Development of resilience in nursing students: A systematic qualitative review and thematic synthesis

Academic resilience of nursing students during COVID-19: An analysis using machine learning methods

AIM

This cross-sectional study investigates the factors that contribute to academic resilience among nursing students during COVID-19 pandemic.

DESIGN

A cross-sectional study.

METHODS

A survey was conducted in a general hospital between November and December 2022. The Nursing Student Academic Resilience Inventory (NSARI) model was used to assess the academic resilience of 96 nursing students. The Boruta method was then used to identify the core factors influencing overall academic resilience, and rough set analysis was used to analyse the behavioural patterns associated with these factors.

RESULTS

Attributes were categorised into three importance levels. Three statistically significant attributes were identified ("I earn my patient's trust by making suitable communication," "I receive support from my instructors," and "I try to endure academic hardship") based on comparison with shadow attributes. The rough set analysis showed nine main behavioural patterns. Random forest, support vector machines, and backpropagation artificial neural networks were used to test the performance of the model, with accuracies ranging from 73.0% to 76.9%.

CONCLUSION

Our results provide possible strategies for improving academic resilience and competence of nursing students.

Simulation as a method in a supervision course, experiences of midwives and specialist nurses: A qualitative study

AIM

To explore supervisors' experience of simulation in a student supervision course BACKGROUND: The relationship between student and supervisor is crucial for the students' learning and quality of education. The supervisors have an important role in facilitating a good start and the best learning opportunities for students in clinical placement. Supervision can be demanding and there is a need to strengthen supervisors in their role. An interprofessional supervision course was designed, using simulation as a method. Simulation is frequently used for acute situations to improve patient safety but is less common in student supervision. In our supervision course, simulation was introduced in the digital component and practiced in the physical component. The 4-6 members of the interprofessional simulation groups were assigned roles as either participants or active observers. They were guided by a facilitator, who constructed student-supervisor scenarios, allocated roles and facilitated reflection.

DESIGN

A qualitative, explorative design involving focus groups and written reflections.

METHODS

Two focus groups (n=9) were conducted following a pilot course in addition to written reflections (n= 80) after four courses. After revising the course and the interview guide, two additional focus groups (n =10) were held and a further 43 written reflections received. The empirical data were analyzed using thematic analysis by Braun and Clarke.

RESULTS

The three themes. 1. Interprofessional simulation provides a wider perspective on the student- supervisor relationship. The participants experienced being active in different roles, followed by subsequent joint reflection. They expressed increased relational understanding as well as the importance of verbal and nonverbal communication in supervision through learning from other interprofessional supervisors. 2. Simulation provides realism by entering into the situation. Simulation fostered activation of the senses that improved the supervisor's ability to be attentive to the student's needs. 3.Challenging to simulate the role of supervisor. Most participants were willing to force themselves out of their comfort zone to learn. However, quite a few felt uncomfortable participating in simulation on communication and preferred observing others.

CONCLUSION

The participants experienced simulation as valuable for strengthening their awareness of their ability to influence students' learning and relational understanding. The results showed the value of reflective observation in addition to participating in simulation. Simulation might contribute to improved supervision, although different experiences that inhibit learning outcomes must be acknowledged.

The wellbeing shelf: A mixed methods study exploring the impact of a resilience web resource for first year nursing and midwifery students

BACKGROUND

Nurturing a resilient nursing and midwifery workforce is vital for the National Health Service's sustainability. Higher Education Institutions (HEIs) must support students, given the challenges and attrition rates. Nursing and midwifery education uniquely balances tuition and placements, posing challenges, especially for first-year students, who face stressors including lack of familiarity, knowledge gaps, and emotional exposure.

OBJECTIVES

This study aimed to introduce and evaluate a co-designed web-based intervention called 'The Wellbeing Shelf' to enhance resilience among first-year nursing and midwifery students.

DESIGN

An exploratory mixed methods approach was employed, combining quantitative pre- and post-intervention questionnaires and qualitative focus groups.

SETTINGS AND PARTICIPANTS

The study involved 353 first-year nursing and midwifery students at Queen's University Belfast.

METHODS

'The Wellbeing Shelf' was developed through co-design workshops. Quantitative measures included the Connor Davidson Resilience Scale (CD-RISC) and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Qualitative data were collected through focus group interviews.

RESULTS

Quantitative data showed a decrease in both resilience and wellbeing scores over time. The CD-RISC scores decreased significantly from Time 1 to Time 3. Qualitative findings revealed three themes: "Acquiring" knowledge about wellbeing, "Actioning" self-care strategies, and "Advocating" for self-care among peers and family.

CONCLUSIONS

The study introduced 'The Wellbeing Shelf' as a resource to enhance resilience among nursing and midwifery students. Whilst the resource offered a variety of activities and fostered a sense of belonging, challenges in resource accessibility and student confidence were identified. The study also highlighted the importance of students advocating for self-care practices. Despite the resource's introduction, resilience and wellbeing scores decreased over time, suggesting a need for further research and potentially a control group. Understanding the initial lower resilience of nursing and midwifery students is crucial for future interventions in this high-demand program.

The predictive role of resilience and the ethical climate of hospital in the fatigue of surgical technologists working in operating rooms

BACKGROUND

Fatigue in surgical technologists is of paramount importance and is known as a priority because it can be regarded as a threat to the nurse's health and patient's safety. The fatigue level of healthcare workers can be affected by some factors, while the role of part of these factors is less known. This study aimed to determine the predictive role of resilience and the hospital ethical climate in the fatigue of surgical technologists working in operating rooms (ORs).

METHODS

This is a cross-sectional study conducted on 217 surgical technologists working in ORs of hospitals affiliated with Shiraz University of Medical Sciences. Data were collected using Connor-Davidson's Resilience scale, Olson's Hospital Ethical Climate Survey, and the Multidimensional Fatigue Inventory, and then analyzed using Pearson's correlation coefficient and multiple regression analysis.

RESULTS

87.1% and 12.9% of surgical technologists reported low and high fatigue, respectively. All fatigue subscales had significant and negative relationships with resilience (p < 0.05). Moreover, the relationship between fatigue and ethical climate was significant (p = 0.02). The multiple linear regression model showed the predictive role of resilience in fatigue (β=-0.29, P < 0.001). According to the model, 10% of the change of fatigue was related to resilience and ethical climate.

CONCLUSION

The present study demonstrated the relationship between resilience and ethical climate with fatigue. Moreover, resilience was a predictor of the surgical technologists' fatigue, so that their fatigue decreased with increasing resilience. However, future studies are recommended to determine other factors influencing fatigue in surgical technologists.

Understanding Resilience Among Generation Z Baccalaureate Nursing Students: A Hermeneutical Phenomenology Study

BACKGROUND

Supporting resilience for nursing student success is critical to future health care. This study explored the meaning and process of resilience among Generation Z traditional baccalaureate nursing students.

METHOD

Using a qualitative hermeneutical phenomenology approach, 13 Generation Z nursing students with the lived experience of resilience were surveyed and interviewed. Results were analyzed interpretively.

