The mediating effect of self-directed learning in the relationship between caring and resilience among Chinese nursing students: A multi-center cross-sectional study

Exploring perceptions of alternative assessment and grading in graduate anatomy education

Alternative assessment approaches, such as pass/fail and feedback-based designs, aim to reduce academic stress and foster deeper learning. Few studies have examined feedback-based evaluation in formative settings in medical education, but none among graduate anatomy students. This exploratory study investigated the impact of feedback-based versus quiz-based assessments on graduate students' academic stress, motivation, and perceived learning quality in an anatomy course. Nine students were interviewed to discern perceptions of the impact of the different assessment types. Four instructors were interviewed to establish the philosophies behind their chosen assessment style, and their responses were compared to the perceptions of their students. Inductive thematic analyses of student interviews yielded multiple themes regarding considerations for the influence of assessment on academic-related anxiety and motivation: (1) communicating clear goals and expectations, (2) instructor approachability and individualized assessment, and (3) alignment between perceived effort and outcomes. Faculty interviewees demonstrated intentions to (1) promote non-technical skills, (2) provide authentic experiences, and (3) emphasize individualized assessment. However, there was some misalignment between instructors' goals and students' experiences, exacerbating students' stress and reducing their motivation. Feedback-based assessments were preferred for their perceived individualized nature and facilitation of deeper learning. Findings indicated that implementing feedback-based approaches, while ensuring constructive alignment, could reduce stress for graduate anatomy students. Furthermore, clear communication and instructor approachability can cultivate stronger teaching presence, which may enhance motivation, engagement, and the quality of learning outcomes. Implementing formative feedback-based assessments may, therefore, be an effective strategy to reduce stress and improve learning experiences for graduate-level anatomy students.

The mediating role of psychological capital on the relationship between perceived stress and self-directed learning ability in nursing students

BACKGROUND

As indispensable reserves for the nursing workforce, undergraduate nursing students must possess self-directed learning abilities to consistently update their professional knowledge and adapt to the evolving demands of professional development. The acquisition of self-directed learning abilities can help undergraduate nursing students augment their theoretical knowledge and refine their clinical practice skills, thus fulfilling the demand from patients for high-quality nursing services. Hence, comprehending and investigating the factors that influence the development of self-directed learning abilities in nursing students is of paramount importance for nursing education and advancement of the nursing profession.

OBJECTIVES

This study investigated the status of and associations between perceived stress, psychological capital, and self-directed learning abilities among undergraduate nursing students. Additionally, it examines the mediating role of psychological capital in the relationship between perceived stress and self-directed learning abilities. Thus, aiming to provide nursing educators with new directions for enhancing self-directed learning abilities.

DESIGN

A cross-sectional descriptive study.

METHODS

In February and March 2023, 900 undergraduate nursing students from 10 nursing schools completed an online questionnaire. The questionnaire included measures of perceived stress, psychological capital, and self-directed learning ability. Data were analyzed using SPSS 27.0 and the PROCESS macro tool.

RESULTS

The scores for perceived stress, psychological capital, and self-directed learning ability among undergraduate nursing students were 40.07 ± 5.90, 99.89 ± 16.59, and 87.12 ± 9.20, respectively. Self-directed learning abilities were negatively correlated with perceived stress (r = -0.415, p < 0.001) and positively correlated with psychological capital (r = 0.465, p < 0.001). Perceived stress was negatively correlated with psychological capital (r = -0.630, p < 0.001). Psychological capital partially mediated the relationship between perceived stress and self-directed learning abilities among undergraduate nursing students, with a mediation effect of -0.166, accounting for 49.55% of the total effect.

CONCLUSION

This study found that undergraduate nursing students perceived high levels of stress, possessed low levels of psychological capital, and had moderate levels of self-directed learning. Perceived stress and psychological capital directly influenced undergraduate nursing students' self-directed learning abilities, and perceived stress indirectly affected self-directed learning abilities through psychological capital. Nursing managers and educators should alleviate the perceived stress of undergraduate nursing students and cultivate their positive psychological capital to enhance self-directed learning abilities.

