Saudi female nursing students experiences of sense of belonging in the clinical settings: A qualitative study

The mediating effect of clinical belongingness on the relationship between anxiety and professional identity in nursing interns: a cross-sectional study

Background

Previous studies have reported that anxiety negatively affects professional identity (PI), and clinical belongingness is positively correlated with PI among nursing interns. However, little is known about the relationship between anxiety, PI, and clinical belongingness among nursing interns.

Objective

To explore the relationship between PI, clinical belongingness, and anxiety among nursing interns, and to demonstrate the mediating role of clinical belongingness in this relationship.

Methods

A cross-sectional study using an online questionnaire was conducted between November 2023 and January 2024 among 1,050 nursing interns from 26 teaching hospitals in Sichuan Province, China. A general information questionnaire, the Belongingness Scale-Clinical Placement Experience (BES-CPE), the Self-Rated Anxiety Scale (SAS), and the Professional Identity Questionnaire for Nursing Students (PIQNS) were used to collect data. SPSS (version 25.0) and AMOS (version 28.0) were used to analyze the data.

Results

Nursing interns had moderate mean scores for all variables; PI (60.77 ± 12.18), clinical belongingness (115.99 ± 17.02), and anxiety (47.44 ± 8.75). Correlation analyses revealed that both PI (r = -0.129, p < 0.01) and clinical belongingness (r = -0.087, p < 0.01) were negatively correlated with anxiety and clinical belongingness was positively correlated with PI (r = 0.601, p < 0.01). The clinical belongingness of nursing interns had a mediating effect on the relationship between anxiety and PI (β = -0.072, 95% confidence interval = -0.133 to -0.013, p < 0.001), accounting for 40% of the total effect.

Conclusion

The anxiety level of nursing interns can have a direct impact on the prediction of PI and an indirect influence on PI mediated by clinical belongingness. Accordingly, nursing educators and managers should screen and channel the mental health problems of nursing interns in a timely manner, improving their clinical belonging, which will help improve PI and ultimately improve the stability of the nursing workforce.

Defining sense of belonging in nursing - An evolutionary concept analysis

OBJECTIVES

The purpose of this analysis is to develop the concept of sense of belonging in nursing. The secondary purpose is to identify the antithesis or direct opposite beyond the negative consequences related to a lack of belonging in nursing.

DESIGN

Rodgers' evolutionary method guided the analysis and advancement of sense of belonging in nursing.

DATA SOURCES

Following PRISMA guidelines, peer-reviewed English articles and dissertations were reviewed from PubMed, ERIC, CINAHL, and PsychINFO. Forty-seven articles describing sense of belonging in the nursing profession, both academic and workforce, were included.

REVIEW METHODS

Inductive thematic analysis was used to determine recurring themes of the antecedents, attributes, consequences, and antithesis of belonging in nursing.

RESULTS

A welcoming, positive atmosphere encouraging a culture of mentorship is key to developing an environment of belonging. The attributes of belonging include being trusted, valued, and an accepted part of the team, and encouraging a connection to the community. Nurses and nursing students have improved confidence, self-esteem, and motivation to learn when a sense of belonging is present. They feel supported and respected in the environment. However, historically minoritized students and nurses report discrimination, bias, and condescension resulting in feeling invisible, isolated, excluded, and neglected. Nurses and nursing students feel invisible, isolated, excluded, and neglected without a sense of belonging.

CONCLUSION

Developing a sense of belonging in nurses and nursing students is critical to our profession. Further research is essential to develop interventions and strategies for cultivating a sense of belonging in nursing.

Nursing students' stressors and coping strategies during their first clinical training: a qualitative study in the United Arab Emirates

BACKGROUND

Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses' sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study.

METHODS

A qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes.

RESULTS

During their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students' clinical experiences. We extracted three main themes that described students' stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies.

CONCLUSIONS

This qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum.

