Learning and teaching approaches promoting resilience in student nurses: An integrated review of the literature

Insights into enhanced learning through virtual reality

INTRODUCTION

This study investigates the impact of Immersive Virtual Reality (VR) on learning outcomes in radiography training using Virtual Medical Coaching's X-Ray Pro VR software. VR offers immersive experiential learning that may enhance academic performance and professional preparedness.

METHODS

The study involved 130 students from two consecutive cohorts: one using traditional training methods and the other using VR software. We employed a mixed-methods approach, integrating quantitative measures of academic performance and clinical competency with qualitative insights into student engagement, enjoyment, and stress levels. The VR group used Virtual Medical Coaching simulation software, while the traditional group used physical simulation machines (Siemens Healthineers) to practice positioning anthropomorphic manikins, adjusting exposure settings, and handling X-ray equipment. Data were collected at four points: immediately post-training and at 1 month, 3 months, and 8 months follow-up.

RESULTS

The VR cohort showed significantly higher knowledge retention, work readiness, and lower stress levels compared to the traditional cohort. Among the participants trained in VR, a vast majority (59 out of 65) reported a high level of satisfaction with the immersive nature of the training, emphasizing its realism and direct applicability to clinical scenarios. Quantitative analysis revealed superior performance metrics for the VR group across all measured time points (p < 0.001). Qualitative feedback highlighted enhanced engagement and enjoyment among VR-trained students.

CONCLUSION

The results of this study clearly indicate that VR training significantly enhances learning outcomes in radiography education. The VR cohort exhibited higher knowledge retention, work readiness, student engagement, and enjoyment, along with lower stress levels and higher confidence compared to the traditional cohort. These findings support the integration of VR into professional training curricula to improve student performance and engagement.

Nursing Students' Perception of the Clinical Learning Environment: A Longitudinal, Cohort Study

BACKGROUND

The clinical learning environment (CLE) plays a vital role in students' learning in clinical settings. However, to our knowledge, no longitudinal cohort studies have been published on how CLE influences nursing students' learning during clinical placements.

PURPOSE

This study investigated a cohort of nursing students' perceptions of CLE during their first and third-year clinical placements.

METHODS

The clinical learning environment inventory (CLEI) questionnaire was used in this study. In 2021, a convenience sample of 450 first-year nursing students was invited to complete the CLEI questionnaire. In 2023, the same cohort of students in their third year of study were invited to complete the questionnaire.

RESULTS

Personalization, satisfaction, and task orientation had higher mean scores than the other CLEI subscales. The lowest mean scores were found for the teaching innovation and individualization subscales. Multiple regression and bivariate correlation analyses revealed task orientation as the strongest predictor of student satisfaction with the CLE.

CONCLUSIONS

Nursing students in Singapore have a moderately positive satisfaction with their CLE. Clinical instructors should design innovative lesson plans to improve the student experience and learning in the CLE.

Practice learning facilitators as roaming assessors

In the UK, student nurses, nursing associates and midwives are supervised by practice supervisors and practice assessors while completing the placement-based component of their training. Because of increased clinical commitments, staff shortages and rising student numbers, demands for the supervision and assessment of student nurses have increased in recent years and this was exacerbated by COVID-19. The Nursing and Midwifery Council's Standards for Student Supervision and Assessment separated the roles of practice supervisor and assessor, giving rise to opportunities to assess students in a different way. Some integrated care systems are exploring the new role of roaming assessor. Roaming assessors can fulfil the role of practice assessors while providing additional support for student nurses. This role could be expanded to other health professions. This article explores the use of practice learning facilitators as roaming assessors for student nurses in the UK and evaluates the potential benefits and limitations of this approach. Roaming assessors may provide a useful service to deliver practice assessments, increasing the reliability and availability of assessments.

The relationship between difficulties in emotion regulation and solution-focused thinking in nursing students

AIM

The aim of this study was to investigate the relationship between emotion regulation difficulty and solution-focused thinking in nursing students.

BACKGROUND

It is essential for nursing students to possess solution-focused thinking and emotion regulation skills to cope effectively with stressors arising from their developmental processes, the nature of education and the profession. This is crucial for enhancing the quality of nursing care.

DESIGN

The study design was cross-sectional descriptive and correlational design.

METHODS

The convenience sample of the study consisted of 416 nursing students. The research was conducted between January 20 and February 15, 2024. Data were collected in Türkiye with the difficulties in emotion regulation scale-brief form and the solution focused inventory. Data were analyzed using multivariate linear regression analysis.

RESULTS

An increase of 1 unit in the level of emotion regulation difficulty was associated with a decrease of 0.236 units in participant resource activation and 0.524 units in problem disengagement (p<.001). An increase of 1 unit in the level of emotion regulation difficulty was also associated with an increase of 0.876 units in participant goal orientation (p<.001). Grade point average, grade and age were identified as factors influencing the sub-dimensions of solution-focused thinking (p<.05).

CONCLUSIONS

The study showed that emotion regulation difficulty is an important predictor of solution-focused thinking in nursing students. Therefore, students' emotion regulation difficulties and solution-focused thinking should be evaluated by academic nurses from the beginning of students' enrollment. Also, it is recommended that intervention programs focusing on developing emotion regulation and solution-focused thinking skills for nursing students should be included and implemented in the nursing curriculum.

Evaluating the online Resilience Skills Enhancement programme among undergraduate students: A double-blind parallel randomized controlled trial

Resilience training has beneficial effects on the ability of undergraduate students to withstand adversity and stress. However, there are inconsistencies in the content and delivery approaches for resilience training. Given the increasing shifts towards computer-assisted instruction, there is a need to develop and evaluate innovative approaches for resilience training. This study aimed to examine the efficacy of two versions of the Resilience Skills Enhancement (RISE) programme. A randomized controlled trial was used to evaluate the effects of blended learning (BL) and a self-guided RISE programme on the resilience, social support, and learning outcomes of undergraduate students. One hundred and fourteen students were recruited and randomly allocated to receive either BL or the self-guided RISE programme. The within-group analyses indicated significant improvements in resilience scores for the BL (F = 37.74, p < 0.001) and self-guided groups (F = 10.16, p < 0.001) with moderate (d = 0.62, 95% CI: 0.25, 1.00) to large effect sizes (d = 1.11, 95% CI: 0.71, 1.50) respectively. There were also significant differences across the three time points for social support scores for the BL (F = 4.50, p < 0.05) and self-guided groups (F = 4.59, p < 0.05). Students in the BL group had considerable improvements in self-efficacy of learning and performance (F = 5.42, p < 0.01) and meta-cognitive self-regulation scores (F = 5.91, p < 0.01). In the between-group analyses, both BL and self-guided RISE were comparable for resilience, social support, and learning scores (p > 0.05). The study provided preliminary evidence that both modes, BL and self-guided RISE programme lead to positive effects on the resilience, social support, and learning scores of students.