Design and practice of blended teaching of internal medicine nursing based on O-AMAS effective teaching model

BACKGROUND

Self-directed learning (SDL) ability is the basis for cultivating nursing students' ability to find and solve problems, lifelong learning, and providing high-quality nursing talents for healthcare. The O-AMAS (Objective, Activation, Multi-learning, Assessment, Summary) model adheres to the teaching philosophy of student-centered, result-oriented, combines the advantages of online and offline teaching, enriching teaching resources and learning channels, diversifying teaching and evaluation methods, and emphasizing integrating and applying knowledge conducive to improving students' SDL ability and achieving teaching objectives. This study explored the course design, practical, and application effects under the O-AMAS effective teaching model in internal medicine nursing to provide a basis and reference for combining effective teaching models with blended teaching in future nursing courses.

METHODS

This study is a self-controlled before-after trial. The participants were 76 nursing undergraduates from Hunan Normal University. This study utilizes the O-AMAS effective teaching model to design internal medicine nursing courses and implement blended online and offline teaching. Main links: The overall course design and application are student-centered, after clarifying macro and micro multi-dimensional learning objectives, with online and offline blended teaching environments activated students' learning behavior and diversified teachers' teaching activities, then based on instant and dynamic provide effective feedback; finally, students take the initiate to make a brief and potent summary under the teacher guidance. After the course, a unified assessment of the learning effect of nursing students was conducted, including the evaluation of the SDL ability of nursing students, a final comprehensive evaluation grade, and a teaching satisfaction survey.

RESULTS

The nursing students' SDL ability scores are higher than before teaching, and the results were statistically significant (P < 0.05). The final average comprehensive evaluation grade of nursing students was 78.38 ± 7.12. More than 96% of the students are satisfied with this course.

CONCLUSION

Applying for internal medicine nursing blended teaching integrated with the O-AMAS effective teaching model is conducive to improving nursing students' SDL ability, academic grades, and teaching satisfaction.

Effects of virtual reality OSCE on nursing students' education: a study protocol for systematic review and meta-analysis

INTRODUCTION

Virtual objective structured clinical examination (OSCE) has been shown to influence the performance of nursing students. However, its specific effects, particularly students' competence, stress, anxiety, confidence, satisfaction with virtual reality OSCE and examiners' satisfaction, remain unclear.

METHOD AND ANALYSIS

This study aims to assess the effects of virtual reality OSCE on nursing students' education. The study follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol guidelines. A literature search is performed on electronic databases, namely, PubMed, Web of Science, CINAHL, EBSCO, EMBASE and the Cochrane Library. The inclusion criteria adhere to the PICOS principle, encompassing nursing students, including those studying in school and those engaged in hospital internship. This review includes studies on the use of virtual reality OSCE as an assessment tool, compared with traditional clinical examinations, such as in-person OSCE. The outcome assessments encompass (1) competence, (2) stress, (3) anxiety, (4) confidence, (5) student satisfaction with virtual reality OSCE and (6) examiners' satisfaction. These studies are designed as randomised controlled trials (RCTs) or quasi-experimental research. The search time is from the inception of each database to 30 June 2023, without language restriction. Studies for inclusion are screened by two reviewers for data extraction dependently. Any dispute is resolved through discussion. Unresolved disputes are decided by consulting a third author. For the risk of bias (ROB) assessment, the Cochrane ROB tool for RCTs and the risk of bias in non-randomised studies of intervention tool are used. Moreover, RevMan V.5.3 is used for meta-analysis.

ETHICS AND DISSEMINATION

This study protocol does not include any clinical research and thus does not require ethical approval. Research findings are published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42023437685.

