Relationships among stress, resilience, and incivility in undergraduate nursing students and faculty during the COVID-19 pandemic: Policy implications for nurse leaders

Learning Environments in Undergraduate Nursing Education During COVID-19: A Scoping Review

BACKGROUND

The COVID-19 pandemic radically changed nursing education.

PURPOSE

To map the existing literature on learning environments (LEs) in undergraduate nursing education during COVID-19 and identify the LE elements based on the 4 domains of Gruppen's conceptual framework: personal, social, organizational, and physical and virtual spaces.

METHOD

Eligible articles were reviewed using the Joanna Briggs framework.

RESULTS

The search retrieved 5003 articles, of which 80 met the inclusion criteria. Most studies were cross-sectional and conducted in the United States. Of the studies included, 68 studies focused on the personal component of students, 67 investigated physical and virtual space components, 19 examined the social domain, and 15 examined organizational aspects.

CONCLUSIONS

The COVID-19 pandemic significantly influenced the LE of nursing students. Based on the current review of LE in nursing education, nurse educators and researchers can develop interventions to maintain the quality and accessibility of nursing education in future crises.

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.

Online prelicensure nursing students' experiences of academic incivility during COVID-19: A qualitative inquiry

AIM

The aim of this study was to describe online prelicensure nursing students' experiences of incivility during COVID-19.

DESIGN

Qualitative descriptive. Five optional open-ended questions were presented to nursing students to share their experiences with incivility during the pandemic.

METHODS

Data were collected from September to October 2020 as a part of a larger multimethod study on stress, resilience and incivility with nursing students and faculty (n = 710) from a large public undergraduate nursing programme in the southwestern United States. Out of the initial 675 students who completed the survey, 260 individuals responded to three or more of the open-ended questions which were reviewed and coded using reflexive thematic analysis.

RESULTS

Thirteen themes were organized into four analytical categories: (1) experiencing incivility, (2) causes and consequences of incivility, (3) the pandemic and academic incivility and (4) promoting civility in the academic setting.

CONCLUSIONS

Prelicensure nursing students perceived unrealistic expectations, a lack of awareness and miscommunication hindered academic performance, as well as, created feelings of stress, discouragement and inadequacy.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Fostering academic civility during virtual educational experiences may require training in proper coping strategies when challenged with incivility.

IMPACT

As the body of research emerges concerning the effects of COVID-19 and undergraduate nursing education, understanding prelicensure students' experiences of academic incivility could prove to be beneficial to designing strategies co-created with students to promote positive educational outcomes. Understanding students' viewpoints of uncivil experiences revealed prioritizing civility awareness is essential in creating healthy academic environments, improving clinical performance and providing safe patient care.

REPORTING METHOD

The COREQ (COnsolidated criteria for REporting Qualitative research) checklist was used.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The relationship among faculty-to-faculty incivility and job satisfaction or intent to leave in nursing programs in the United States

BACKGROUND

There have been numerous studies examining student-faculty and faculty-student incivility in nursing programs (Atmiller, 2012; Clark et al., 2021; Clark & Springer, 2010; Eka & Chambers, 2019; Tourangeau et al., 2014). Research on faculty-to-faculty incivility in nursing programs has been lacking.

PURPOSE

The purpose of this study was to determine if there was a relationship among faculty-to-faculty incivility, job satisfaction and intent to leave. Furthermore, this study examined the barriers to addressing incivility, the contributing factors to workplace incivility and strategies to improve workplace incivility.

METHODS

The initial sampling method used was a randomized stratified cluster sampling method. Due to a poor response rate the sampling process was changed to convenience sampling. The researcher collected data using The Workplace Incivility/Civility Survey. Additional questions were added to collect demographic data, incidences of incivility in the workplace, the physical and emotional response to these incidences, job satisfaction and intent to leave.

RESULTS

Data analysis showed that 50 % of the participants believe faculty-to-faculty incivility is a moderate to severe problem in their workplace. Furthermore, there is a negative correlation between faculty-to-faculty incivility and job satisfaction or faculty retention. Additional findings showed that 38.6 % of the participants had minimal to no confidence in addressing workplace incivility. Fear of professional or personal retaliation was the greatest barrier to addressing workplace incivility.

CONCLUSION

The current nursing faculty shortage has created a barrier to addressing the nursing workforce shortage. Universities and nursing programs need to address the factors that lead to decreased job satisfaction and faculty attrition with incivility being one of the factors.