Academic resilience in nusing students: a concept analysis

BACKGROUND

Academic resilience is a crucial concept for nursing students to cope with academic challenges. Currently, there is significant variation in the description of the concept attributes of academic resilience among nursing students, which impedes the advancement of academic research. Therefore, it is essential to establish a clear definition of the concept of academic resilience for nursing students.

PURPOSE

The purpose of this paper is to report the results of concept analysis of academic resilience of nursing students.

METHODS

The Rodgers evolutionary concept analysis was employed to test the attributes, antecedents, consequences and related concepts of academic resilience of nursing students. Walker and Avant's method was utilized to construct a model case and provide empirical referents.

RESULTS

The findings indicate that the attributes of nursing students' academic resilience include self-efficacy, self-regulation and recovery, and the antecedents include internal factors and external environmental factors. The consequences include adaptability, career maturity, adversity quotient level, probability of academic success, a sense of belonging to school and low levels of psychological distress.

CONCLUSION

The systematic understanding of academic resilience among nursing students provides a pathway for nursing educators and students to enhance academic resilience, promote academic success, and establish a foundation for the training of more qualified nurses.

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.

"A shoulder to lean on during your first year"-An exploration into a Canadian post-secondary institution's peer mentor program for varsity student athletes

The transition period from high school to post-secondary can be particularly challenging for many, including varsity student-athletes (SAs). To better support SAs through this transitional experience, some institutions have created peer mentor programs. What is unclear, however, is the perceived value of these mentorship programs from the perspectives of multiple stakeholder positions. This paper contributes to the Scholarship of Teaching and Learning by presenting findings of a program evaluation that investigated the perceived value of a peer mentor program to its stakeholders. To accomplish this, semi-structured interviews were conducted with 30 participants to discuss SA's experiences with being a first year student, making the transition from high school to post-secondary studies, and also, to discuss their lived experiences with the peer mentor program developed for SAs. Using the findings from the inductive thematic analyses, the peer mentor program's effectiveness, areas of strengths, and areas of improvement are discussed to better align with the stakeholders' needs and experiences. Findings offer insights into a) the trials and tribulations of the first year SA experience, b) how peer mentor programs can better support SA's transition to post-secondary education, c) the benefits of conducting a program evaluation, and d) strategies to enhance the peer mentor program to better support students' needs.

The moderating role of stigma in the relationship between depression and resilience: results of a cross-sectional study in university students

Background/objective

Depression is a growing concern in university students and resilience has shown to play a protective role. The impact of stigma is still under-explored, with reference to its moderating role between depression and resilience. The present study investigate such a relationship among Italian university students.

Methods

A cross-sectional design was applied in a simple of 1,912 students to examine the interrelationships between depression (Patient Health Questionnaire-9), resilience (Nicholson McBride Resilience questionnaire), and stigma (Stigma-9). Correlation, predictor, and moderation analyses were applied in RStudio.

Results

A negative correlation was found between depressive symptoms and resilience (r = -0.455, p < 0.001). A positive correlation was found between depressive symptoms and stigma (r = 0.207, p < 0.001). Lower levels of resilience and higher levels of stigma were significant predictors of depressive symptoms [F(df, n) = 190.8(3, 1884), p < 0.001, R2 = 0.236]. The moderation analysis showed a weakening of resilience protective effect against depression as stigma levels increase [F(df,n) = 186.7(3,1908), p < 0.001, R2 = 0.226].

Conclusion

Stigma influences the relationship between depression and resilience. Anti-stigma interventions and programs empowering resilience, should be implemented in university settings to protect students from depression.

Intrinsic Factors and Psychological Safety Among Nursing Students During Simulation-Based Learning-A Correlational Design

INTRODUCTION

Well-designed simulation-based learning (SBL) experiences enhance students' self-confidence, self-efficacy, clinical judgment, and psychomotor skill development. An emerging concept in SBL research is psychological safety. There is currently no research on factors influencing psychological safety specifically related to the SBL environment, nor is there any literature found to determine whether intrinsic student characteristic, such as self-compassion and resilience, contributes to SBL learning outcomes. The aim of this study is to determine whether there is a relationship between nursing students' intrinsic characteristics (self-compassion, resilience, and anxiety sensitivity) and their psychological safety.

METHODS

Bivariate correlation was used to examine associations among sociodemographic variables and outcome variables. Multiple regression was used to determine the predictive nature of the sociodemographic variables. Assumptions for variables in multiple regression models were tested (normal distribution, heteroscedasticity, multicollinearity). All data were analyzed in SPSS, Version 28. The P value of significance was set at 0.05 for all analyses.

RESULTS

Most of the 118 participants were non-Hispanic (89%), White (65%), and females (95%). Results of the demographic bivariate analysis revealed no significant differences among this diverse group or semester in the curriculum for psychological safety. The multiple regression found self-compassion (β = 29, P = 0.004), anxiety sensitivity (β = -0.16, P = 0.049), and resilience (β = 0.26, P = 0.004) predict psychological safety.

CONCLUSIONS

The importance of creating a psychologically safe learning environment has been recognized as essential to best practices. Our findings suggest that an understanding of student characteristics that impact their perception of psychological safety will allow educators to develop strategies to better support learners in the simulation environment.

The impact of digital technology use on nurses' professional identity and relations of power: a literature review

AIM

This study seeks to review how the use of digital technologies in clinical nursing affects nurses' professional identity and the relations of power within clinical environments.

DESIGN

Literature review.

DATA SOURCES

PubMed and CINAHL databases were searched in April 2023.

METHODS

We screened 874 studies in English and German, of which 15 were included in our final synthesis reflecting the scientific discourse from 1992 until 2023.

RESULTS

Our review revealed relevant effects of digital technologies on nurses' professional identity and power relations. Few studies cover outcomes relating to identity, such as moral agency or nurses' autonomy. Most studies describe negative impacts of technology on professional identity, for example, creating a barrier between nurses and patients leading to decreased empathetic interaction. Regarding power relations, technologically skilled nurses can yield power over colleagues and patients, while depending on technology. The investigation of these effects is underrepresented.

CONCLUSION

Our review presents insights into the relation between technology and nurses' professional identity and prevalent power relations. For future studies, dedicated and critical investigations of digital technologies' impact on the formation of professional identity in nursing are required.

IMPLICATIONS FOR THE PROFESSION

Nurses' professional identity may be altered by digital technologies used in clinical care. Nurses, who are aware of the potential effects of digitized work environments, can reflect on the relationship of technology and the nursing profession.

IMPACT

The use of digital technology might lead to a decrease in nurses' moral agency and competence to shape patient-centred care. Digital technologies seem to become an essential measure for nurses to wield power over patients and colleagues, whilst being a control mechanism. Our work encourages nurses to actively shape digital care.

