Resilience-building module for undergraduate nursing students: A mixed-methods evaluation

Nursing students' mindfulness and emotional regulation: an integrative review

OBJECTIVE

to identify the scientific evidence available in national and international literature on the relationships between nursing students' mindfulness and emotional regulation.

METHODS

an integrative literature review, in four databases, with a time frame from January 2002 to December 2022. Articles in English, Spanish and Portuguese available in full were included.

RESULTS

the sample consisted of six original articles, predominantly with a quantitative approach, with cross-sectional designs standing out.

CONCLUSION

the synthesis of scientific production revealed that there is a lack of research at national and international level on the subject with experimental and qualitative designs that enable conclusions about cause and effect and/or take into account subjective experiences of the applicability of mindfulness-based practice in nursing students' emotional regulation.

Grit, resilience and growth-mindset interventions in health professional students: A systematic review and meta-analysis

OBJECTIVES

Grit, resilience and a growth-mindset influence students' ability to positively adapt to the challenges of health professional training. However, it is unclear if interventions can improve these traits. This systematic review aimed to explore if interventions can improve these traits in health professional students (primary) and their impact on academic and/or wellbeing outcomes (secondary).

METHODS

A comprehensive search of CINAHL, MEDLINE, Eric and Embase was conducted from inception until 15 March 2023. Randomised or non-randomised controlled trials and single-group intervention studies that aimed to improve health professional students' resilience, grit and/or growth-mindset were eligible for inclusion. Two reviewers independently screened studies for inclusion and evaluated quality using the Mixed Methods Appraisal Tool. Post-intervention data from randomised and non-randomised control trials were pooled using a random-effects model to calculate standardised mean differences (SMD) and 95% confidence intervals (CIs).

RESULTS

Resilience interventions improved resilience by a moderate amount in 13 studies with 990 participants (pooled SMD 0.74, 95%CI 0.03 to 1.46) and a large amount when interventions were greater than one session duration in 10 trials with 740 participants (pooled SMD 0.97, 95%CI 0.08 to 1.85). Grit and growth-mindset interventions improved grit (pooled SMD 0.48, 95%CI -0.05 to 1.00, n = 2) and growth-mindset (pooled SMD 0.25, 95%CI -0.18 to 0.68, n = 2) by a small amount. Resilience interventions decreased perceived stress by a small amount (pooled SMD -0.38, 95%CI -0.62 to -0.14, n = 5).

CONCLUSIONS

Resilience interventions improve resilience and decrease perceived stress in health professional students. Preliminary evidence suggests grit and growth-mindset interventions may also benefit health professional students. Interventions may be most effective when they are longer than one session and targeted to students with low baseline levels of resilience and grit.

Effectiveness of a resilience-focused educational program for promoting resilience in nursing students: A systematic review and meta-analysis

AIM

To evaluate the effectiveness of a resilience-focused educational program to promote resilience among the forming year's BSN students.

BACKGROUND

Resilience is a resource for the well-being and growth of nursing students. Lack of resilience is a high-risk condition for psychosocial health problems that hinder students' academic and professional growth during the BSN program.

DESIGN

A systematic review and meta-analysis are reported using PRISMA guidelines. The review was registered at the PROSPERO with the ID number: CRD42023475098.

METHODS

A primary search was done on the most relevant databases: PubMed, CINAHL, and PsycINFO while a secondary search was done on the Wiley Online Library, HEC Digital Library, and Science Direct for studies in the English language that assessed resilience-building interventions in forming years (1st and 2nd year) undergraduate nursing students till Oct 2023. Both quasi-experimental studies (QESs) and randomized control trial studies (RCTs) were included in this review. The meta-analysis was performed on three QESs and two RCTs that provided information about a pooled estimate of resilience promotion.