Emotion regulation in undergraduate nursing students: A latent profile analysis

BACKGROUND

Current research on emotion regulation of undergraduate nursing students mainly focused on the overall level of emotion regulation and its relationship with other variables, ignoring the individual heterogeneity of emotion regulation of undergraduate nursing students.

AIM

By latent profile analysis (LPA), this study aimed to identify different emotion regulation profiles among undergraduate nursing students and to explore demographic and personal factors associated with different emotion regulation profiles.

METHOD

This was a cross-sectional study. A total of 578 nursing students were investigated by the demographic questionnaire, the emotion regulation scale, the Connor-Davidson resilience scale-10 item and the core self-evaluations scale. LPA was used to analyze the latent profiles of emotion regulation among undergraduate nursing students. And multiple logistic regression was used to explore the predictors of different profiles.

RESULT

Three potential profiles were identified: profile 1-- low suppression and moderate reappraisal group, profile 2-- moderate suppression and high reappraisal group, profile 3-- high suppression and high reappraisal group. Resilience, family monthly income and perception of nursing profession were predictors of different profiles.

CONCLUSION

Most nursing students were classified into profile 2 and their emotion regulation was relatively good. However, students in profile 1 were with moderate cognitive reappraisal and students in profile 3 were with high expressive suppression, and their emotion regulation need to be further improved by increasing their cognitive reappraisal and decreasing their expressive suppression. Strategies tails to improve resilience, increase scholarships and change the perception of nursing profession may be effective ways to improve emotion regulation of undergraduate nursing students in different profiles.

Relationship between optimism, emotional intelligence, and academic resilience of nursing students: the mediating effect of self-directed learning competency

Background

The evolution toward future education following the 4th industrial revolution and the coronavirus disease 2019 (COVID-19) pandemic have changed nursing education dramatically. Online classes have become a new paradigm of education, and are expected to develop and be maintained in various forms even after the end of COVID-19. Therefore, attention is focused on finding ways to improve learners' achievements in a distance learning environment. This study aimed to examine the mediating effects of self-directed learning competency on the relationships between optimism, emotional intelligence and academic resilience among nursing students.

Methods

A cross-sectional descriptive design was conducted using convenience sampling of 195 nursing students in South Korea. Data were analyzed with descriptive statistics, Pearson's correlation coefficients, multiple regression, and mediation analysis using SPSS/WIN 26.0 program.

Results

There were significant positive correlations among self-directed learning competency, optimism, emotional intelligence and academic resilience. The self-directed learning competency acts as a mediator in explaining relationship between optimism, emotional intelligence and academic resilience, respectively.

Conclusion

This study provides the evidence for the role of self-directed learning competency in the relationship between optimism, emotional intelligence and academic resilience in nursing students. Rapid changes in education are inevitable due to changes in clinical settings and the impact of repeated infectious disease outbreaks including the COVID-19 pandemic. This study suggests strengthening positive psychology and self-directed learning capability of nursing students as a strategy to prepare for changes in education and clinical areas.

Subgroups of self-directed learning ability and their differences in professional identity among nursing undergraduates during the COVID-19 pandemic: a latent profile analysis

BACKGROUND

Promoting self-directed learning (SDL) among nursing undergraduates is crucial to meet the new requirements of the healthcare system and to adapt to online learning contexts during the COVID-19 pandemic. Therefore, identifying the classification features of SDL ability and developing targeted interventions are both critical. Professional identity (PI) may contribute to the cultivation of SDL ability, but their relationship remains relatively unknown. This study aimed to explore the subgroups of SDL ability and their differences in PI among nursing undergraduates during the COVID-19 pandemic.

METHODS

A total of 2438 nursing undergraduates at four universities in China were enrolled in this cross-sectional study from November 2021 to February 2022. The Self-Directed Learning Scale of Nursing Undergraduates (SLSNU) and the Professional Identity Scale for Nursing Students (PISNS) were administered. A latent profile analysis was performed to explore SDL ability latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the PI scores in each latent profile.