REPORTING METHOD

We adhere to the JBI Manual for Evidence Synthesis where applicable. EQUATOR reporting guidelines were not applicable for this type of review.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Relationship between nurses' resilience and quality of professional life

AIM

This study aimed to investigate the correlation between the resilience levels of nurses and qualit of their professional life.

BACKGROUND

Nurses' resilience level can affect their professional qualityof life. A higher resilience level enables them to manage stress and overcome challanges more effectively leading to enhanced patient care and satisfaction. Coversly, lower resiliance can lead to burnout, negatievly impacting both the nurses' wellbeing and the quality of service delivered to patients.

INTRODUCTION

It is crucial to understand the correlation between the professional life quality and resilience of nurses working in difficult conditions.

METHODS

This correlational study was conducted between September 2021 and February 2022. A total of 276 nurses were included in the study. Data were collected using the Demographic Data Form consisting of sociodemographic characteristics, the Professional Quality-of-Life Scale, and the Resilience Scale for Adults.

RESULTS

The resilience score was above average, and the professional quality of life was high. Compassion satisfaction and compassion fatigue, which are components of professional quality of life, were moderate, and the burnout level was low. A robust positive correlation was observed between resilience and the professional quality of life. The linear regression model showed that choosing the profession unwillingly, dissatisfaction with the unit in which one works, and the level of psychological resilience are independent factors of professional quality of life.

CONCLUSION

According to the findings, high psychological resilience increases the quality of professional life. Resilience, choosing nursing willingly, and liking the unit in which one works are determinants of professional quality of life.

IMPLICATIONS FOR NURSING POLICY

Enhancing the professional quality of life of nurses has important individual, institutional, and social consequences. Enhancing resilience has the potential to elevate the quality of professional life. Hence, it is important to develop national and international policies and models. Additionally, managers bear significant responsibilities in ensuring a positive work environment. Undoubtedly, having nurses work in units they like, feel happy in, and prefer will increase their professional quality of life and make positive contributions to patient care, the institution, and society.

Resilience and its related factors among women with breast cancer

OBJECTIVES

Breast cancer is the most challenging disease, and the level of resilience in patients determines their ability to cope with the arising stress. There is relatively limited information on the resilience of patients in clinical settings. Our study aims were to evaluate the extent of resilience and identify factors that predict resilience in women with breast cancer.

PATIENTS AND METHODS

A cross-sectional study was conducted with the participation of 218 women with breast cancer who were referred to the Oncology clinic in 2022. The participants completed three scales, namely the Conner-Davidson Resilience, Schneider's Life Expectancy, and the Multidimensional Scale of Perceived Social Support, along with sociodemographic information. Descriptive statistics, bivariate, and multiple linear regression were used to explore the predictors of resilience.

RESULT

The mean (SD) scores for resilience, social support, and hope were 59.22 (17.25), 38.53 (6.19), and 59.37 (16.68), respectively. Based on analysis 50.8% of the variations in resilience could be explained by 6 variables including social support, hope, women's age, employment, and income status as well as the stage of illness (R 2adj = 0.508, P < 0.001). Employment status and disease stage did not show a significant relationship with resilience and social support was the factor with the highest impact on resilience (β = 0.516, P < 0.001).

CONCLUSION

Our study showed social support, hope, age, and income level predict significant resilience in women with breast cancer. The findings emphasize the importance of fostering strong support networks, cultivating a hopeful mindset, embracing life's transitions, and addressing financial considerations in the pursuit of enhanced resilience.

Dialogues with human books to promote professional commitment and learning among first-year nursing students: A mixed-methods study

BACKGROUND

First-year nursing students in Taiwan typically have a limited understanding of nursing as they initiate their studies. Curriculum demands can be overpowering, and students may become averse to developing a positive commitment toward nursing. One strategy to assist in inculcating professional commitment is the integration of a Living Library with "human books."

OBJECTIVES

This study aimed to investigate the effects of interacting with human books on first-year nursing students in terms of their professional commitment, learning motivation, and learning career adaptability.

DESIGN

A mixed-methods, pretest-posttest study design was used.

METHODS

The convenience sampling method was used to recruit 46 students with the following eligible criteria: enrolled in an introductory nursing course, first-year students in the 2022-2023 academic year, and willingness to participate in the study. Participants interacted twice for 20-30 min using self-regulated learning with human books. Quantitative outcomes were professional commitment, learning motivation, and learning career adaptability using the IBM SPSS Statistics V28.0 for statistical analysis. Qualitative outcomes came from the content analysis of written feedback.

RESULTS

Participants experienced a significant improvement in their professional commitment, learning motivation, and learning career adaptability after engaging with human books. Contents analysis of feedback showed four categories: Professed value for nursing, motivation to pursue a career in nursing, reflection and transformation, and positive career possibilities and expectations.

CONCLUSION

Human books offer a novel strategy for nursing students to learn from real-life experiences to enhance professional commitment and learning for a nursing career.

Effects of problem-solving skills development training on resilience, perceived stress, and self-efficacy in nursing students: A randomised controlled trial

AIM

This study aimed to investigate the effects of problem-solving skills development training for nursing students on their levels of resilience, perceived stress, and self-efficacy.

BACKGROUND

Although there are many studies on the problem-solving skills of nursing students, few have been based on the social problem-solving model. Most are cross-sectional and descriptive studies. Surprisingly, the number of studies that examine the effects of training for problem solving in nursing students is also quite limited.

DESIGN

This was a single-blind, randomised controlled trial.

METHODS

The study was conducted at the department of nursing of a state university in Western Turkey. Seventy-two second-year nursing students initially participated in the study. The mean age of the participants was 19.97 ± 1.39 years. Of the participants, 72.2% were women, and 70.8% did not consider themselves academically successful. Participants were randomly assigned to the experimental or control group. The experimental group received problem-solving skills development training based on the Social Problem-Solving Model once a week in a total of seven weeks (eight sessions), in which two sessions were in the last week. Duration of each session took at least 55 min and 150 min at max. Data were collected using a self-administered questionnaire that included a personal information form, Resilience Scale for Nurses, Social Problem Solving-Inventory-Short Form, Perceived Stress Scale, and General Self-Efficacy Scale. Measurements were performed at three different times: at the beginning of the study (T0), immediately after the training provided to the experimental group (T1), and one month follow-up measurement after the intervention (T2). Repeated-measures analysis of variance and covariance were performed to analyse data.

RESULTS

The mean post-training and 1-month follow-up scores for problem-solving, resilience, and self-efficacy of the students in the experimental group (the mean of T1 and T2 scores) were significantly higher, and the mean post-training and 1-month follow-up perceived stress scores of the students in the experimental group was significantly lower than those of the control group.