Resilience's role in clinical belongingness and presenteeism of new nurses: A moderated mediation model

This study explored the mediating effect of resilience on clinical belongingness and presenteeism of new nurses. A total of 271 new nurses completed the Connor-Davidson Resilience Scale, Belongingness Scale-Clinical Placement Experience, and Stanford Presenteeism Scale. It was found that resilience correlated positively with clinical belongingness, while presenteeism was negatively correlated with resilience and clinical belongingness. The mediating effect of resilience on clinical belongingness and implicit absence accounted for 42% of the total effect value. Hence, new nurses' resilience plays an intermediary role between clinical belongingness and presenteeism. Nursing managers can develop interventions to reduce the sense of clinical absence by improving the resilience of new nurses.

Psychometric evaluation of the Persian version of the Sense of Belonging in Nursing School (SBNS): a quantitative and cross-sectional design

BACKGROUND

This study aimed to evaluate the psychometric indicators of the Persian version of the Sense of Belonging in Nursing School scale (SBNS).

METHODS

The study conducted in Shahroud and Semnan schools of nursing and midwifery in Iran examined nursing students using a cross-sectional approach by convenience sampling method from 3/6/2023 to 24/8/2023. To assess the SBNS scale, the forward-backward procedure was used to translate it into Persian. Face and content validity were evaluated, and exploratory and confirmatory factor analyses were conducted with sample sizes of 200 and 182, respectively. Reliability was assessed using Cronbach's alpha coefficient, MacDonald's omega, and intra-class correlation coefficient.

RESULTS

The exploratory factor analysis resulted in the exclusion of four items, leaving a final selection of 15 items. These items were categorized into three factors: classmates, clinical staff, and inclusive educational environment, which accounted for 49.16% of the overall variance. The confirmatory factor analysis indicated that the model was a good fit for the observed data, and the subscales had high internal consistency (Cronbach's alpha coefficient was 0.752 to 0.880) and stability (intra-class correlation coefficient was 0.889 to 0.968).

CONCLUSION

According to the results, it can be concluded that the Persian version of the SBNS scale demonstrates sufficient validity and reliability in assessing students' sense of belonging to the nursing school.

Predictors of Empowerment Among Undergraduate Nursing Students: A Cross-Sectional Study

Objective

To predict the factors that influence undergraduate nursing students' perception of empowerment.

Methods

A cross-sectional design was used, and fourth-year nursing students (n = 164) were selected using convenient sampling. The data collection methods included the Arabic version of self-reported questionnaires: The (LES), (LOGO-II), and (UNSASS).

Results

The results showed a positive correlation between nursing students' perception of empowerment and their attitudes toward learning. Also, the results showed a strong correlation between students' perception of empowerment and their academic satisfaction. In addition, in-class teaching was found to be the strongest predictor of students' perception of empowerment.

Conclusions

Verified the factors that may contribute to promoting the teaching-learning process to focus and stress on them. Teachers and instructors should utilize the available resources in the teaching environment to maximize the learning outcomes. All these factors are not limited and will enhance the nursing students' perception of empowerment.

Exploring the barriers to Registered Nurses undertaking clinical teaching in clinical settings: A qualitative descriptive study

AIM

The study aimed to explore and describe the barriers affecting Registered Nurses in undertaking clinical teaching in clinical settings. The exploration was based on the experiences of Registered Nurses at a selected teaching hospital in Namibia. The researcher intended to identify strategies that could be used to mitigate the negative effects of barriers to effective clinical teaching.

DESIGN

A qualitative explorative, descriptive and contextual research design was used.

METHODS

Purposive sampling was used to select 16 participants. Data were collected through in-depth, semi-structured interviews, which were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.

RESULTS

Clinical teaching is negatively affected by several barriers that hamper clinical teaching and nursing students' learning outcomes. Seven main themes were identified: (1) participants' understanding of clinical teaching; (2) organizational barriers; (3) patient barriers; (4) Registered Nurse barriers; (5) student barriers; (6) training institution barriers; and (7) strategies to mitigate barriers to clinical teaching.