RESULTS

Themes of resilience among Generation Z nursing students were identified relative to study questions. Identified themes included "Maneuvering the Murky Water" and "This Can Either Ruin Me or I Can Keep Moving With It," as well as a resilience process within the context of nursing education. Open-response data provided further reflective insights on resilience and recommendations for resilience in nursing education programs.

CONCLUSION

Supporting resilience begins with understanding students' individual and generational perspective. Future nursing education research should include innovative interventions wherein the perspectives of Generation Z students are central to design. [J Nurs Educ. 2024;63(7):460-469.].

Improving the academic resilience of hospital nursing interns through a hybrid multi-criteria decision analysis model

Purpose: To identify the main variables affecting the academic adaptability of hospital nursing interns and key areas for improvement in preparing for future unpredictable epidemics. Methods: The importance of academic resilience-related variables for all nursing interns was analyzed using the random forest method, and key variables were further identified. An importance-performance analysis was used to identify the key improvement gaps regarding the academic resilience of nursing interns in the case hospital. Results: The random forest showed that five items related to cooperation, motivation, confidence, communication, and difficulty with coping were the main variables impacting the academic resilience of nursing interns. Moreover, the importance-performance analysis revealed that three items regarding options examination, communication, and confidence were the key improvement areas for participating nursing interns in the case hospital. Conclusions: For the prevention and control of future unpredictable pandemics, hospital nursing departments can strengthen the link between interns, nurses, and physicians and promote their cooperation and communication during clinical practice. At the same time, an application can be created considering the results of this study and combined with machine learning methods for more in-depth research. These will improve the academic resilience of nursing interns during the routine management of pandemics within hospitals.

Experiences of Nursing Students Regarding Challenges and Support for Resilience during Clinical Education: A Qualitative Study

Nursing students require resilience to navigate the complexities of clinical practice. This characteristic is essential for managing demanding workloads, unpredictable patient situations, and emotional stressors while maintaining performance and well-being. Fostering resilience helps students develop the capacity to adapt to adversity, overcome setbacks, and remain committed to providing high-quality patient care. This qualitative study explores the challenges and supports influencing nursing students' resilience during clinical education. Interviews with 28 Thai nursing students revealed two key themes: the "experience of vulnerability" and the "experience of meaningfulness". The sub-themes of vulnerability included "navigating uncertainty", "transcending professional struggles", and "being exposed to diverse encounters". The sub-themes of meaningfulness focused on restoring strength through social interactions and engaging in positive transformation. This study highlights the need for comprehensive support systems that address personal and professional vulnerabilities. Integrating caring theory principles could further enhance resilience by emphasizing compassionate care and fostering student empathy. This suggests that instructors and stakeholders can significantly impact student well-being by creating supportive environments built on collaboration, empathy, and mentorship, all of which are aligned with caring theory.

Comprehensive Strategies for Metabolic Syndrome: How Nutrition, Dietary Polyphenols, Physical Activity, and Lifestyle Modifications Address Diabesity, Cardiovascular Diseases, and Neurodegenerative Conditions

Several hallmarks of metabolic syndrome, such as dysregulation in the glucose and lipid metabolism, endothelial dysfunction, insulin resistance, low-to-medium systemic inflammation, and intestinal microbiota dysbiosis, represent a pathological bridge between metabolic syndrome and diabesity, cardiovascular, and neurodegenerative disorders. This review aims to highlight some therapeutic strategies against metabolic syndrome involving integrative approaches to improve lifestyle and daily diet. The beneficial effects of foods containing antioxidant polyphenols, intestinal microbiota control, and physical activity were also considered. We comprehensively examined a large body of published articles involving basic, animal, and human studie, as well as recent guidelines. As a result, dietary polyphenols from natural plant-based antioxidants and adherence to the Mediterranean diet, along with physical exercise, are promising complementary therapies to delay or prevent the onset of metabolic syndrome and counteract diabesity and cardiovascular diseases, as well as to protect against neurodegenerative disorders and cognitive decline. Modulation of the intestinal microbiota reduces the risks associated with MS, improves diabetes and cardiovascular diseases (CVD), and exerts neuroprotective action. Despite several studies, the estimation of dietary polyphenol intake is inconclusive and requires further evidence. Lifestyle interventions involving physical activity and reduced calorie intake can improve metabolic outcomes.

Cognitive maturity of Portuguese nursing students to intervene in disasters: initial training contribution

OBJECTIVE

To understand whether, from the perspective of coordinators/directors of nursing courses and nurses with skills in the field of disasters, nursing students have the necessary cognitive maturity to articulate the various dimensions inherent to the area of disasters, allowing efficient performance.

METHOD

A study with a qualitative methodological approach, based on inductive reasoning and rigorous phenomenon description, based on exploratory research.

RESULTS

Given the specificity and complexity of these phenomena, the inclusion of the disaster domain in the teaching-learning process, supporting valid knowledge construction and allowing the development and maturity of nursing students' cognitive processes, is crucial.

CONCLUSION

Currently, reduced technical-scientific training in the field of disasters in Portugal constitutes a barrier in the development of nursing students' cognitive maturity, impeding their ability to respond when faced with phenomena of this complexity.

Assessment of academic burnout and professional self-concept in undergraduate nursing students: A cross-sectional study

BACKGROUND

Nursing turnover and shortage are an increasing phenomenon throughout the world; thus, it is critical to determine the factors that contribute to them. Nursing students' retention plans and turnover intentions are significantly influenced by academic burnout and professional self-concept. The COVID-19 pandemic could aggravate the study-associated stresses leading to burnout and jeopardize the nursing student's professional socialisation which is a key factor in their professional self-concept formation, it is important to investigate their relationship.

PURPOSE

To examine the relationship between professional self-concept and academic burnout among undergraduate Bachelor of Nursing students and identify predictors related to academic burnout.

METHOD

This cross-sectional study was conducted from May to June 2021. The participants were undergraduate Bachelor of Nursing students from two campuses of a large university in Victoria, Australia. Out of 1630 students, 198 participated in the study. The students were invited to complete an online survey through the university's online learning platform or flyers. Descriptive statistics, Pearson correlation, and Bootstrapping approaches were used to analyse the data.

RESULTS

The analysis found a significant positive correlation between the nursing students' total professional self-concept and academic burnout professional efficacy (r = 0.48; p < 0.01). A significant negative correlation was also detected between the total professional self-concept and academic burnout cynicism (r = - 0.21; p < 0.01). Moreover, the total nurse professional self-concept was a significant predictor of both academic burnout subscales cynicism and professional efficacy (p < 0.01).

CONCLUSIONS

Positive nursing professional self-concept may alleviate student's academic burnout, and it might contribute to the promotion of their professional efficacy.

Integrating wellness into curricula using the ten dimensions of wellness as a framework

Burnout is a public health crisis that persists at the expense of clinician well-being, the healthcare workforce, and the quality of care provided. Clinician well-being is a professional imperative, yet nursing students still report higher levels of burnout than non-nursing students. Cultivating an academic learning environment that supports the development of resiliency, well-being, and improved student mental health requires a coordinated and sustained effort from nurse educators and academic leaders. This article aims to inspire nurse educators to take the first or next steps toward integrating wellness into nursing curricula. The ten dimensions of wellness provide a framework for wellness programming. Practical strategies aligned with each dimension are offered. As an exemplar, the Banding Together for Wellness program is summarized, including innovative incentives for student participation. Over the past five years, 426 (approximately 54 %) undergraduate nursing students voluntarily completed the program. While best practices may vary by institution, the strategies and resources offered herein can support nurse educators in the classroom, lab, and clinical setting as we all work to foster personal and professional well-being in nursing students. Nurse educators can be instrumental in cultivating the knowledge, skills, and attitudes required for life-long self-care, well-being, and nursing practice.