CONCLUSIONS

This study concluded that problem-solving skills training based on a social problem-solving model provided to nursing students increased their social problem solving, resilience, and self-efficacy levels and reduced their perceived stress. Therefore, further studies that plan intervention and training programs aimed at improving the social problem-solving levels of nursing students and include social problem-solving courses in university curricula are recommended.

Better Together: Collaboration to Enhance the Nursing Workforce

Nursing is a demanding profession that calls for nurses to devote time, energy, advocacy, and compassion to improving clients' lives while providing safe, efficient care. Nurses make personal sacrifices to meet their clients' needs, which do not come without costs to their well-being. An increased migration of novice nurses out of the profession and the need to increase the volume of the nursing workforce by an average of 8% annually to address the projected nursing shortage presents a compelling need for immediate action. Reimagining the concept of academic-service partnerships to provide exposure to opportunities that can equip and empower novice nurses as they emerge into professional practice cannot be underestimated. Implementing approaches to assess, support, and nurture the health and well-being of nurses and health care organizations is foundational to retention.

Registered Nurses' and nursing students' perspectives on moral distress and its effects: A mixed-methods systematic review and thematic synthesis

AIM

To examine Registered Nurses (RNs') and nursing students' perspectives on factors contributing to moral distress and the effects on their health, well-being and professional and career intentions.

DESIGN

Joanna Briggs Institute mixed-methods systematic review and thematic synthesis. Registered in Prospero (Redacted).

METHODS

Five databases were searched on 5 May 2021 for studies published in English since January 2010. Methodological quality assessment was conducted in parallel with data extraction.

RESULTS

Searches yielded 2343 hits. Seventy-seven articles were included. Most were correlational design and used convenience sampling. Studies were mainly from North America and Asia and situated in intensive and critical care settings. There were common, consistent sources of moral distress across continents, specialities and settings. Factors related to perceived inability or failure to enact moral agency and responsibility in moral events at individual, team and structural levels generated distress. Moral distress had a negative effect on RNs health and psychological well-being.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution to this systematic review.

Transition to remote/hybrid learning during the COVID-19 pandemic among Saudi students of the College of Applied Medical Sciences: a cross-sectional study

Background

The novel Coronavirus Disease 2019 (COVID-19) pandemic has presented unparalleled and unique stressors and challenges to the field of applied health sciences education. This study explored how the College of Applied Medical Sciences (COAMS) Saudi students perceive the transition to remote/ hybrid learning during the COVID-19 pandemic.

Methods

A cross-sectional exploratory investigation was carried out during the months of February and March in the year 2023 among 196- COAMS Saudi students, using the 48-item previously developed and validated questionnaire, and with a non-probability convenient sampling technique. Descriptive statistics were generated for participants' demographics, and for each questionnaire item and statistical analysis was performed using chi-square test.

Results

Out of the 283 undergraduates who have enrolled in COAMS, a total of 196 students have agreed to participate in the study with an overall response rate of 69.3%. Over 70% of COAMS students were satisfied and engaged in their on-site coursework. Nevertheless, questionnaire data indicates that their satisfaction and level of engagement diminished following the shift to remote learning. More than 62% of COAMS students were satisfied with their instructors' instructional and assessment strategies during on-site coursework, but such perceptions have decreased with remote instruction. Hybrid learning can be beneficial and effective in improving the performance and learning experience of COAMS students. As compared to female students, COAMS male students were more satisfied with remote learning because it met their needs (p = 0.017).

Conclusion

Remote classrooms have lower attendance and interest than on-site classes. Despite lower satisfaction levels in online courses, hybrid learning was viewed favourably by COAMS students. Higher educational institutions should develop plans to increase student involvement, improve academic integrity, and assess the effect of the pandemic on undergraduate education on a regular basis. By incorporating these measures, educational institutions can enhance and support the remote learning experience for their students.

Turkish adaptation of the nursing student academic resilience inventory: A validity and reliability study

BACKGROUND

Due to the stressful nature of nursing education, it is stated that academic resilience is an important skill for students. However, there is no measurement tool to determine nursing students' academic resilience in our country.

OBJECTIVES

This study was conducted to adapt the nursing student academic resilience inventory to Turkish and determine its validity and reliability.

DESIGN

A descriptive, cross-sectional, and methodological design was used.

SETTING

The study was conducted with nursing students between May 2022 and June 2022.

PARTICIPANTS

The study included 250 s, third, and fourth-year nursing students.

METHODS

The data were collected using a personal information form, the nursing student academic resilience inventory and the resilience scale for nurses.

RESULTS

The inventory showed a 6-factor structure, namely optimism, communication, self-esteem/evaluation, self-awareness, trustworthiness, and self-regulation and consisted of 24 items. In confirmatory factor analysis, all factor loads were found to be >0.30. The fit indexes of the inventory were χ2/df = 2.294, GFI = 0.848, IFI = 0.853, CFI = 0.850, RMSEA = 0.072, and SRMR = 0.067. Cronbach's alpha of the total inventory was 0.887.

CONCLUSIONS

The Turkish version of the nursing student academic resilience inventory was shown to be a valid and reliable measurement tool.

Veterinary Nursing Students' Experience in the Clinical Learning Environment and Factors Affecting their Perception

Student veterinary nurses (SVNs) spend a significant proportion of their training time within the clinical learning environment (CLE) of a veterinary practice. These clinical experiences are vital for building practical and professional skills. To evaluate the current satisfaction of SVNs in the CLE, a cross-sectional survey design was used incorporating a previously validated instrument. To provide understanding of factors that may affect the SVN satisfaction, additional validated tools were added across factors, including resilience, wellbeing, personality, and work place belonging. A total of 171 SVNs completed the survey. In addition, two open questions were included to provide greater depth of understanding of the SVN experiences. Results showed that 70.76% of respondents were satisfied/very satisfied with the CLE. Significant factors that affected the satisfaction scores included, depression, anxiety, and stress (p ≤ .001), psychological sense of organizational membership (p ≤ .001), agreeableness (p = .022), and emotional stability (p = .012). The qualitative data demonstrated shared SVN factors that are considered to contribute to clinical learning and those that detract from clinical learning. Educational facilities and training veterinary practices can support the SVN within the CLE by creating a greater sense of belonging, considering the SVN individual personality and wellbeing, and including the SVN in discussions around learning support needs.

Evaluating the use of reflective cafés in Specialist Community Practitioner and Specialist Community Public Health Nurse programmes

Background: Specialist Community Practitioner (SCP) and Specialist Community Public Health Nurse (SCPHN) students are required to evidence their competency by the use of reflective practice as part of the NMC proficiencies. A reflective café trilogy comprising of three reflective teaching sessions was developed and introduced into a university programme to support and encourage alternative methods for deeper reflection within this student group. Aim: It was important for educators to evaluate if a reflective café met the student's needs and understand the usefulness of a 'reflective café' as a technique to support the process of reflecting on practice. Methods: Evaluation was undertaken using an online questionnaire. Findings: Students evaluated if the reflective café was useful for their own development and identified that the number of sessions met their developmental needs. Conclusion: The potential to develop alternative methods to reflect was recognised and the team plan to develop other reflective processes to support students in the future.