RESULTS

Three latent profiles were identified and labeled 'low SDL ability' (n = 749, 30.7%), 'low initiative of help-seeking' (n = 1325, 54.4%) and 'high SDL ability' (n = 364, 14.9%). Multinomial logistic regression analysis suggested that nursing undergraduates who voluntarily chose a nursing major, had served as a student cadre, and had participated in clinical practicum were less likely to be included in the "low SDL ability" group. The average PI score was statistically different across the three profiles (F = 884.40, p < 0.001).

CONCLUSION

The SDL ability among nursing undergraduates was divided into three profiles, and results show that promoting PI may effectively foster SDL ability. This study highlights the importance of targeted interventions by considering their distinct SDL ability patterns, especially during the COVID-19 pandemic.

Resilience and academic motivation's mediation effects in nursing students' academic stress and self-directed learning: A multicenter cross-sectional study

AIMS

To investigate the mediating role of resilience and academic motivation between academic stress and self-directed learning.

BACKGROUND

Academic stress in nursing students is a well-reported concept that affects resilience, academic motivation and self-directed learning. However, there is a dearth of studies investigating the mediating role of resilience and academic motivation between academic stress and self-directed learning.

DESIGN

Cross-sectional study and mediation analysis.

METHODS

Nursing students (n = 718) were recruited from five nursing schools via convenience sampling. Four self-report scales (Perception of Academic Stress Scale, Connor and Davidson Resilience Scale, Short Academic Motivation Scale and Self-directed Learning Instrument) were used to collect data from August to December 2022. Pearson's r, bivariate analysis and multistage regression analyses were employed to analyze the data.

RESULTS

Academic stress negatively influences nursing students' resilience, academic motivation and self-directed learning. Resilience and academic motivation have a positive impact on self-directed learning. Resilience and academic motivation mediate the relationship between academic stress and self-directed learning, as evidenced by a reduction in the negative impacts of academic stress on nursing students.

CONCLUSION

Resilience and academic motivation, as mediators, reduce the effects of academic stress on self-directed learning. Nursing educators and administrators should promote programs that strengthen resilience and academic motivation. Thus, improving educational and clinical performance.

Self-leadership as an attribute of service leadership: Its relationship to well-being among university students in Hong Kong

Introduction

In the scientific literature, although conceptual models and empirical evidence have shown that leadership attributes are intimately linked to the well-being of followers, there is a lack of studies focusing on leadership in the service economy. According to the Service Leadership Theory, service leadership is a process that satisfies the needs of self, others, and systems (teams, organizations, communities, and societies) in ethical ways that is characterized by leadership competence, character, and care. With specific reference to self-leadership emphasized in service leadership, higher levels of service leadership attributes should promote personal well-being. However, the relationships between "service leadership attributes" and "well-being" in leaders at the intrapersonal level in leadership education among Chinese university students are rarely examined.

Methods

In this study, we collected data from 198 students to understand the linkages between "service leadership attributes" and "well-being" in university students taking a course on service leadership. For tracking changes in students, we collected both pretest and posttest data on validated measures of "service leadership attributes" (i.e., "knowledge," "attitude," and "behavior") and "well-being" (i.e., "positive youth development attributes" and "life satisfaction").

Results

Results showed that the posttest scores on all three domains of "service leadership attributes" as well as two dimensions of "well-being" encompassing life satisfaction and positive youth development attributes were higher than the respective pretest scores, suggesting that students experienced a shift in a positive direction after taking the course. Cross-lagged analyses showed that pretest service leadership attitude and behavior predicted posttest positive youth development attributes; pretest service leadership behavior predicted posttest life satisfaction. Pretest life satisfaction also predicted posttest service leadership behavior.

Discussion

Findings suggest that there is an intimate relationship between "service leadership attributes" and "well-being" in the "pre-work" context among university students.