprehensive picture of the impacts of the pandemic on the PI development of intern nursing students.

METHODS

Arksey and O'Malley's five-stage scoping review framework was used. Combinations of keywords were used to search relevant articles in both Chinese and English databases published from inception of the articles until the final search date (10 March 2022). The initially included articles were also appraised for their quality, and those that passed the appraisal were left for data analysis. The analytic results were cross-checked among the reviewers.

RESULT

Three themes emerged from the included studies: 1) the PI levels, 2) the impacts of personal and social factors of PL, and 3) the specific impact of the COVID-19 pandemic. The levels of students' PI ranged from 66%-80% of the total scores in PI instruments, almost the same levels as in pre-pandemic time, despite the elevated social image of nurses after the COVID-19 pandemic. There is no consensus about the impacts of most personal and social factors on students' PI across the studies. The impacts of COVID-19 on PI were both positive and negative.

CONCLUSIONS

COVID-19 epidemic exerted complicated impacts on the PI of intern nursing students. While it is necessary to address the fear of the COVID-19 pandemic among intern nursing students, the pandemic may not be an opportunistic time to enhance the students' PI.

Perceived Parenting Style and Subjective Well-Being among Chinese Nursing Undergraduates: The Role of Self-Efficacy and Gender

The question of how to improve the subjective well-being (SWB) of nursing students is an important factor for reducing nursing loss and improving nursing quality. The current study aimed to investigate the influence of parenting style and self-efficacy (SE) on SWB among Chinese nursing undergraduates. The moderating role of gender between parenting style and SWB was also examined. Descriptive analysis, Pearson's correlation analysis, and the Hayes' PROCESS Macro Model 4 and Model 5 were used to analyze the available data. A total of 665 nursing undergraduates (M_age = 19.86, SD = 1.19) completed questionnaires. The results showed that PPS was positively correlated with SWB (r = 0.421, p < 0.01), while NPS was negatively correlated with SWB (r = -0.167, p < 0.01). Meanwhile, SE was positively correlated with PPS (r = 0.167, p < 0.01) and negatively correlated with NPS (r = -0.175, p < 0.01). In addition, SE was positively correlated with SWB (r = 0.273, p < 0.01) and played a partial mediating role in the association between parenting style and SWB. Furthermore, gender moderated the direct effect of parenting style on SWB. Specifically, compared with male nursing students, parenting style has a greater influence on the SWB of female nursing students. These findings can be used to develop targeted improvement strategies for nursing educators to improve SWB levels among nursing undergraduates.