Socialization in professional reality integration for nursing student transition (SPRINT) to improve professional competence: A quasi-experimental study

Background

Professional socialization could support competency achievement and assist the transition phase. It is rare to find quantitative studies examining the effects of professional socialization for nursing students (NS).

Objectives

To investigate the effects of a socialization in professional reality integration for nursing student transition (SPRINT) to improve the professional competence of undergraduate NS in Indonesia.

Design

A quasi-experimental study non-equivalent control group pre-test post-test design was conducted using convenience sampling.

Participants

One hundred twenty NS (60 participants in the experimental group and 60 participants in the control group) from two nursing departments in private universities in Indonesia.

Methods

The SPRINT educational intervention consisted of professional socialization training using several learning methods and activities. Meanwhile, the control group received conventional socialization. The Nurse Professional Competence short-form (NPC-SF) scale was evaluated prior to the participants' internship program, lasting from 6 to 12 weeks after clinical education in both groups.

Results

SPRINT intervention significantly increased overall professional competence scores of the experimental groups higher than the control group. By comparing the mean scores in three times measurement, the six competency areas mean score increased significantly for the experimental group while, for the control only three areas of competence increased in twelve week post-test.

Conclusion

A "SPRINT" as an innovative educational program developed in collaboration with academia, clinical preceptors, could improve professional competence. It is recommended to implement SPRINT program to assist the smooth transition from academic into clinical education.

An Explanatory Model of Work-family Conflict and Resilience as Predictors of Job Satisfaction in Nurses: The Mediating Role of Work Engagement and Communication Skills

BACKGROUND

The Job Demands and Resources (JD-R) model is used to examine predictors of well-being, work engagement, and individual or organizational outcomes. According to the model, work engagement and communication skills play a mediating role between work-family conflict and resilience to job satisfaction in nurses.

METHODS

A cross-sectional study was conducted considering 431 Peruvian nurses of mean age (M = 40.31 years; SD = 10.94) ranging from 22 to 68 years working in public hospitals in the Lima region. Data were collected using a self-reported form of the Job Satisfaction Scale, communication skills, work engagement, work-family conflict, and resilience. The theoretical model was evaluated using structural equation modeling (SEM).

RESULTS

A theoretical model with adequate fit was obtained [χ²(2) = 6.0, P < .001, CFI = 0.995, RMSEA = 0.068, SRMR = 0.015]. Results indicated an inverse relationship between work-family conflict with communication skills (β = -.24, P < .001) and work engagement (β = -.10, P = .003). Likewise, resilience had an influence on communication skills (β = .55, P < .001) and work engagement (β = .33, P < .001). In addition, the model explains 71% of job satisfaction. Also, the results indicate the influence of work-family conflict and resilience through the mediating role of work engagement and work-family conflict on job satisfaction.

CONCLUSIONS

The model confirmed that work engagement and communication skills are valid moderators to mitigate work-family conflict and strengthen resilience that favors job satisfaction in nurses.

Self-Compassion and Resilience in a National Sample of Nursing Students Amid the COVID-19 Pandemic

Nationwide, nursing students experienced multiple interruptions in learning because of the pandemic. Little is known about the impact of COVID-19 on resilience and self-compassion. A descriptive cross-sectional design was used to examine pandemic-related factors, resilience, and self-compassion using the Brief Resilience and Self-Compassion scales. The majority of participants (n = 259, 73.4 percent) described declining mental health. There was a moderate relationship between resilience, self-compassion, and age (r = .30, n = 353, p = .00/r = .290, n = 353, p < .01). Resilience and self-compassion are integral to student success. Strategies to support students' mental and physical health are discussed.

The importance of developing meaningfulness and manageability for resilience in rural doctors

INTRODUCTION

Retention of rural doctors is a problem in many countries. A previous study has identified resilience as a factor associated with longer retention. However, this needs a deeper study to understand what local and personal factors are at play. Studies suggest resilience can be developed during training. We propose that a better understanding of factors associated with resilience might assist in training students for rural practice and increase retention.

AIM

This study aimed to understand the differences in resilience development between the more and the less resilient rural doctors. A secondary purpose was to identify how to assist this developmental process through health professional education.

METHODS

This study employed a mixed-method design and was part of a more extensive study aiming to develop rural doctors' resilience in a low-resource setting. A prior survey assessed rural doctors' resilience levels. This study sampled high-level and low-level resilience participants to be interviewed. A total of 22 rural doctors participated in the individual semi-structured interviews. The interviews were analyzed qualitatively based on Richardson's Resilience Model and the six resilience dimensions looking for factors that explained high or low resilience.

RESULTS

Two important themes emerged during the qualitative analysis: 'meaningfulness' and 'manageability.' The different responses of high and low-resilient participants can be explained through cases.

CONCLUSIONS

The participants' perceived meaningfulness and manageability of the stressor determine the responses. We suggest that teachers may better construct students' resilience by focussing on assisting them in finding meaning and developing a sense of manageability.

Mediating Role of Resilience on Nursing Faculty and Student QoL during COVID-19

COVID-19 greatly impacted nursing education and required nursing faculty and students to quickly adapt to changes caused by disease mitigation. The purpose of this study was to examine the mediating effects of resilience between the influence of demographics and school-related risk factors and nursing faculty and student quality of life (QoL) during the COVID-19 pandemic. A secondary data analysis was conducted using structural equation modeling to examine the mediating role of resilience on latent variables. Resilience had a positive, direct effect on nursing faculty and student QoL. Having a designated home workspace and being well-prepared for online learning had positive, indirect effects on QoL, mediated through resilience. Assisting children with schoolwork had a negative impact on the psychological and environmental QoL domains. Remarkably, having a caregiver role positively influenced the psychological QoL domain. Supporting and promoting faculty and nursing students' health and well-being is imperative during and after the pandemic.

The blacksmith approach: a strategy for teaching and learning in the medical anatomy course (a qualitative study)

BACKGROUND

Anatomy is a symbolic, essential core topic and one of the fundamental pillars of medical and paramedical knowledge. Nevertheless, few exploratory data analyses have focused on how students approach learning anatomy. This study examined how students perceive their learning experience during anatomy lessons and how to make a model which promotes their meaningful learning and professional identity.

METHODS

Using purposive sampling with maximum variation, we conducted a qualitative content analysis at the Shiraz University of Medical Sciences in Iran (2020 to 2021). Twenty-four medical students and twelve faculty members of Iran's medical science universities were enrolled in the study. The data were collected through semi-structured interviews and analyzed according to the theme.