Nurse Educators' Perceptions and Self-efficacy in Response to COVID-19: A Scoping Review

BACKGROUND

During the COVID-19 pandemic, nurse educators had to adapt quickly to required changes in nursing education following isolation mandates. Educators worked diligently to provide a quality remote/online educational experience with limited resources.

PURPOSE

The purpose of this review was to explore nurse educators' perceptions and self-efficacy toward the transformation from the traditional face-to-face teaching to remote/online teaching and simulation/laboratory modifications in response to the COVID-19 pandemic.

METHODS

A scoping review, informed by PRISMA-SCR guidelines, was performed in PubMed, Web of Science, CINAHL Complete, OVID MEDLINE, and Google Scholar.

RESULTS

There were 34 articles included in the final review, with 7 themes identified: teaching pedagogy, technology challenges, online teaching role, learning environment, leadership, clinical education, and well-being.

CONCLUSIONS

The review is relevant to nursing faculty across the globe. Planning for future pandemics should include self-care, use of evidence-based practices, protocols, and increased communication.

Implementation of a Student Success Seminar and its Correlation with Resilience in Nursing Students: A Mixed-Methods Study

AIM

To identify sustainable curricular practices that promote student resilience.

METHOD

Sophomore students in a four-year baccalaureate nursing program attended a positive psychology seminar and a formal mentoring program led by senior- and junior-level nursing students. Sophomore students 'resilience was measured pre- and post-intervention using the Predictive 6-Factor Resilience Scale (PR6). Additional rich descriptions from the experience of the mentoring program were obtained in surveys from the study participants and mentors at the completion of the program.

FINDINGS

Quantitative and qualitative results supported a strong increase in resilience.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

Nursing schools can provide students with sustainable support that promotes resilience.

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

A cross-sectional design.

SETTINGS

Five universities in China.

PARTICIPANTS

Undergraduate nursing students (N = 511).

METHODS

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

RESULTS

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

CONCLUSIONS

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

Associations between psychosocial stressors at work and moral injury in frontline healthcare workers and leaders facing the COVID-19 pandemic in Quebec, Canada: A cross-sectional study

Healthcare workers (HCWs) on the frontline of the COVID-19 pandemic exhibit a high prevalence of depression and psychological distress. Moral injury (MI) can lead to such mental health problems. MI occurs when perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. Since the start of the pandemic, psychosocial stressors at work (PSWs) might have been exacerbated, which might in turn have led to an increased risk of MI in HCWs. However, research into the associations between PSWs and MI is lacking. Considering these stressors are frequent and most of them are modifiable occupational risk factors, they may constitute promising prevention targets. This study aims to evaluate the associations between a set of PSWs and MI in HCWs during the third wave of the COVID-19 pandemic in Quebec, Canada. Furthermore, our study aims to explore potential differences between urban and non-urban regions. The sample of this study consisted of 572 HCWs and leaders from the Quebec province. Prevalence ratios (PR) of MI and their 95% confidence intervals (CI) were modelled using robust Poisson regressions. Several covariates were considered, including age, sex, gender, socio-economic indicators, and lifestyle factors. Results indicated HCWs exposed to PSWs were 2.22-5.58 times more likely to experience MI. Low ethical culture had the strongest association (PR: 5.58, 95% CI: 1.34-23.27), followed by low reward (PR: 4.43, 95% CI: 2.14-9.16) and high emotional demands (PR: 4.32, 95% CI: 1.89-9.88). Identifying predictors of MI could contribute to the reduction of mental health problems and the implementation of targeted interventions in urban and non-urban areas.

Association of stress, resilience, and nursing student incivility during COVID-19

Although incivility in nursing education is linked with negative physical and psychological effects on students, it is unclear how resilience and stress interact and relate to student incivility. The purpose was to understand the role of resilience and stress with peer incivility in a sample of prelicensure nursing students during coronavirus disease 2019. The study design was cross-sectional and correlational. Data were from an online survey administered to undergraduate nursing students of one college of nursing in a southwestern US state during September-October 2020. In a sample of 490 students, ordinal regression model results supported that including a stress and resilience interaction term resulted in a nonsignificant effect of stress and resilience, as the main effect correlates on low-level uncivil student behavior. More research is needed to understand the prevalence of stress and resilience at different points in prelicensure nursing education so that targeted interventions can be developed and deployed to assist students.