CONCLUSION

The findings revealed that several barriers negatively affect clinical nursing education and hamper the clinical teaching and learning of nursing students.

PATIENT OR PUBLIC CONTRIBUTION

This study may assist in the development of targeted interventions that address the barriers that hinder clinical teaching at teaching hospitals. Additionally, this study could assist in improving the health care that is provided by nursing students to patients. The findings may assist with improved quality by reducing nursing students' theory-practice gap and by promoting collaboration between Registered Nurses and nurse educators in clinical settings.

Midwifery students' experiences of their clinical internship placement during the COVID-19 pandemic in Ireland: A qualitative descriptive study

OBJECTIVE

To explore the impact of the COVID-19 global pandemic on midwifery students' experiences of clinical internship placement in the final year of their midwifery programme.

DESIGN

A qualitative descriptive study was conducted following ethical approval. Four online focus groups were facilitated.

SETTING AND PARTICIPANTS

To prepare for autonomous practice, BSc Midwifery students in the Republic of Ireland (RoI) undertake a 36-week internship in the final year of their programme. Midwifery students (n = 15), from one Higher Education Institute (HEI), who were undertaking internship across two clinical practice sites volunteered to participate in the study.

FINDINGS

Four overarching themes were identified: Fear and uncertainty of internship in the context of a pandemic, Consequences of COVID-19 within the clinical environment, Student supports, Opportunities and challenges during internship. Working within a health care environment dominated by the presence of COVID-19 had significant consequences for the students and their provision of care for women and families. Students were challenged with managing increased responsibility within the context of COVID-19 practice requirements and restrictions. Students balanced their need to progress to autonomous practice, whilst acknowledging their needs as learners. COVID-19 also brought unexpected benefits, which included enhancing students' ability to develop relationships with women in their care, and students described a sense of belonging within the midwifery team.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

Midwifery students identified internship, during the COVID-19 pandemic as challenging and stressful. However, students also portrayed a sense of pride in their achievements. Support structures assisted students to cope during this period which included peer support, protective reflective time (PRT) in the HEI and support from clinical placement coordinators in midwifery (CPC-Midwifery) within clinical placements sites. It is essential that these support structures continue within midwifery educational programmes. Promoting peer support in a more formal support structure may need consideration. These support structures need to be protected and enhanced during unprecedented times, such as the COVID-19 pandemic.

The impact of clinical placement site, community clinic versus tertiary hospital, on midwifery students' clinical learning experience in Sierra Leone: a cohort study

BACKGROUND

In midwifery education, the clinical learning experience (CLE) is a critical component to gaining competency and should comprise greater than 50% of a student's education. Many studies have identified positive and negative factors affecting students' CLE. However, few studies have directly compared the difference in CLE based on placement at a community clinic versus a tertiary hospital.

METHODS

The aim of this study was to examine how clinical placement site, clinic or hospital, impacts students' CLE in Sierra Leone. A once 34-question survey was given to midwifery students attending one of four public midwifery schools in Sierra Leone. Median scores were compared for survey items by placement site using Wilcoxon tests. The relationship between clinical placement and student's experience were assessed using multilevel logistic regression.

RESULTS

Two-hundred students (hospitals students = 145 (72.5%); clinic students = 55 (27.5%) across Sierra Leone completed surveys. Most students (76%, n = 151) reported satisfaction with their clinical placement. Students placed at clinics were more satisfied with opportunities to practice/develop skills (p = 0.007) and more strongly agreed preceptors treated them with respect (p = 0.001), helped improve their skills (p = 0.001), provided a safe environment to ask questions (p = 0.002), and had stronger teaching/mentorship skills (p = 0.009) than hospital students. Students placed at hospitals had greater satisfaction in exposure to certain clinical opportunities including completing partographs (p < 0.001); perineal suturing (p < 0.001); drug calculations/administration (p < 0.001) and estimation of blood loss (p = 0.004) compared to clinic students. The odds of students spending more than 4 h per day in direct clinical care were 5.841 (95% CI: 2.187-15.602) times higher for clinic students versus hospital students. There was no difference between clinical placement sites in regards to number of births students attended (OR 0.903; 95% CI: 0.399, 2.047) or number of births students managed without a preceptor/clinician present (OR 0.729; 95% CI: 0.285, 1.867).