Preparing Compassionate Nurses: Infusing School Mission and Values in Undergraduate Education

ABSTRACT

In preparation for a curriculum revision, a cross-sectional, descriptive mixed-method research study sought to describe senior-level students' perspectives of Mercy and Jesuit faith-based tradition values integration in a pre-licensure BSN program. Integration of values was examined in both clinical settings and didactic classes. Students strongly articulated the importance of the school's values and mission to their future role as professional nurses. However, although value integration is occurring, greater attention to mission and values is needed in the clinical area.

The process and indicators of resilience among nursing students in clinical practicum in Taiwan: A qualitative study

Background

Resilience is essential for managing stress and maintaining equilibrium. During the clinical practicum, nursing students may experience tremendous physical and mental stress, and these negative experiences are considered a source of resilience for students. However, no universal definition of resilience among nursing students exists in the literature, occasioning the need to define the processes and indicators of resilience.

Purpose

This study aims to explore the resilience process and indicators among nursing students in clinical practicum in Taiwan. Participants: Fifteen fifth-year junior college nursing students in Northeastern Taiwan who had completed the clinical practicum were interviewed, including 12 females and three males. All participants were aged 20.3 ± 0.61 years and all participants had clinical practicum experiences over four months.

Methods

A qualitative descriptive study, using purposive and snowball sampling methods, was conducted to collect the experience of the nursing students in their internship. Data were collected using a semi-structured guide and deep interviews, and analyzed through the content analysis method by Waltz, Strickland, & Lenz (2010).

Results

Based on the participants' practical experiences during their clinical practicum, three main themes and nine indicators were identified. The resilience of nursing students is considered a process. The main themes are (1) uncontrolled clinical practical stress, (2) Maintain learning-life balance, (3) Positive attitude toward nursing.

Conclusions

Resilience is a critical factor to stabilize nursing students and enable them to recover from adversity. Both positive and negative experiences significantly impacted the students' attitudes and confidence levels during the clinical practicum. The findings will provide faculty to adapt their teaching method to various situations of nursing students.

Impact of an educational intervention on standard precautions during the COVID-19 pandemic

OBJECTIVE

To evaluate the impact of an educational intervention on the knowledge of nursing professionals regarding standard precautions.

METHODS

This is an almost experimental study conducted with 100 nursing professionals. Data collection was performed using a sociodemographic characterization instrument and the Standard Precautions Knowledge Questionnaire. The educational intervention was based on five moments, where the approach to questions with less than 70% accuracy was intensified.

RESULTS

There was a significant difference between the scores of healthcare professionals before (16.20 ± 1.51) and after (16.90 ± 1.31) the educational intervention (W=3.336; p < 0.05). Regarding knowledge about hand hygiene after glove use, an increase in knowledge from 83% to 93% was obtained.

CONCLUSIONS

A positive effect on the professionals' knowledge was recorded, demonstrating advances regarding the strengthening of already acquired knowledge and the understanding of new knowledge.

Association between proactive personality and professional identity of nursing undergraduates: The mediating role of resilience and irrational belief

AIM

To examine the relationship between proactive personality and professional identity of undergraduate nursing students, including the role of psychological resilience and irrational belief as mediators.

BACKGROUND

Personality has been shown to play a crucial role in determining professional identity. However, the influence of proactive personality on professional identity in the nursing field is poorly understood and requires further investigation.

DESIGN

We conducted a cross-sectional study in China. Between July and December of 2021, 860 nursing undergraduates participated in an online questionnaire survey.

METHODS

Four main variables (proactive personality, psychological resilience, irrational belief and professional identity) and two covariates (willingness to choose nursing profession and family attitude towards nursing) were assessed. The assessment tools chosen are both valid and reliable. To test the proposed multi-mediation model, linear regression analysis by Hayes's SPSS macro-PROCESS was used.

RESULTS

The results revealed that PP, PR and PI were positively connected with one another, but negatively with IB. PP positively predicted PI through direct and indirect paths, after controlling for two covariates. The percentage of indirect path (78.72%) outweighed the direct path (21.28%). The indirect effect of PR (72.51%) was higher than that of PR and IB (6.21%). PI was also positively predicted by students' "Yes" willingness and families' "supportive" attitude towards nursing.

CONCLUSION

This study stated that nursing educators should take nursing students' PP seriously, which would allow for activities to be taken to improve their PR and decrease their IB, hence continuously enhancing their PI. In addition, respecting students' professional aspirations and improving family support may also be valuable ways to boost their PI.

Moving the needle further and faster: Policy and leadership opportunities to support early career nurse faculty and build resilience in establishing and growing their programs of research

Nurse scientists play a critical role in advancing the nursing field and improving health, but early career faculty can enter the academic ranks with little training in how to effectively establish, manage, and grow a program of research (POR) or weather the storms that accompany a research-intensive academic path. This can lead many nurse scientists to leave academic positions or even abandon their POR altogether. This is problematic at a societal level because nurse scientists bring a unique and valuable holistic perspective to scientific inquiry and an orientation towards community-based work, team science, intersectionality, and participatory approaches essential to address urgent health challenges. To enhance the impact of nurse scientists as a collective on academic research and human health, more attention should be given to the concept of resilience in the context of a research-focused career and the necessary structural changes that effectively support early career faculty in establishing thriving PORs. This article offers considerations relevant to administrative leaders, policymakers, and established faculty, at both the institutional and disciplinary level, to support early career faculty in establishing PORs that take root and flourish.

Factors associated with perceived resilience among unergraduate nursing students: findings of the first cross-sectional study in Palestine

BACKGROUND

Resilience has emerged as a concept that could explain and predict good academic and well-being of students in stressful and traumatic situations. This study was conducted to assess resilience and identify predictors of high or low resilience scores among future nurses in Palestine.

METHODS

This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology statement. Undergraduate nursing students in all academic years were recruited and asked to complete a questionnaire that contained the Trait Resilience Scale and the State-Resilience Scale. Multiple linear regression models were used to identify predictors of higher resilience scores and to control for potentially confounding factors.

RESULTS

In this study, 290 students completed the questionnaire (response rate = 92.4%). The means of trait, state, and combined resilience scores were 71.4 (SD: 7.5), 62.7 (SD: 6.7), and 134.1 (SD: 12.8), respectively. There was a significant moderate positive correlation between state resilience scores and trait resilience scores (r = 0.63, p < 0.001). Having a study routine on daily basis predicted higher trait (β = -0.20, p < 0.001), state (β = -0.12, p = 0.032), and combined (β = -0.18, p = 0.001) resilience scores. Trait and combined resilience scores were predicted by the absence of chronic diseases (β = 0.12, p < 0.05), experiencing addiction issues (β = -0.11, p < 0.05), living in Israeli seized areas (β = 0.16, p < 0.05), and living in a house with enough number of rooms per siblings (β = 0.13, p < 0.05). On the other hand, state and combined resilience scores were predicted by being in the first academic year (β = -0.18, p < 0.01), and state resilience scores were predicted by living in urban areas (β = -0.12, p < 0.05).