RESULTS

Of 596 identified records, six were found eligible comprising four QESs and two RCTs with a total of 472 participants. Studies were found with variability in sample size, intervention strategy, teaching-learning activities, intervention content and duration, measurement scales, and statistical analysis of the main outcome. Meta-analysis of QESs showed no effects between pre-and post-intervention resilience scores, the standardized mean difference (SMD) of 0.04 [95 % CI -0.22, 0.30]. The RCTs immediately after intervention showed a non-significant effect, SMD 0.35 [95 % CI -0.06, 0.75]; however, at follow-up of one month, it showed a statistically significant effect in favor of the experimental group, SMD 0.54 [95 % CI 0.12, 0.95].

CONCLUSION

This review has provided evidence of a delayed effect of educational intervention to improve resilience among nursing students. The resilience-focused educational intervention has the potential to improve the resilience of nursing students. However, because of the time-bound and multi-faceted nature of resilience, a need to develop an inclusive multi-dimensional approach for resilience building is recommended for future studies.

REPORTING METHOD

The manuscript has been written in adherence with PRISMA guidelines for the systematic review and meta-analysis.

Resilience and Ethics in Nursing Education and Practice: Needs and Opportunities

BACKGROUND

Nursing faculty and clinicians are leaving the profession due to increased workload and burnout. Evidence-based interventions to build skills in resilience and well-being are encouraged; however, strategies to implement them in nursing curricula and nurse residency programs (NRPs) are not well known.

PURPOSE

To understand the current state of resilience, well-being, and ethics content in the curriculum in schools of nursing and NRPs in the state of Maryland as part of a statewide initiative for Renewal, Resilience and Retention of Maryland Nurses (R 3 ).

METHODS

A descriptive survey was distributed to leaders of all Maryland nursing schools and NRP directors.

RESULTS

Respondents (n = 67) reported minimal resilience, well-being, and ethics content. Teaching modalities included lecture, journaling, mindfulness, and the code of ethics. Barriers included lack of faculty knowledge, low priority, time constraints, and limited resources.

CONCLUSION

Resilience, well-being, and ethics content is limited in nursing curricula. Developing educator skills and best practices to foster resilience and ethical practice are needed.

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 New Look at Resilience in Nursing Students: Stress, Social Media, and Student Athletes

ABSTRACT

Resilience in nursing students is important for academic and practice success and a necessary subcompetency in the American Association of Colleges of Nursing 2021 Essentials. This study examined levels of resilience and identified related factors in prelicensure nursing students. Data were collected via an online survey that included a descriptive questionnaire with resilience and stress scales. Significant findings include negative relationships between resilience and stress, and resilience and social media use; positive relationships between stress and social media use, specifically TikTok use; and high resilience levels in student athletes. Specific implications for nursing education and future research are discussed.

The impact of COVID-19 on stress and resilience in undergraduate nursing students: A scoping review

BACKGROUND

Being a nursing student can be a stressful experience, faced with considerable academic and clinical demands. It has been suggested that the Coronavirus Disease 2019 (COVID-19) may have further exacerbated the pressure nursing students face. It has been posited that resilience, a complex psychological concept, may help nursing students overcome stressful situations.

AIMS

The aim of this scoping review was to examine the relationship between resilience and stress in nursing students during the COVID-19 pandemic.

METHODS

Relevant publications were identified by a comprehensive search of the literature from January 2019 to September 2022 to capture relevant publications during the COVID-19 global pandemic period from the following databases: CINAHL, Medline Complete, APA PsycInfo, Ovid EmCare and Web of Science. Fifteen studies met our inclusion criteria and were included in the review using Arskey & O'Malley's (2005) methodological framework for scoping reviews.

RESULTS

Our findings suggest that nursing students from all around the world have experienced high levels of stress during the COVID-19 pandemic. Almost unanimously, resilience was identified as a key protective factor against stress and the development of psychological morbidity. Those nursing students with higher levels of resilience were deemed more likely to stay on track with their studies, despite COVID-related challenges.

CONCLUSION

In conclusion, this scoping review adds to the well-established argument to incorporate resilience-building activities in undergraduate nursing curricula. Developing levels of resilience has the potential to empower nursing students for academic and clinical success, whilst facing the challenges of an ever-changing world.

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.

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.

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.