CONCLUSION

The clinical placement site, hospital or clinic, impacts midwifery students' CLE. Clinics offered students significantly greater attributes of a supportive learning environment and access to direct, hands-on opportunities for patient care. These findings may be helpful for schools when using limited resources to improve the quality of midwifery education.

DEVELOPMENT AND PSYCHOMETRIC TESTING OF THE SENSE OF BELONGING IN NURSING SCHOOL SCALE

Background and Purpose: While sense of belonging is essential for human motivation, impaired belonging among nurses can impact the care and safety of patients. This article reports the development and psychometric testing of the Sense of Belonging in Nursing School (SBNS) scale to assess nursing students' sense of belonging in three different environments: Clinical, classroom, and among the student cohort. Method: Principal component exploratory factor analysis with varimax rotation was used to determine the construct validity on the 36-item SBNS scale with a sample of 110 undergraduate nursing students. Cronbach's alpha was used to determine the scale's internal consistency. Results: The scale was reduced to 19-items with high internal consistency (α = 0.914). Principal component analysis then identified four factors (sub-scales) with high internal consistency: Clinical staff (α = 0.904), clinical instructor (α = 0.926), classroom (α = 0.902), and classmates/cohort (α = 0.952). Conclusion: The SBNS scale is a reliable and valid tool to measure sense of belonging across three environments among nursing students. Further research is needed to determine the scale's predictive validity.

The process of learning and professional development according to nursing students' experience during Covid-19: A constructivist grounded theory study

AIM

This study explored the experiences of nursing students with respect to learning processes and professional development during internships with COVID-19 patients to build a novel theoretical model.

BACKGROUND

The COVID-19 outbreak had a profound impact on the worldwide learning system and it interrupted the internship experiences of nursing students. After the second wave of COVID-19, to balance academic activities with COVID-19 containment, some Italian universities allowed nursing students' internships in COVID-19 units. This new experience may have influenced nursing students' learning processes and professional development, but this is yet to be investigated.

DESIGN

A qualitative study using a constructivist grounded theory (CGT) approach.

METHODS

Nursing students were recruited from two hospitals in northern Italy between January and April 2021. Data are gathered from interviews and a simultaneous comparative analysis were conducted to identify categories and codes, according to Charmaz's (2006) theory.

RESULTS

The sample consisted of 28 students. The results suggested the core category, that is the 'Students' sense of belonging to the nursing profession' and four main categories: (1) From knowledge to know-how, (2) A new relationship modality, (3) Sharing and socialisation and (4) Responsibilization. Finally, a premise and a corollary, respectively (5) Motivation and the (6) Circularity of the process, were identified.

CONCLUSION

Our study proposed a new theory of nursing students' learning processes in clinical contexts during internships with COVID-19 patients. Despite significant difficulties, the nursing students developed a unique learning process characterised by motivation. Therefore, our study provided insight into the learning process during a pandemic and investigated the support needed for nursing students to continue their internships.

Belongingness in undergraduate/pre-licensure nursing students in the clinical learning environment: A scoping review

AIM

The aim of this scoping review was to map the literature investigating belongingness in undergraduate/pre-licensure nursing students in the clinical learning environment.

BACKGROUND

The concept of belongingness, which encompasses feelings of acceptance, connection and value alignment, has been tied to positive outcomes in undergraduate/pre-licensure nursing students including increased learning, participation, confidence and professional socialization. It is critical for educators and clinical staff to foster a sense of belongingness for nursing students to promote positive and effective clinical learning experiences.