CONCLUSIONS

Undergraduate nursing students in Palestine reported relatively high trait and state resilience scores. Higher trait, state, and combined resilience scores were predicted by having a study routine on daily basis. More studies are still needed to investigate the relationship between resilience scores, perceived well-being, willingness to care, and the future success of nursing students in Palestine.

An integrative review of resilience among nursing students in the context of nursing education

AIM

This integrative review aimed to examine empirical research on resilience among nursing students in the context of nursing education. Resilience helps nursing students handle challenges, such as changing learning styles and experiencing their first clinical practice.

DESIGN

An integrative review.

METHODS

The search terms focused on resilience and health in nursing students and nursing education. The database used in this review were CINAHL Plus, PubMed and MEDLINE. The Mixed Methods Appraisal Tool appraised the studies' quality.

RESULTS

This study explored 52 records and revealed three current research focuses related to nursing students' resilience: (1) the concept and description of resilience, (2) the characteristics affecting resilience and (3) the mediating role of resilience in maintaining holistic health. Recommendations include adding a resilience topic to the nursing curriculum, providing resilience enhancement programs, examining the relationship between resilience and holistic health and exploring the influence of resilience about global health crises.

PUBLIC CONTRIBUTION

Resilience among nursing students plays a vital role in helping them to overcome adversities during their nursing education. Additionally, after graduation, nursing students can continue contributing to society as resilient Registered Nurses in the future.

Academic resilience, moral perfectionism, and self-compassion among undergraduate nursing students: A cross-sectional, multi-center study

BACKGROUND

Academic resilience has been identified as a coping method for nursing students' educational and practice challenges. Despite the importance of academic resilience, knowledge on how to enhance academic resilience is under-researched. To suggest suitable approaches, relationships between academic resilience and other constructs need to be appraised.

OBJECTIVES

This study aims to evaluate predictors of academic resilience, examining its relationships with other essential constructs: self-compassion and moral perfectionism, in undergraduate nursing students in Iran.

DESIGN

This descriptive cross-sectional study was conducted in 2022.

PARTICIPANTS

A convenience sample of 250 undergraduate nursing students at three universities in Iran participated in this study by completing self-report measures.

METHODS

Data collection tools were Nursing Student Academic Resilience Inventory, Moral Perfectionism scale, and Self-Compassion Scale-Short Form. Correlation and regression analyses were conducted.

RESULTS

The mean and standard deviation of academic resilience were 57.57 ± 23.69; moral perfectionism 50.24 ± 9.97, and self-compassion 37.19 ± 5.02. Self-compassion had significantly related to moral perfectionism (r = 0.23, p < 0.001). Academic resilience had no statistically significant relationship with moral perfectionism (r = -0.05, p = 0.41) and self-compassion (r = -0.06, p = 0.35), but significantly affect age (r = 0.14, p = 0.03), Grade point average (r = 0.18, p < 0.001) and university of study (r = 0.56, p < 0.001). The grade point average and the university of the study predicted 33 % of the changes in academic resilience, and the greatest impact was related to the university (r = 0.56, p < 0.001).

CONCLUSION

Adopting appropriate educational strategies and supporting the students will help improve nursing students' academic resilience and performance. Promoting self-compassion will lead to the development of nursing students' moral perfectionism.

The relationship between self-regulated learning, mindful agency, and psychological resilience in Chinese master of nursing specialists: A cross-sectional study

Background

Self-regulated learning helps to improve academic performance and is an important strategy for the sustainable development of Master of Nursing Specialists. Consequently, it is relevant to identify the factors that affect self-regulated learning and analyze the correlation between them.

Objective

This study examined the status quo of self-regulated learning, the relationship between self-regulated learning, mindful agency, and psychological resilience, and explored whether mindful agency and psychological resilience influence self-regulation learning.

Methods

Chinese Master of Nursing Specialists were recruited to participate in an online survey from March to November 2022. Self-regulated learning, mindful agency, and psychological resilience were measured using three questionnaires, including the Self-Regulated Learning Scale for Clinical Nursing Practice Scale (SRLS-CNP), the Mindful Agency Scale, and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). The data were processed and analyzed using SPSS26.0. The statistical methods included descriptive statistics, Pearson’s correlation analyses, and multiple linear regression.

Results

Self-regulated learning of Chinese Master of Nursing Specialists was medium level (59.24 ± 9.33 scores). Mindful agency and psychological resilience were positively correlated with self-regulated learning (p &lt; 0.01) and important predictors of self-regulated learning of Master of Nursing Specialists, explaining 44.6% of the variation.

Conclusion

Mindful agency and psychological resilience affected the self-regulated learning level of Master of Nursing Specialists in clinical practice. These results will enable clinical educators to pay more attention to the personal psychological factors of Master of Nursing Specialists to improve their self-regulated learning ability through mindful agency and psychological resilience.

It's a hard process - Nursing students' lived experiences leading to dropping out of their education; a qualitative study

BACKGROUND

Dropout from nursing education is a serious problem worldwide. Student nurse attrition has a profound effect not only on the nursing profession and patient care, but also on the students themselves. Dropout is recognized as a complex phenomenon that has multiple causes. A more detailed and nuanced understanding of the complexity behind dropout is needed if we are to retain more nursing students.

AIM

To explore the students' experiences and considerations before dropping out and their reflections after dropping out to gain a deeper understanding of the factors that prompted them to leave their nursing education.

DESIGN/METHOD

A qualitative explorative design inspired by Gadamer's philosophical hermeneutics was used to explore the students' lived experiences and considerations concerning dropping out. Qualitative telephone interviews were conducted on 15 nursing students.

RESULTS

The analysis revealed three main themes that disclosed and elucidated the nursing students' reasons for dropping out: (i) Resources to make a difference and help others; (ii) Clinical practice was more demanding than expected; (iii) The learning environment was important - the social environment was essential.

CONCLUSION

The students encountered a lack of support to deal with the difficult emotions that arose when witnessing serious illness and death. They expressed feeling overwhelmed by their vulnerability and called for support to develop resilience. The social environment and a sense of belonging to the nursing profession were cited by students as being essential to this support.

Resilience as a protective factor on the quality of life (QoL) of Indian nursing students during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic negatively impacted the quality of life of individuals around the world, including health care professionals. There has been little research that examines the role of resilience concerning the impact of COVID-19 on the quality of life of nursing students. This study aimed to determine how resilience influenced the quality of life among nursing students during the COVID-19 pandemic.

METHODS

A cross-sectional research design was adopted for this study. A total of two hundred sixty-eight nursing students from three universities, South India responded in the web-based survey. Data was collected using self-reported questionnaires in June 2021.

RESULTS

Our findings revealed that the participants' resilience was normal, which had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. The COVID-19 impact on QoL significantly differed with year of education (F = 3.087; p < 0.02) and university (F = 6.697, p < 0.001). Bivariate analysis revealed significant inverse relationships between the impact of COVID-19 on quality of life with resilience (r = -0.259; p < 0.001) and perceived knowledge on COVID-19(r = -0.168; p < 0.006).