RESULTS

A conceptual model emerged from the data analysis with the main theme called the blacksmith approach, which included Three sub-themes: (1) making a new forge (adequate preparation and mindful beginning), (2) heating the students' hearts (considering supporting systems that learners need) and (3) using Sledgehammer's approach (teaching anatomy by using more active methods and engaging all neuroanatomical regions) and (Using fun for enjoyable learning). All the concepts were related to each other.

CONCLUSION

Medical students experience a challenging fundamental evolution into professional doctors. Educational systems focus primarily on teaching and learning, while students' transition can be facilitated by a three-step model called the Blacksmith Approach. It best serves as an educational framework for any pivotal, preclinical course capable of helping students acquire new roles and tackle challenges. Further research should be conducted to confirm how hard work leads to satisfying results with the opportunity to create enjoyable learning.

Analysis of Nurses' Attitudes toward Patient Death

(1) The aim of the study was to analyze nurses' attitudes toward a patient's death, taking into account the emotions they experience and the general perception of death. (2) The study involved 516 nurses from the West Pomeranian Voivodeship in Poland. The research was carried out using the diagnostic survey method using The Death Attitudes Profile Revisited (DAP-R-PL), the Scale of Fear and Fascination with Death, and a demographic questionnaire. (3) Research has shown that nurses accept the phenomenon of death as a natural process of human life; however, they adopt the attitude of fear of death. Most of the respondents experienced: sadness (73.4%), helplessness (58.5%), and regret (43.6%) due to the patient's death. (4) Both age, sex, marital status, and place of residence significantly influenced the attitudes of nurses toward the patient's death. Therefore, it is important to provide psychological support or special education in the case of dealing with the fear of death.

Depression-related factors in nursing students: A path analysis

PURPOSE

This study aimed to evaluate the effect of self-efficacy and automatic thoughts on depression as mediated by anxiety in nursing students.

METHODS

This was a descriptive study to identify direct and indirect variables that affect depression levels of nursing students and to examine the relationship between independent variables. A total of 477 students from the Nursing Department participated in the study.

FINDINGS

As a result of the data analysis, the direct effect of self-efficacy and automatic thoughts on depression was found to be significant. The effect of automatic thoughts on depression as mediated by anxiety was significant.

PRACTICAL IMPLICATIONS

It is thought that understanding the relationship between these variables will be useful in designing appropriate interventions for university students with depression, especially for nursing students.

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.

Specific coping styles and its relationship with psychological distress, anxiety, mental health, and psychological well-being among student nurses during the second wave of the COVID-19 pandemic

PURPOSE

To identify specific coping skills that contribute to relieving anxiety and stress while supporting student nurses' mental health and psychological well-being.

DESIGN AND METHOD

This is a cross-sectional online survey involving 261 students nurses from private and government-owned nursing schools in the Central Philippines.

RESULTS

Resilience was associated with reduced stress and anxiety and better mental health and psychological well-being. Mental disengagement was associated with lower anxiety and stress levels. Spiritual and not scientific sources of support were associated with lower stress and increased psychological well-being and mental health.

PRACTICE IMPLICATIONS

Nurse faculty should foster functional coping skills in student nurses to enhance their ability to endure negative psychological and mental health outcomes related to the pandemic.

The impact of teacher attitude and teaching approaches on student demotivation: Disappointment as a mediator

Student demotivation with English as a medium of instruction has attracted increased attention of scholars, particularly in those countries where it is taught as a second or foreign language. While there is a consensus that proficiency in English brings several benefits, it is found that students are demotivated to learn in English. As a result, many studies have tried to investigate the factors that reduce the motivation to learn in English. Drawing on disappointment theory, this study aims to investigate why and how the discouraging attitude of a teacher and discouraging teaching approaches create negative emotions (i.e., disappointment with English as a medium of instruction), which in turn demotivates Chinese students with English as a medium of instruction. This study has adopted a cross-sectional research design. The data were collected through a self-administered questionnaire survey from Chinese students (n = 428) studying in different universities in China. The hypothesized relationships were tested through PLS-based SEM by using Warp-PLS 7.0 software. The findings show that teachers' discouraging attitudes and discouraging teaching approaches are important determinants of student demotivation with English as a medium of instruction. The results also confirm that student disappointment is an important underlying mechanism in the relationship between exogenous and endogenous variables. This study contributes to the literature on student demotivation with English as a medium of instruction by superficially identifying teacher-related factors in China, which were previously overlooked. The implications of this study are that the university administration should monitor the attitude of the teachers toward English, as well as their teaching approaches, in order to curb any potential threat to student motivation. The administration should train the teachers on how to show a positive attitude and follow encouraging teaching approaches. In this way, students' disappointment with the English language and teaching methodology can also be overcome, which will ultimately increase their motivation with English as a medium of instruction in universities.

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.

A Transformative Learning Experience for Senior Nursing Students

BACKGROUND

Research suggests that clinical practicums in hospital-based settings are important, even if condensed, to provide students with the opportunity for real-world learning experiences. Rational dialogue makes learning meaningful and empowers students to learn by reflecting on experiences.

PROBLEM

The COVID-19 pandemic minimized availability of traditional one-to-one mentorship practicums.

APPROACH

This article describes the use of critical reflection on experiences in an undergraduate senior mentorship course to assess student learning through the thematic analysis of writing assignments. Guided by Mezirow's transformative learning theory, students completed a traditional group clinical practice, written reflective journals and virtual seminars focused on role development, and reflection on concurrent learning in clinical and simulation experiences.

OUTCOMES

Transformative learning was evident in their writing. Student journals demonstrated themes of responding to change, discovering resilience, developing confidence, finding gratitude, embracing advocacy, and transforming and becoming.

CONCLUSIONS

Through critical reflection, students recognized the opportunities mentorship afforded them, despite challenges.

COVID-19 on New Primary Care Nurse Practitioners: A Qualitative Exploration

New nurse practitioners (NPs) struggle with the transition to practice and feelings of uncertainty concerning roles and responsibilities. COVID-19 has added a new layer of stress. This pilot study used a qualitative case study design featuring semistructured interviews of 10 newly graduated primary care NPs. Data analysis revealed 2 main themes: (1) emotional burden, and (2) coping and support. Emerging themes highlight the resiliency of NPs, who cope and seek support when faced with emotional burdens. This study informs educators and employers on the needs of new NPs during a global pandemic in order to better support the future workforce.

Academic self-efficacy, resilience and social support among first-year Israeli nursing students learning in online environments during COVID-19 pandemic

BACKGROUND

Academic self-efficacy (ASE) has been found to be an important motivator for academic success among nursing students. The associations between ASE, resilience and social support have not been fully explored among nursing students, especially those in their first year who are learning online.