DESIGN

The scoping review strategy established by the Joanna Briggs Institute was followed. The databases searched were CINAHL Complete (EBSCO), Education Source, Medline Complete (EBSCO), APA PsycINFO (EBSCO) and Epistemonikos.

METHODS

Following a search of the five databases, studies were screened by title and abstract by two independent reviewers for inclusion. Data including population, concept, context, methods and key findings relevant to the review question were extracted and synthesized using an instrument developed by the reviewers.

RESULTS

A total of 47 articles with varying methodologies were critically appraised. Three overarching focus areas emerged: outcomes resulting from feelings of belongingness versus alienation, factors that contribute to a sense of belongingness in the clinical learning environment and interventions to promote a sense of belongingness while students are immersed in the clinical learning environment.

CONCLUSIONS

Belongingness in the clinical learning environment is an important concept that lends itself to positive learning experiences and increased satisfaction of undergraduate/pre-licensure nursing students. Environmental, relational and experiential factors can be maximized and specific interventions employed to promote belongingness. This review identifies a lack of evidence on measured interventional effectiveness at the student, school and clinical unit level. Future research to address these gaps is recommended.

TWEETABLE ABSTRACT

Scoping review suggests environmental, relational and experiential factors promote positive outcomes in belongingness of nursing students.

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.

Barriers to Implementing Evidence-Based Practice among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Study

Several studies have been conducted to investigate the barriers to implementing evidence-based practice (EBP) worldwide. In Saudi Arabia, a few studies were conducted in hospital and mental health settings, and no study has explored the topic in primary healthcare settings. This study aimed to examine the barriers perceived by primary healthcare nurses in implementing EBP. This study employed a correlational and cross-sectional design. A total of 284 nurses were surveyed using the BARRIERS scale. Regression analysis was performed to identify the effects of predictor variables on the four subscales. The overall raw score on the BARRIERS scale was 86.21 (standard deviation = 16.15). The highest mean score was reported in the organizational subscale, followed by the innovation and communication subscales, whereas the lowest mean score was reported in the adopter subscale. The findings showed that the three top-ranked barriers were: (1) results of the studies are not generalizable to nurses’ setting, (2) facilities are inadequate, and (3) physicians do not cooperate with the implementation. Findings showed that nurses encounter organizational-related barriers to a moderate extent and EBP implementation varies depending on gender, level of education, and job position. There is a need to create and implement educational interventions and programs to overcome the barriers to effective EBP implementation among primary healthcare nurses.

Dual Collegiate Roles-The Lived Experience of Nursing Student Athletes

BACKGROUND

Teamwork and communication, characteristics learned through playing college sports, can precipitate a sense of wonder in the lived experiences of nursing students who played a college sport.

METHOD

A phenomenological study was conducted to understand the meaning of the collegiate roles of the nursing student and the student athlete. These roles carry different sets of responsibilities, social contacts, and physical and emotional demands. Thirteen practicing nurses who played a college sport during their nursing program were interviewed.

RESULTS

Data analysis revealed four essential themes that described the meaning of their experience: athletic identity, perseverance, advocates and adversaries, and belongingness. Results suggest participation in college sports creates a sense of belonging that assists in the transition into college.

CONCLUSION

Although nursing students may be deterred from coordinating academics and athletics, this study indicates it is possible and may even have benefits, both academically and during students' transition into practice. [J Nurs Educ. 2022;61(3):117-122.].

Modification, Translation, and Psychometric Testing of the Arabic Version of the Belongingness Scale-Clinical Placement Experience (BES-CPE)

BACKGROUND

This paper aimed to describe the modification, translation, and psychometric testing of the Arabic version of the Belongingness Scale-Clinical Placement Experience (BES-CPE).

METHODS

This study included the following phases: modification of the original BES-CPE based on the qualitative findings from a previous study; translation and back-translation of the scale; evaluation of the content validity by experts from Saudi Arabia; evaluation of the internal consistency reliability; and other psychometric properties of the Arabic BES-CPE.