CONCLUSION

In our study, we found that resilience had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. Therefore, it is important to promote students' resilience and improve their quality of life during stressful situations.

Patient safety and its relationship with specific self-efficacy, competence, and resilience among nursing students: A quantitative study

BACKGROUND

Patient safety is a relevant subject in the nursing curriculum. Each university programs patient safety teaching and practical training differently. However, few studies have sought to explore the relationship between patient safety as perceived by nursing students and other important psychosocial competencies in the nursing curriculum, such as self-efficacy, competence, and resilience.

OBJECTIVES

To analyze differential patient safety integration into three nursing education programs, and to assess agreement levels regarding patient safety climate, students' knowledge of patient safety and correlations with specific self-efficacy, competence and resilience.

METHODS

Participants were 647 undergraduate students from three universities. Patient safety climate and knowledge of patient safety (good praxis) were measured using the Hospital Survey on Patient Safety Culture for nursing students, and other psychosocial variables were also analyzed using other instruments: specific self-efficacy, perceived competence and resilience. Nursing education programs and patient safety climate were analyzed using the Rwg(j) and ICC measures of inter-rater agreement across different academic levels.

RESULTS

The ICC and Rwg indexes revealed high inter-rate agreement in all three universities. Differences were observed between Univ-2 and Univ-3 in patient safety climate scores and agreement values between academic levels. Differences in good praxis were found when academic levels were compared in Univ1-and Univ-2. Patient safety climate was found to correlate significantly with the psychosocial variables studied, but only in Univ-1.

CONCLUSIONS

Perceived patient safety climate differs between universities and academic levels. This competency is related to self-efficacy, competence and resilience, which endorses the assessment of patient safety integration from a broader perspective.

Resilience in nursing education: an evolutionary concept analysis

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

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

Stress and Resilience of Nursing Students in Clinical Training During the COVID-19 Pandemic: Palestinian Perspective

Introduction

Stress reduces nursing students' capacity to think critically, impedes decision-making, and eventually lowers academic performance and limits success. The circumstances surrounding the COVID-19 outbreak drove students into new virtual learning settings, adding stress to their academic responsibilities.

Objectives

The purpose of this study was to assess the perceived stress and resilience among nursing students in clinical training during the COVID-19 pandemic.

Method

A cross-sectional study was conducted on 315 students studying nursing. Data collection utilized the Perceived Stress Scale and the Connor-Davidson Resilience Scale.

Results

The analysis revealed that the stress score mean was 75.2 ± 6.6 and the resilience score mean was 26.0 ± 3.4. Also, there was a weak negative association between nursing students' stress and their resilience (p < 0.05). Additionally, the results indicated statistically significant differences between stress and gender, study year level, and age (p < 0.05).

Conclusion

Stress was high and resilience was moderate during the COVID-19 pandemic among nursing students.

Novel approaches to communication skills development: The untapped potential of qualitative research immersion

Objective

Participation in qualitative research, particularly analysis of recorded medical dialogue, offers real-time, longitudinal immersion that can strengthen clinical trainee communication skills. The study objective was to explore how qualitative research participation impacts clinical trainees' self-perceived communication skills development and practice.

Methods

In this study, a 17-member multidisciplinary working group of child life specialists, advanced practice providers, undergraduate/medical students, residents, fellows, attending physicians, social scientists, and career researchers with recent qualitative and communication research experience assembled to discuss this topic using a structured discussion guide. Content analysis was used to identify concepts and themes.

Results

Three key themes characterizing the impact of qualitative research participation on aspiring clinicians' communication skills development and practice arose - the 3Cs: (1) Connection, therapeutic alliance, and accompaniment; (2) Clarity and prognostic communication; (3) Compassion, empathy, and understanding. Participants emphasized that qualitative research learning improved their understanding of patient/family lived experiences, preparing them for future clinical encounters, strengthening their emotional intelligence, and promoting self-care, resilience, and professional affirmation.

Conclusions

Immersion in clinical communication through participation in qualitative research is an under-utilized resource for supporting clinical trainees in communication skills development.

Innovation

The process of collaborative knowledge production through the collective exploration of an a priori question related to group members' collective experiences is methodologically innovative. Further, re-thinking qualitative research participation as an underutilized educational opportunity is pedagogically novel, and leaders in medical education and qualitative research should collaborate to realize the potential of this teaching tool.

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

BACKGROUND

Despite the proliferation of literature focusing on resilience, a paucity of research has attempted a thorough and accurate examination of factors that contribute to resilience among nursing students.

OBJECTIVES

To examine the mediating effect of self-directed learning in the relationship between caring and resilience in Chinese nursing students.

DESIGN

A cross-sectional design.

SETTINGS

Five universities in China.

PARTICIPANTS

Undergraduate nursing students (N = 511).

METHODS

The Caring Ability Inventory, Self-Rating Scale of Self-Directed Learning, and Connor-Davidson Resilience Scale (CD-RISC) were administered. Socio-demographic and academic data were collected from nursing students after obtaining their informed consent. A multiple linear regression analysis was performed to assess factors associated with resilience. A structural equation model with bootstrapping estimation was conducted to further explore the potential mediating role of self-directed learning in the relationship between caring and resilience.

RESULTS

The average score of CD-RISC for nursing students was 92.96 ± 14.85. Multiple linear regression analyses indicated that caring and self-directed learning were significantly positively associated with resilience. Self-directed learning (β = 0.327, 95% Confidence Interval [CI]: 0.049-6.667, p < 0.001) had a significant mediating effect on the relationship between caring and resilience in nursing students, explaining 67.1% of the total effect of caring on resilience.

CONCLUSIONS

Interventions that enhance students' self-directed learning have the potential to enhance resilience level. Innovative pedagogical approaches, strategic reinforcement, and nursing curriculum transformation are recommended to promote self-directed learning awareness and internalize self-directed learning skills.

Student Perspectives on Sources of Resilience During Nursing School

Resilience is important to the academic and career success of nursing students; however, the literature on nursing student resilience is sparse and remains undertheorized. This article describes nursing students' perspectives on sources of resilience during nursing school at one institution of higher learning. A constant comparative analysis of baccalaureate nursing student focus group responses was performed. Three themes emerged: negative experiences, supportive structures and relationships, and individual coping processes and abilities. Interrelationships between thematic findings highlight the centrality of supportive structures and relationships. Based on these findings, theoretical guidance for future nursing student resilience assessments and interventions is provided.

Resilience, Social Support, Loneliness and Quality of Life during COVID-19 Pandemic: A Structural Equation Model

AIM

To determine the parsimonious model of the interrelationships of personal resilience, social support, loneliness and quality of life (QoL) and to identify the mediating effect of loneliness among nursing students amidst the pandemic.

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic led to control measures which increased loneliness among students due to disrupted social connections and sudden shift to virtual learning. During these changes, resilience and social support can significantly influence how learners deal with pandemic-related stresses thus, minimizing loneliness and enhancing QoL. Although studies posited the influence of resilience and social support with loneliness and QoL, these were conducted prior the COVID-19 pandemic wherein loneliness and feelings of isolation play a crucial part.