Self-Efficacy and Professional Identity Among Freshmen Nursing Students: A Latent Profile and Moderated Mediation Analysis

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students (FNSs) from the Be Resilient to Nursing Career (BRNC) program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest (15.6%), Med-low (45.0%), Med-high (32.7%), and Highest (6.7%). The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies.

Heterogeneity in Psychological Resilience and Mental Health among Newly Graduated Nursing Students: A Latent Profile and Generalized Additive Model Analysis

Background

Psychological resilience is important to mental health and professional development in newly graduated nursing students (NGNSs). However, the association between psychological resilience and mental health in NGNSs is less explored.

Purpose

The current study was designed to determine mental health profiles measured by the Kessler 10 scale (K10) and evaluate the non-linear association between psychological resilience and mental health in NGNSs.

Methods

A total of 472 NGNSs from the Be Resilient to Nursing Career program were assessed using the K10 and ten-item Connor–Davidson Resilience Scale (CD-RISC 10). Latent profile analysis and generalized additive model analysis were performed.

Results

A four-class model based on the K10 was identified: lowest (28.0%), lower-middle (36.4%), upper-middle (26.1%), and highest (9.5%) subgroups. Academic degree and psychological resilience were significant indicators of mental health profiles. Psychological resilience was negatively and nonlinearly correlated with mental health when the CD-RISC 10 score was >17.

Conclusion

There exists heterogeneity in NGNSs’ mental health. The negative and nonlinear association between psychological resilience and mental health can only be confirmed in NGNSs with moderate and high resilience levels.

Quality of life and academic resilience of Filipino nursing students during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

Studies on quality of life (QoL) and academic resilience among nursing students during the Coronavirus disease (COVID-19) pandemic remain underreported. This study investigated the relationship between nursing students' QoL and academic resilience and their predictors during the COVID-19 pandemic.

METHODS

A descriptive survey, cross-sectional study that used two self-reported questionnaire scales to evaluate the QoL and academic resilience of Filipino nursing students (n=924). Chi-squared test and multiple regression were used to analyze the data.

RESULTS

There was no significant association between the QoL and academic resilience to participants' profile variables. Gender and year level of nursing students were significant predictors of QoL and academic resilience.

CONCLUSIONS

Our study concludes that a better understanding of the QoL and academic resilience, which are two distinct concepts critical in developing a student's mental well-being, will help stakeholders in nursing education establish effective psychoeducation programs for nursing students.

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.

Professional quality of life and resilience in emergency department healthcare professionals during COVID-19 in Hong Kong: A cross-sectional study

Background:

The professional quality of life of healthcare professionals in emergency departments may be compromised during the COVID-19 pandemic.

Objectives:

This study aims to examine professional quality of life and resilience as well as their relationships among emergency department healthcare professionals in Hong Kong during the COVID-19 outbreak.

Methods:

This study employed a cross-sectional design. Healthcare professionals (doctors and nurses) working in emergency departments in Hong Kong were recruited via snowball sampling. The Professional Quality of Life Scale, version 5, and the 10-item Connor-Davidson Resilience Scale were used to assess their positive (compassion satisfaction) and negative (secondary traumatic stress and burnout) aspects of professional quality of life and self-reported resilience. Socio-demographics and work-related characteristics were also analysed.

Results:

A total of 106 participants provided valid responses. The results showed an overall moderate level of compassion satisfaction, secondary traumatic stress and burnout among emergency department healthcare professionals. The mean score of the 10-item Connor-Davidson Resilience Scale was 23.8. Backward linear regression analyses revealed self-reported resilience was the only significant predictor of compassion satisfaction (regression coefficient B = 0.875; p < 0.001), secondary traumatic stress (B = −0.294, p < 0.001) and burnout (B = −0.670; p < 0.001), explaining 70.6%, 18.5% and 59.8% of total variance, respectively.

Conclusion:

Emergency department healthcare professionals in Hong Kong experienced an overall moderate level of professional quality of life during the COVID-19 outbreak. Those with a higher level of self-reported resilience had better compassion satisfaction and lower levels of secondary traumatic stress and burnout. The results support the importance of developing interventions that foster resilience among this group of emergency department healthcare professionals to combat COVID-19.