RESULT

The results demonstrated acceptable psychometric properties. The Cronbach's alpha ranged from 0.68 to 0.92.

CONCLUSION

The Arabic BES-CPE is a promising tool that can be used to assess Saudi nursing students' sense of belonging. However, testing the tool with other undergraduate nursing students in a different context is recommended.

Moral intelligence, clinical placement experience and professional behaviors among Iranian undergraduate nursing students in a baccalaureate nursing program: A descriptive correlational study

AIMS

This study was intended to examine the relationship of both moral intelligence (MI) and Clinical Placement Experience (CPE) with the level of nursing students' professional behaviors (PB).

BACKGROUND

The foundation of belief, belonging and ethical values develop PB as a meaningful attribute during the period students and caring for patients.

DESIGN

A descriptive correlational study was conducted.

METHODS

Descriptive data were derived from the Belongingness Scale-Clinical Placement Experience (BES-CPE), the Moral Intelligence Questionnaire (MIQ) and the Nursing Students Professional Behaviors Scale (NSPBS) including 200 students (response rate 94.5%).

RESULTS

We found a statistically strong positive correlation between NSPB, MI and CPE. The regression model accounted for 57.8% of the variance in NSPB; CPE and MI were significant explanatory variables of NSPB. Moreover, the non-employed dormitory students had a significant statistical difference in the scores of all three variables. Female students had significantly higher CPE and MI (p˂0.05).

CONCLUSIONS

According to our findings, preventive and mediation endeavors for nursing students can explicitly target their behavioral skills to reduce perceived rejection and improve morality. As a result, an optimal plan to improve the quality of professional training courses for students should be designed based on the comprehension of clinical belonging and moral intelligence.

Factors that influence the preceptor role: a comparative study of Saudi and expatriate nurses

OBJECTIVES

The aim of this study was to compare expatriate and Saudi nursing staff's perceptions of factors that influence their role as preceptors of nursing students.

METHODS

Descriptive comparative study using a self-administered survey was completed by a convenience sample of eligible nurses (n=285). It was conducted in five different hospitals within the Ministry of Health in the Kingdom of Saudi Arabia.

RESULTS

Most preceptors were expatriate nurses (70.5%), while Saudi preceptors represented only 29.5%. The findings show that there is a difference between Saudi and expatriate nurses in their perception of the role, that cultural factors influence the role of expatriate preceptors and that organisational factors influence both groups.

CONCLUSIONS

Expatriate preceptors felt that there were cultural obstacles that hindered their role. These findings will contribute to the development of a more contemporary and culturally sensitive preceptorship model.

Challenges faced by student nurses and midwives in clinical learning environment - A systematic review and meta-synthesis

OBJECTIVES

This systematic review aimed to offer insight and understanding, through synthesis of findings from studies that report on perspectives of student nurses/midwives, clinical instructors, clinical nurses/midwives on the challenges faced by student nurses/midwives in the clinical learning environment (CLE).

DESIGN

All primary qualitative research studies published in the English language that reported on the views of student nurses/midwives, clinical instructors and clinical nurses/midwives on the challenges faced by student nurses/midwives in the CLE were included.

DATA SOURCES

The electronic databases of Medline EBSCO (1946-), CINAHL (1970), Embase Ovid (1974-), ScielO, WHOLIS (2002-), ASSIA (1985-), Web of Science (1956-), PsycINFO (1800s-) and Maternal and Infant Care (1970-) were searched in November 2019.

REVIEW METHODS

Retrieved papers were reviewed independently by two authors for selection by title, abstract and full text, and two authors agreed for inclusion of the papers. The COREQ criteria checklist was used for assessment of methodological quality of the included studies.

RESULTS

The review included 32 studies published over 22 years between 1997 and 2019 involving 853 nursing/midwifery students, clinical instructors, and clinical nurses/midwives from 14 countries. Three key themes emerged: 'The support structure', 'Personal factors', and 'Planning and organisation - influence of extrinsic factors'.