DESIGN

Correlational, theory testing using covariance-based structural equation modeling METHODS: A total of 550 nursing students from a comprehensive university in Manila, Philippines were recruited from September to October 2021 and answered four standardized, validated scales.

RESULTS

A good and parsimonious model (x2/df = 2.84, RMSEA = 0.058, GFI = 0.999, CFI = 0.999, PNFI = 0.048) highlighted the mediating effect of loneliness between social support, personal resilience and QoL. While personal resilience positively influenced the physical and psychological domains of QoL, social support positively affected the social relationships and environmental domains. Loneliness was a strong, negative predictor of the psychological and social domains of QoL and had a moderate, negative effect on the physical domain. Personal resilience also mediated the influence of social support on loneliness and QoL.

CONCLUSION

Social support and personal resilience positively affected QoL, while loneliness had a negative effect. Through the mediation of loneliness, the effects of social support on QoL decreases. However, the mediation of resilience further decreases loneliness and improves QoL. The presented model assists nurse educators and administrators in developing strategies to enhance social support, resilience and QoL among students while mitigating the negative effects loneliness during the pandemic.

TWEETABLE ABSTRACT

Loneliness and Resilience are mediators of student nurses' quality of life during COVID-19 pandemic. Social support is the common predictor.

An Exploration of Resiliency Among Nurse Educators During the COVID-19 Pandemic

AIM

The purpose of this study was to explore resilience among nursing faculty during the COVID-19 pandemic and to examine associations or differences that may exist among variables and between groups.

BACKGROUND

Nurse educators' resilience has been identified as an important characteristic because of the challenges involved in nursing education. It is important to explore resilience among nurse educators to determine which factors promote or inhibit this important characteristic.

METHOD

This correlational research study used an online survey to explore factors related to resilience among nurse faculty during the COVID-19 pandemic. Correlational analyses were used to determine the relationship between various resilience constructs and select demographic variables.

RESULTS

Findings indicated that higher levels of resilience were associated with age (ρ = .21, p < .001), experience teaching online ( r = .22, p < .001), and professional development related to online teaching ( M = 80.7, SD = 11.0), t (276) = 2.41, p = .017.

CONCLUSION

Resilience and related characteristics have the potential to assist nurse educators in adapting successfully to stressful circumstances. It is crucial that schools of nursing develop programs to enhance or develop resilience among nurse educators. Support and training in the area of online education are also of paramount importance.

Trends in mental health indicators among nurses participating in healthy nurse, healthy nation from 2017 to 2021

BACKGROUND

American healthcare workers face unprecedented stress and trauma in the workplace during COVID-19, putting nurses at increased risk for poor mental health. Examining trends of mental health from before and during COVID-19 can illuminate the toll of the pandemic on nurses well-being.

METHODS

Nurses enrolled in Healthy Nurse, Healthy Nation receive a prompt to take an annual survey (n = 24,289). Mental health was assessed by active diagnoses of anxiety and depressive disorder, and feeling sad, down or depressed for two or more weeks in the past year. Logistic regression models were used to calculate predictive probabilities of health outcomes in year 4 (May 1, 2020 - April 30, 2021) compared to years 1-3 (each from May 1 to April 30), controlling for age, sex, race/ethnicity, and nurse type. Models were also stratified by work setting and nurse type.

RESULTS

In year 4, nurses had a 19.8% probability of anxiety disorder, significantly higher than year 3 (16.3%, p < .001), year 2 (13.7%, p < .001), and year 1 (14.0%, p < .001). Similarly, nurses had a 16.7% probability of depression disorder in year 4, significantly higher than year 2 (12.9%, p < .001) and year 1 (13.9%, p < .01). Year 4 nurses had a 34.4% probability of feeling sad, down or depressed for two weeks, significantly higher than previous years (year 1 = 26.8%, year 2 = 25.9%, year 3 = 29.7%, p < .001). Trends in probabilities of mental health indicators were similar among each nurse type and work setting. Nurses in medical/surgical work settings and those with licensed practical nurse and licensed vocational nurse titles consistently had the highest probability of poor mental health.

LINKING ACTION TO EVIDENCE

In 2020-2021, nurses faced challenges unlike any experienced in previous years. Unsurprisingly, nurses reported increased instances of poor mental health indicators. Positive disruptive strategies are needed to systemically change organizational culture and policy to prioritize and support nurses' well-being.

Fostering Resilience in Nursing Students in the Academic Setting: A Systematic Review

BACKGROUND

Nursing students experience similar stress-related health issues as RNs and have been identified as a group of health professionals who may be unable to cope effectively with stress. Studies have emphasized the need to incorporate resilience programs at higher education institutions for nursing students. However, it is important to identify strategies that increase resilience to ensure future programs are effective and follow an evidence-based approach.

METHOD

This mixed-methods systematic review was conducted using Joanna Briggs Institute (JBI) methodology. A comprehensive literature search was conducted using JBI Critical Appraisal Checklists for assessment and quality appraisal. Data were extracted and synthesized thematically.

RESULTS

Category intervention strategies were identified and used to cluster three intervention strategy themes. Three outcome themes also were synthesized to examine strategy effectiveness.

CONCLUSION

Findings indicate multicomponent interventions that include information sharing, skill application, and reflective learning are effective in helping nursing students manage stress and increase resilience. [J Nurs Educ. 2022;61(5):229-235.].

The impact of the work environment on the health-related quality of life of Licensed Practical Nurses: a cross-sectional survey in four work environments

BACKGROUND

Nurses are known to have negative health outcomes related to their work. While it is acknowledged that nursing work is associated with things like back injuries and burnout, there is limited evidence as to what factors in the work environment contribute to these issues.

PURPOSE

The aims of this study were to assess how Licensed Practical Nurses (LPNs) report their Health-related quality of life (HRQoL), and how nurses' health is impacted by their work environment.

METHODS

These data used for analysis comes from a cross-sectional survey administered online to all LPNs in Alberta (2018). The survey collected data on the following variables: participant's demographics, the SF-36 HRQoL, Practice Environment Scale of the Nursing Work Index (PES-NW) and the CD-RISC measure of resilience. The beta distribution was used to model HRQoL outcomes. In instances where optimal health (score of '1') was observed then an extended version of beta distribution (called one-inflated beta) was applied.

RESULTS

4,425 LPNs responded to the survey. LPNs (mean age: 40) report lower scores on each SF-36 subscale than the general Canadian population aged 35-44. LPNs who work 'causal' had better physical health, (OR 1.21, CI 1.11-1.32, p = 0.000), and mental health (OR 1.22, CI 1.12-1.30, p = 0.000) than LPNs who work full time, even after controlling for resilience. LPNs' views on the adequacy of staffing and resources in their workplaces have an influence across all dimensions of health.

CONCLUSION

This study suggests that improvements in the work environment could positively impact health outcomes and that adequate resourcing could support the nursing workforce.

The role of resilience in higher education: A meta-ethnographic analysis of students' experiences

BACKGROUND

There is increasing evidence that being resilient negates the deleterious impacts of stress and promote academic success. To develop an insight into how important resilience is, it is vital to explore how higher education students perceive and develop resilience.