OBJECTIVES

To explore a) the associations between ASE, resilience and social support among first-year nursing students learning in an online learning environment; and b) students' views regarding the difficulties they have encountered and the available assistance.

DESIGN AND METHODS

A cross-sectional survey design on a sample of 222 undergraduate first-year Israeli nursing students. Questions were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the university's online learning platform.

RESULTS

Positive correlations were found between ASE and resilience and social support. Significant differences were found in the research variables according to the students' gender, cultural group and their perceived difficulty in studies. Resilience, social support, perceived difficulty in studies and being a female explained 31% of the students' variance in ASE.

CONCLUSIONS

Nurse educators should develop and promote strategies to enhance students' resilience and perceived social support. These have the potential to significantly improve students' ASE also in online environments. In addition, faculty should promote the preparation of online learning environments in accordance with students' needs and proficiencies.

Analysis of Literary Situation and Reconstruction of the Writing Subject in Literary Education by Educational Psychology

Educational psychology focuses on the laws of change in the knowledge, skills, and individual psychology of the educatees in the process of education and teaching. Writing teaching is a key and difficult point in literature teaching. Nowadays, it is common for students to be afraid and tired of writing in school literature education. In view of these problems, the present work optimizes the teaching mode of writing from the perspective of reconstructing the writing subject. Through literature research and interdisciplinary analysis, a questionnaire is designed to analyze the literary situation and the reconstruction of writing subjects in literary education. The questionnaire is aimed at three aspects, namely the hidden educational effect of teachers' personality charm, the influencing factors of students' psychology and students' learning effect, and the influencing factors of psychology of the communication between teachers and students and teachers' teaching effect. Then, the changes of students' performance in literary class in these three aspects before and after using the teaching strategy of writing subject reconstruction are analyzed. Finally, the changes of students' grades in the literary course are investigated. In this experiment, a total of 400 questionnaires were distributed, and a total of 389 questionnaires were collected. The survey results show that the number of students who feel the classroom atmosphere is active increases by 10%, the number of students who listen carefully and take notes increases by 7%, and 45% of students have improved their grades. Besides, after the implementation of the teaching strategy, most students change their attitude to the literature course, become more active, and significantly improve their motivation for learning. This study has a certain reference value for the analysis of literary situations and the reconstruction of writing subjects in literary education from the perspective of educational psychology.

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.

Turkish adaptation of the resilience scale for nurses: A validity and reliability study

BACKGROUND

The psychological resilience of nursing students is often measured with scales developed for the general public. However, the Resilience Scale for Nurses is an updated scale developed using concept analysis based on the findings of in-depth interviews with nurses.

OBJECTIVES

This study aimed to adapt the Resilience Scale for Nurses into Turkish and test its validity and reliability in a study group of nursing students.

DESIGN

A descriptive, cross-sectional, methodological design.

SETTING

A faculty of nurses in a state university in Western Turkey.

PARTICIPANTS

A total of 422 nursing students participated in the first stage, and 100 nursing students participated in the second stage of the study.

METHODS

Confirmatory factor analysis was used to test construct validity, and Pearson correlations between the Resilience Scale for Nurses and several self-report measures were used to test convergent validity. Internal reliability was assessed with an alpha coefficient. Test-retest reliability was tested with the Pearson correlation between these two measures.

RESULTS

Confirmatory factor analysis indicated that a construct with four factors (dispositional, relational, situational, and philosophical patterns) showed an acceptable model fit. Students' scores on the Resilience Scale for Nurses showed significant positive correlations with other psychological resilience scale scores and a negative correlation with perceived stress scores. The alpha coefficient of the scale was 0.93. A significant positive correlation was found between the test and retest scores of the scale (r = 0.72, p < 0.001).

CONCLUSION

It was concluded that the Turkish version of the Resilience Scale for Nurses showed good construct validity, convergent validity, internal reliability and test-retest reliability. It is recommended that the psychological resilience of nursing students and nurses be measured with a scale developed specifically for nursing instead of scales that are developed for the general public.

Using simulation exercises to improve student skills and patient safety

The COVID-19 pandemic has affected the delivery of nursing training in higher education and how workforce development programmes are delivered. Using simulated practice is an opportunity for experiential and immersive learning in a safe and supported environment that replaces real life. This article discusses the use of simulation in nurse education to improve patient safety.

Evaluation of a Brief Mindfulness Intervention on Examination Anxiety and Stress

BACKGROUND

Nursing students report increasing levels of stress and anxiety related to academic performance. Mindfulness programs have been found to reduce stress, yet such programs have been identified as a time-burden for students. This study evaluated the integration of a brief preexamination mindfulness reflective intervention for nursing students. Perceived stress, anxiety, resilience, and acceptability were evaluated.

METHOD

A mixed-methods experimental design with random assignment was used. Forty-nine nursing students were randomized to either an intervention group (N = 25) who participated in the brief preexamination mindfulness intervention or a control group (N = 24) who took their examinations without any intervention. Self-report tools measured stress, resilience, and mindfulness. Qualitative responses were collected.

RESULTS

Outcomes revealed decreased feelings of helplessness and anxiety in the intervention group. Although students had positive views of mindfulness, barriers were indicated.

CONCLUSION

Brief preexamination mindfulness interventions provide students with anxiety-reducing options. [J Nurs Educ. 2021;60(11):625-628.].

The predictive role of nursing students' individual characteristics and psychological resilience in psychological distress

PURPOSE

This study aims to determine the predictive role of nursing students' individual characteristics and psychological resilience in psychological distress.

DESIGN AND METHODS

This study is a descriptive cross-sectional study. The study sample included 652 nursing students. Binary logistic regression analysis was used for analysis.

FINDINGS

It has been determined that 65.3% of nursing students have psychological distress. Having a chronic disease, being a woman, poor academic success, choosing the profession so as not to be unemployed, being single and low psychological resilience are factors that affect psychological distress.

PRACTICE IMPLICATIONS

It is recommended to screen nursing students for psychological distress to increase interventions that improve the psychological resilience of risky students.

Do Medical Students' Learning Styles and Approaches Explain Their Views and Behavior Regarding Lecture Attendance?

INTRODUCTION

Medical students' attendance at lectures, particularly in the preclinical years, has been steadily declining over the years. One of the many explanations offered for this observation is that students have different learning styles and approaches, such that not all of them benefit from attending lectures; however, no studies have specifically examined this possibility. While there is evidence against learning styles as affecting objective measures of learning, they are associated with subjective measures of learning and may therefore influence student behavior. We hypothesized that students' learning styles and/or approaches influence their views about the value and purpose of lectures and their motivation to attend them, which, in turn will affect their behavior.