CONCLUSION

Attitude of clinical staff, instructors, and significant others had a major influence on students' clinical learning. Lack of a sense of belongingness and self-motivation to learn, and perceived fear of doing errors were some of the demotivating factors. Lack of resources to facilitate need-based training, staff shortages, workload and inconsistencies between theory and practice were other key challenges in the CLE. Understanding the challenges faced by students in clinical practice can help overcome the barriers leading to development of competent and confident nurses and midwives.

Mental Health Literacy Scale Arabic Version: A Validation Study Among Saudi University Students

Mental health problems significantly affect students' university education. However, studies about mental health literacy (MHL) among Saudi university students are very limited. The two-fold objective of this study was to validate an Arabic version of the Mental Health Literacy Scale (MHLS) and assess the MHL of university students. The study participants involved 339 female students. Psychometric evaluation of the MHLS-Arabic version was conducted, and correlation and regression analyses were performed. The scale was successfully cross culturally adapted and found to be valid and reliable. The highest MHL indicator was the students' perception of confidence in using a computer or telephone to inquire about mental illness data. Conversely, the lowest MHL indicator was the student's disagreement with the notion that mental infirmity is not an actual medical challenge. Marital status, college attended, and academic level were found to have statistically significant effects on the MHL of university students. The Arabic version of the MHLS validly and reliably assessed MHL. This work adds to existing evidence for assessing MHL and can help administrators formulate better strategies to improve the MHL of university students.

The visualization of stress in clinical training: A study of nursing students' perceptions

Aim

To determine the perceived level and types of stress experienced by nursing students during clinical training.

Design

A descriptive correlational cross-sectional design.

Methods

A convenience sample of 238 nursing students was recruited. Level and types of stress were measured by Perceived Stress Scale. The data were collected in February 2020.

Results

The mean score of perceived stress was 2.58 (SD 0.92). Different sources of stressors perceived by students were identified in current study. The highest type of stressors perceived by students was stress from taking care of patients (mean = 2.81, SD 1.13). In addition, junior students perceived higher level of stress than senior students and female students experienced a higher level of stress than male counterparts. Students who have been supervised by clinical instructors whom their "primary" language is English scored a higher level of stress.

Proceso de Atención de Enfermería como instrumento del cuidado, significado para estudiantes de último curso

Introducción: El Proceso de Atención de Enfermería (PAE) como guía para el cuidado, se aplica desde que inicia la formación académica. Comprender el significado que tiene para estudiantes del último curso permite visualizar la importancia y dificultades que se presentan en su aplicación, para proponer estrategias que fortalezcan la calidad educativa. Objetivo: Comprender el significado del PAE que tienen los estudiantes del último curso de Enfermería. Método: Estudio con enfoque cualitativo. Referencial teórico y metodológico fue el Interaccionismo Simbólico y la Teoría Fundamentada en los Datos. Muestra por saturación teórica. Colecta de datos con entrevistas semiestructuradas en 17 estudiantes del 10° ciclo de una universidad privada de Lima Este. Análisis de datos basado en la codificación de Strauss y Corbin posibilitó la identificación de categorías y subcategorías, y el fenómeno central. Resultados: Emergieron cinco categorías: 1) Cuidado enfermero utilizando el PAE desde el inicio de su formación (Condición causal); 2) Satisfacción o insatisfacción al dar cuidado con el PAE (Contexto); 3) PAE como herramienta de investigación en formación profesional (Condiciones Intervinientes); 4) Dificultades en la aplicación del PAE en el cotidiano de los profesionales (Estrategias de Acción/ Interacción) y 5) Mejora de la práctica al dar cuidado con PAE (Consecuencias). Conclusiones: El fenómeno central es el PAE, instrumento que guía el cuidado de enfermería para brindar a las personas atención integral y con fundamento en evidencia científica; a partir de la experiencia profesional con una proyección positiva al campo laboral, no exenta de limitaciones en su aplicación en el campo hospitalario.