OBJECTIVES

The purpose of this review was to gather students' experiences of their resilience journey in an educational setting.

DESIGN

Systematic review and meta-ethnography of qualitative evidence REVIEW METHODS: This review was reported in accordance with the eMERGe guidelines. The data were analysed with reference to the seven steps of meta-ethnography. The Grading of Recommendations, Assessment, Development and Evaluation's Confidence in Evidence from Reviews of Qualitative research (GRADE-CERQual) was used to appraise the quality of the evidence.

RESULTS

Three themes emerged: (1) resilience associates with internal resources, (2) resilience develops through meaningful relationships and (3) resilience can be instilled by educational institutions. An individual's trait, outlook and engagement within their social network can influence resilience. The presence and availability of institution-based support services can ease students transition into higher education.

CONCLUSION

This review provides a basis for influencing further research and curriculum development in ensuring students' well-being and success in school.

Resilience Training for Nurses: A Meta-analysis

Nurses frequently face stressful situations during work, which makes resilience an essential quality of their personality to cope with professional stress and to prevent burnout. Resilience can be improved by training and practice. To analyze the effect of resilience training in nurses, studies reporting the changes in resilience before and after resilience training were identified by conducting the literature search in electronic databases. Meta-analyses of standardized mean differences (SMDs) between postintervention and preintervention scores of resilience and other related variables were performed. Thirteen studies (576 nurse participants) were included. Resilience training improved the resilience scores of the participants (SMD, 0.58; 95% confidence interval [CI], 0.23-0.94; P = .001), whereas there was no improvement in the resilience scores of nurses who did not participate in resilience training (SMD, -0.13; 95% CI, -0.54 to 0.27; P = .523). The stress (SMD, -0.60; 95% CI, -0.80 to -0.40; P < .00001), anxiety (SMD, -0.50; 95% CI, -0.80 to -0.20; P = .001), depression (SMD, -0.43; 95% CI, -0.67 to -0.19; P < .0001), and burnout (SMD, -1.01; 95% CI, -1.25 to -0.76; P <˂ .0001) scores of the participants were also decreased after resilience training. In conclusion, resilience training improved the resilience scores of nurses, which was also associated with improvements in stress, depression, anxiety, and burnout scores. However, because of the variations in training contents and measuring tools, only generalized assessments could be made.

Structural equation modeling of the relationship between nursing students’ quality of life and academic resilience

Objective

Across the Middle Eastern countries, there is a lack of studies exploring the connection between the quality of life (QoL) and academic resilience of nursing students. This study determines the association between nursing students’ profile variables and their QoL and academic resilience (AR).

Methods

A descriptive cross-sectional design with structural equation modeling (SEM) was adopted. This study was conducted at the College of Nursing at the University of Ha'il, KSA. Survey questionnaires using the 12-item Brunnsviken Brief Quality of Life Scale (BBQ) and 30-item Academic Resilience Scale (ARS-30) were utilised to collect data from nursing students (n = 384). SEM via latent variable analysis (lavaan) software version 0.6–7 was used for statistical derivation and analysis.

Results

SEM revealed no correlation with QoL and AR when compared using the participants’ profile variables (gender, year level, and enrolled units). There was a correlation between the grade point average (GPA) and QoL. However, no association was found between QoL and AR.

Conclusion

GPA exhibited a positive correlation with QoL; thus, nursing students with higher GPA have a more stable and desirable QoL. Additionally, our findings illustrate the individuality of nursing students despite their shared characteristics.

Undergraduate nursing students' resilience, challenges, and supports during corona virus pandemic

The coronavirus global pandemic interrupted teaching at Australian universities. Face-to-face teaching was replaced by online delivery. This presented challenges for nursing programmes due to the hands-on teaching requirements and clinical placements. Questions were raised around students' resilience and stress in the face of adversity. This study explored undergraduate nursing students' resilience, challenges experienced, and supports utilized during the pandemic. Convenience sampling recruited students from one nursing programme (n = 340). Quantitative and qualitative data were collected. The Connor-Davidson Resilience Scale (CD-RISC-25) examined resilience scores through non-parametric analysis. Narrative responses were analysed using inductive thematic analysis. 121 surveys (40.3%) were completed. Most participants were from second year (n = 77, 63.6%). The difference in median resilience scores among employed participants was statistically significant (P = 0.029) and higher than the unemployed. The median scores of students working in nursing-related roles were higher than others. Median resilience score across all year levels was 70 (IQR = 62-80), in the lowest score range. Major themes identified were fear of the virus, isolation, and mental health problems. The coping strategies identified were developing daily routines, staying connected, and establishing self-help techniques. This research has implications to optimize students' learning experience, enhance resilience, and promote mental health and well-being.

Fear of death and its relationship to resilience in nursing students: A longitudinal study

AIM

Taking a corpus of nursing students enrolled in the 2017-2021 nursing degree, we aim to analyse how students' levels of resilience and fear of death evolve in the first three years of the degree and whether there are differences between students based on age and gender. In addition, we aim to describe the relationship between resilience and fear of death.

BACKGROUND

Throughout their training, nursing students will encounter situations of grief and death that may generate reactions of rejection, anxiety and emotional imbalance. Recognising and controlling these emotions through specialised training in end-of-life care and fostering resilience is essential.

DESIGN

Comparative, correlational and longitudinal study.

METHODS

Our corpus comprised 100 nursing students who were followed through the first three years of their training. Data were collected using a sociodemographic questionnaire, the Collet-Lester Fear of Death Scale and the Resilience Scale.

RESULTS

The corpus reported medium-high levels of fear of death overall. Patterns were similar for all academic years: fear of other people's death was invariably the highest scoring subscale; and while individual dimensions of the Collet-Lester scale correlated directly and significantly with each other they were found to be inversely related to student age. High levels of resilience were recorded and were highest in the final year.

CONCLUSIONS

In this sample of student nurses, fear of death and resilience do not appear to be related to each other. Nursing education must include training specifically targeted at increasing levels of resilience and decreasing fear of death to improve end-of-life care.

"You Need to Get Over the Difficulties and Stand Up Again"-A Qualitative Inquiry into Young Nurses' Coping with Lateral Violence from the Feminist Perspective

Previous studies have reported lateral violence (LV) styles among nurses and the adverse impacts of LV on nurses and nursing. Young nurses, including nursing students and novice nurses, are often victims of LV. A large qualitative research study that contained three sub-studies exploring professional identity development in different professional stages was conducted by a research team in Macau, Special Administrative Region of China. Semi-structured interviews with nursing students and clinical nurses were carried out; among the 58 participants in the three sub-studies, 20 described some forms of LV and their ways of dealing with them. Framed by the feminist perspective, the researchers explored young nurses’ coping strategies in dealing with LV perpetrated by senior colleagues. Two themes were developed reflecting the coping strategies for LV: “making extra efforts” and “soothing emotional distress”. Three sub-themes were under the theme of “making extra efforts”: “catching up knowledge”, “making the most use of learning resources”, “adjusting communication manner”; another batch of sub-themes was under the theme of “soothing emotional distress”: “seeking support from schoolmates”, “living with family but crying alone”, and “adjusting lifestyle”. The study implied that young nurses exerted their agency in coping with LV in clinical practices. Nursing managers and educators should support young nurses’ efforts in overcoming power-based LV and incivility.