MATERIALS AND METHODS

A LimeSurvey was distributed to all preclinical students at the American University of Beirut. The survey included questions about demographic data, self-reported attendance rates in Year 1 of medical school, two validated and standardized questionnaires assessing the students' learning styles (visual, auditory, kinesthetic, tactile, group, individual) and learning approaches (superficial, deep, strategic), and a series of questions exploring the students' views about the purpose and value of lectures and their motivation to attend lectures.

RESULTS

No associations were found between learning styles or approaches and attendance rates, but this may have been confounded by the mandatory attendance policy at the time. There were, however, a few positive associations between some learning styles or approaches and the students' views about the value of attending lectures. In particular, students with high scores as auditory learners tended to see absolutely no value in attending lectures, and those with high scores as group, auditory or visual learners, tended to see less value in taking their own notes in lectures. Students with superficial approaches to learning felt that watching videos of a lecture provides equivalent education to attending a lecture. There were no statistically significant associations with either the perceived purpose of lectures or the motivation to attend lectures after correction for multiple testing.

CONCLUSIONS

This study reveals that except for some interesting findings related to auditory learners, differences in learning styles or approaches among students cannot adequately explain differences in their attitudes, and likely, behavior, regarding lecture attendance. The idea that learning styles and approaches can influence educational preferences and outcomes, while attractive and intuitive, continues to require supporting evidence.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01362-3.

Resilience and stress in frontline social workers during the COVID-19 pandemic in Singapore

As social work under normal circumstances is already a stress-laden helping profession, this study intended to examine the level of psychological distress among the frontline social workers during the COVID-19 pandemic and whether resilience and organizational support played a part in mitigating their psychological distress. Frontline social workers from various social service sectors across Singapore were surveyed using two standardized measurements to assess resilience (Connor-Davidson Resilience Scale 25) and psychological distress (Depression Anxiety and Stress Scale 21). A self-designed questionnaire comprising 10 items measured "personal" and "work-related" support at the organization. Sociodemographic data were captured using a structured questionnaire. The results showed that the frontline social workers, although resilient, were psychologically distressed in all the three areas of depression, anxiety and stress. The results indicated that those working in the Family Service Centers (FSC) were the most affected. Significant correlations were observed between psychological distress, resilience, and organizational support. Organizations must be mindful that support can help frontline staff who are usually younger and less experienced during challenging times such as the pandemic. Building the resilience of social workers will prepare them for their daily challenges and those that accompany unexpected situations.

Posttraumatic growth and positive determinants in nursing students after COVID-19 alarm status: A descriptive cross-sectional study

PURPOSE

To determine the relationship between posttraumatic growth (PTG), psychological flexibility, and psychological resilience of nursing students after the COVID-19 alarm status.

DESIGN AND METHODS

This descriptive cross-sectional study was conducted with nursing students (N = 292) studying at a nursing school of a university. The data collection instruments included a form on descriptive variables, and the PTG, psychological flexibility, and psychological resilience scales. Descriptive statistics, independent-samples t test, ANOVA, correlation, simple, and hierarchical linear regression analyses were used to analyze the data.

FINDINGS

The mean scores regarding psychological flexibility, psychological resilience, and PTG were 27.56 ± 11.06, 18.10 ± 5.75, and 63.49 ± 20.64, respectively. While psychological flexibility explained 36.7% of the total variance in psychological resilience, the predictive effect of seven descriptive variables, including psychological flexibility and psychological resilience, on PTG was determined as 13.4%.

PRACTICE IMPLICATIONS

PTG, psychological flexibility, and psychological resilience may help nursing students prepare for their transition to the profession.

Shifting Focus from Burnout and Wellness toward Individual and Organizational Resilience

Burnout is reported to be epidemic among physicians and medical trainees, and wellness has been the predominant target for intervention in academic medicine over the past several years. However, both burnout and wellness suffer from a lack of standardized definition, often making interventions difficult to generalize and extrapolate to different sites. Although well-meaning, current frameworks surrounding wellness and burnout have limitations in fully addressing the challenges of improving physician mental health. Wellness as a framework does not inherently acknowledge the adversity inevitably experienced in the practice of medicine and in the lives of medical trainees. During a crisis such as the current pandemic, wellness curricula often do not offer adequate frameworks to address the personal, organizational, or societal crises that may ensue. This leaves academic institutions and their leadership ill-equipped to appropriately address the factors that contribute to burnout. More recently, resilience has been explored as another framework to positively influence physician wellness and burnout. Resilience acknowledges the inevitable adversity individuals encounter in their life and work, allowing for a more open discussion on the tensions and flexibility between facets of life. However, emphasizing personal resiliency without addressing organizational resiliency may leave physicians feeling alienated or marginalized from critical support and resources that organizations can and should provide. Despite intense focus on wellness and burnout, there have not been significant positive changes in physicians' mental health. Many interventions have aimed at the individual level with mindfulness or other reflective exercises; unfortunately these have demonstrated only marginal benefit. Systems level approaches have demonstrated more benefit but the ability of organizations to carry out any specific intervention is likely to be limited by their own unique constraints and may limit the spread of innovation. We believe the current use of these conceptual lenses (wellness and burnout) has been clouded by lack of uniformity of definitions, an array of measurement tools with no agreed-upon standard, a lack of understanding of the complex interaction between the constructs involved, and an over-emphasis on personal rather than organizational interventions and solutions. If the frameworks of burnout and wellness are limited, and personal resilience by itself is inadequate, what framework would be helpful? We believe that focusing on organizational resilience and the connecting dimensions between organizations and their physicians could be an additional framework helpful in addressing physician mental health. An organization connects with its members along multiple dimensions, including communication, recognition of gifts, shared vision, and sense of belonging. By finding ways to positively affect these dimensions, organizations can create change in the culture and mental health of physicians and trainees. Educational institutions specifically would be well-served to consider organizational resilience and its relationship to individuals.

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.

"To teach is to learn twice" Added value of peer learning among medical students during COVID-19 Pandemic

This article was migrated. The article was marked as recommended. In medical education, peer learning has a significant impact on deeper learning and considered an effective method of collaborative and deeper learning. This article highlights the adjustment of the final year medical students to the peer learning style during the COVID-19 pandemic. It explores the additional benefits of peer learning style and recommend key points that can help medical students to combat the current stressful situation. Adaptation to peer learning strategy may help to overcome this stressful situation and motivate each other to focus on studies. This approach can assist medical students to stay in touch with each other, collaborate, communicate, and boost each other morally. The peer learning style provides an opportunity for students to share thoughts and emotional reactions freely and friendly. This way can help to reduce stress and develop resilience. Students get rapid adaptation to technology-enhanced learning smoothly and effectively by helping each other to learn new skills. The feeling of staying connected with peers during the online sessions significantly augmented the ability to combat the crisis and augment social interactions.