Impacts of Nursing Student Burnout on Psychological Well-Being and Academic Achievement

BACKGROUND

Burnout, depression, and suicide among health care professionals and learners have reached a rampant level. This systematic review aimed to synthesize literature findings of nursing student burnout and its impact on psychological well-being and academic performance.

METHOD

This systematic review followed PRISMA guidelines and included data-based studies on nursing student burnout published in peer-reviewed journals between January 2015 and January 2020.

RESULTS

This review included 17 articles. Four major themes were identified: 1) a negative relationship between burnout and student self-concept, 2) a negative association between burnout and student engagement, 3) risk factors contributing to student burnout, and 4) interventions to mitigate student burnout. Promoting positive self-concept, engagement, and resilience may alleviate student academic burnout.

CONCLUSION

Student burnout has negative influences on health and academics, and interventions to mitigate burnout should be considered early in nursing programs. Nurse educators can create an engaging learning environment to build resilience and reduce burnout. [J Nurs Educ. 2021;60(7):369-376.].

Development and psychometric properties of the Nursing Student Academic Resilience Inventory (NSARI): A mixed-method study

Introduction

Resilience has been proposed as a suitable solution to better deal with nursing students in cases of challenges but the complex and multidimensional nature of resilience has made its measurement challenging. This study aimed to develop and validate a new inventory theory-driven labeled Nursing Student Academic Resilience Inventory.

Methods

This study was performed with an exploratory sequential mixed-method design. In the qualitative phase of the study, individual interviews were conducted by including 15 participants to elicit the concept of resilience through purposive sampling. In the quantitative phase, psychometric analysis of the extracted items was performed using face, content, and construct validities (exploratory and confirmatory factor analyses) on a sample size of 405 nursing students. Besides, reliability has been tested using internal consistency and test-retest methods. According to the COSMIN standards, beside two important indicators of validity and reliability, responsiveness and interpretability were also considered.

Results

A 6-factor structure (optimism, communication, self-esteem/evaluation, self-awareness, trustworthiness, and self-regulation) with 24 items were extracted in terms of the derived categories from the qualitative phase. In confirmatory factor analysis, the χ²/df ratio was calculated as 2.11 for the NSARI six-factor structure. Suitable values were obtained for the goodness of fit indices (CFI = 0.904, AGFI = 0.885, IFI = 0.906, PCFI = 0.767, and RMSEA = 0.053). In the second-order factor analysis, AVE = 0.70 indicated the existence of both convergent and divergent validities. The Cronbach’s alpha and omega coefficients were investigated as (0.66–0.78) and (0.66–0.80), respectively. The AIC was between 0.33 and 0.45 for all factors, which is an acceptable rate. Additionally, an intraclass correlation coefficient (ICC) was obtained as .903 for the whole instrument (CI .846- .946, P <0.0001).

Conclusion

Multidimensional nature of resilience was supported through exploring its 6-factor structures in the nursing students’ field. This tool also showed an acceptable validity and reliability for measuring resilience in the population of nursing students.

Strengthening internal resources to promote resilience among prelicensure nursing students

Resilience is a complex construct that is not universally defined, but reflects the ability of a person, community, or system to positively adapt to adversity in a way that promotes growth and well-being. Developing resilient nurses is a promising strategy to reduce nurse burnout and improving retention. The purpose of this paper is to review selected literature, synthesize, and interpret the findings that point toward promising practices that educators can employ to support student resilience. Four prominent prelicensure nursing student internal protective factors associated with resilience and derived from the literature include self-efficacy, optimism, emotional intelligence, and self-stewardship/self-care. Interventions to promote nursing student resilience is not well developed, however, there are promising evidence to inform concepts and interventions to guide the development, skills, practices, and strategies for nurse educators. Educational strategies to enhance student nurse internal protective factors include reflection, positive reframing, problem-based learning, and mindfulness. Specific examples of each educational modality applied to prelicensure student nurse resilience are provided. Integrative strategies to support and cultivate internal protective factors to strengthen student resilience are paramount to nursing education and clinical nursing practice.

Moral Resilience in Nursing Education: Exploring Undergraduate Nursing Students Perceptions of Resilience in Relation to Ethical Ideology

Introduction

Moral resilience has recently been proposed as one strategy to address moral distress in nurses and nursing students. Central to nursing students’ capacity for moral resilience is how they understood and enact resilience with an element of realism, suggesting an ethical, ideological influence. Resilience is shown to differ significantly across students, and possibly because of a disconnect between a students’ perceived resilience and their ethical ideology. Yet, resilience seldom has been explored in relation to ethical ideology.

Objective

This study aims to explore self-reported resilience in relation to ethical ideology in undergraduate nursing students, compare differences in scores, and explore relationships between study variables and selected demographic characteristics.

Methods

A descriptive cross-sectional research design was followed. An online encrypted survey was conducted among a convenient sample of nursing undergraduates who met the eligibility criteria and provided implied informed consent. This study complied with ethical principles outlined in the Canadian Tri-Council Policy Statement for research with human subjects. Ethical approval was secured from the University’s Research Ethics Board. Data were analyzed using mean scores, standard deviations, independent sample t-test, variance analysis with post hoc–testing, and Pearson correlation to explore differences in perceptions and associations between study and selected demographic variables.

Results

Undergraduate students have a high level of self-reported resilience. Statistically significant differences in self-reported resilience across selected demographic variables were observed. The association between resilience and ethical ideology was not significant. Ethical relativism was significantly correlated with age and year of study.

Conclusion

Findings suggest that faculty cultivating resilience in nursing students pays attention to gender’s influence discourses in students’ perceptions of resilience and ethical ideology and provides students with opportunities for ethical self-reflection and dialogue to critically examine their ethical ideological perspectives and the influence these may have on moral resilience development. Implications for future research are discussed.

Nursing Students in Crisis Mode: Fluctuations in Anxiety During the COVID-19-Related Lockdown

Supplemental digital content is available in the text.

The COVID-19 pandemic initiated a period of new and difficult challenges for nursing students.

Factors Affecting Resilience of Nursing, Optometry, Radiography and Medical Laboratory Science Students

Background: The concern over the high level of stress experienced by students of the caring professions has led to increased attention being paid to the promotion of their resilience. Most earlier studies have focused on the resilience of medical and nursing students. There has been little exploration of the resilience and associated factors of students of other health-care disciplines. The aim of this study was to gather data from students of pre-registration health-care disciplines to identify the factors that influence their resilience. Method: Valid questionnaires were used to assess respondents’ resilience, self-efficacy, mindfulness, coping and trait positive and negative affect. The data were analyzed using descriptive statistics and univariate and general linear regression. Results: A total of 1320 university students from nursing, medical laboratory science, radiography and optometry were recruited. The results showed that the subjects’ resilience scores were lower than those of students in Western countries. We found self-efficacy and denial to be the common predictors for students of all disciplines. Conclusion: The resilience of students in the four disciplines was predicted by a combination of predictors. Faculties of universities and clinical mentors should collaborate in building resilience in their health-care students and support them to grow both personally and professionally during their careers.