“My mentor didn't speak to me for the first four weeks”: Perceived Unfairness experienced by nursing students in clinical practice settings

Student radiographers' confidence of adapting practice for autistic patients: A qualitative survey on the role of placement experiences

INTRODUCTION

Healthcare services can be inaccessible to autistic people without adaptions to clinical practice and the care provided. Therefore, understanding how radiographer education develops students' confidence in adapting care for autistic patients is crucial. This study aimed to explore how placement experience impacts student radiographer confidence in adapting care for autistic patients.

METHODS

UK final-year student diagnostic and therapeutic radiographers were invited to complete a qualitative online survey. The survey asked for a description of placement experiences; of observing and/or performing the care of autistic patients and how this impacted confidence in caring for autistic patients. The data was thematically analysed.

RESULTS

43 responses (of 44 received) were included, from which 5 themes emerged. Those who felt placement experiences developed confidence described opportunities to apply theory learnt at university (theme 1) or drew attention to the benefit of prior (external) experience with autistic people (theme 3). However, the balance of power with the supervising radiographer (theme 2), witnessing autistic patients in distress (theme 4), and the heterogeneous nature of autism (theme 5) disrupted students' development of confidence.

CONCLUSION

Several participants in this study found clinical placement developed confidence with autistic patients through applying knowledge and providing an opportunity for reflexive learning. However, various obstacles hindered this development, such as witnessing distressed patients, limited experiences with autistic patients and difficulty navigating relationships with radiographers.

IMPLICATIONS FOR PRACTICE

To improve student radiographers' confidence of providing care for autistic patients, educators should consider methods, e.g., co-produced simulation, to fill potential gaps in their experience. There is also a pressing need for all radiographers to understand their responsibility in educating students and their impact on student wellbeing.

The opinions and experiences of nursing students, nurses, and patients regarding clinical practices: A mixed-methods study

The aim of this mixed-methods study was to examine the experiences of nursing students (NSs), nurses, and patients regarding the clinical practices of NSs and to determine NSs' stress levels regarding clinical practices. The quantitative part of the study was completed with 240 NSs, and the "Perceived Stress Scale for Nursing Students" was used. In the qualitative part, the focus group interviews were held with 24 NSs, and the individual interviews were conducted with 15 patients and 20 nurses. Descriptive and stepwise regression analyses were used to analyze quantitative data, and narrative analysis was used to analyze qualitative data. Regression analysis determined that the age, grade point average, and attitude of mentors were associated with the perceived stress levels of NSs. In the narrative analysis of the data obtained from the interviews with NSs and nurses, four categories were identified: Emotions, Facilitators, Barriers, Roles, and Competencies. Three categories (Emotions, Problems, Roles, and Competencies) were identified from patient interviews. This study showed that NSs' clinical practice experiences were affected by many factors and experienced high stress during clinical practice.

Exploration of student nurse experiences of being mentored by practice supervisors/assessors in placement settings

The Nursing and Midwifery Council changed its standards in 2018 regarding student learning and assessment on placements. Previously, students were allocated a mentor with whom they spent at least 40% of their time and who also assessed them; the new standards brought in the separate roles of practice supervisor and a practice assessor and abolished the 40% minimum, with the student being supported by a wider range of practitioners. While extensive literature examines the experiences of qualified staff supporting students, there is little evidence on the student experience. A qualitative approach using semi-structured interviews with student nurses from two universities in the south of England was used to explore their experiences. The students reported benefits of being supported by the wider healthcare team, said being taught and assessed by different people was beneficial and that they felt better prepared for assessments.

The influence of supervisory support on clinical learning as experienced by Czech Nursing and health professional students in the context of patient safety events: A qualitative study

AIM

To explore the influence of supervisory and mentoring relationships on the clinical learning experiences of Czech Nursing and health professional students in the context of patient safety events BACKGROUND: Clinical experience is integral to healthcare education, shaping skills, behaviours, values and professional identity. During clinical placements, students may encounter memorable patient safety events and experience varied reactions from mentors/supervisors/others. Some research has highlighted challenges faced by students on clinical placement. Few studies involve multiple professions, most emanating from Western Europe, the UK, the USA and Australia with little relating to central European countries such as the Czech Republic.

DESIGN

Two stage interpretivist qualitative study based in social constructionism METHODS: Convenience sample across 13 undergraduate and 18 postgraduate health professions courses. Stage 1 (2022): using SLIPPS Learning Event Recording Tool translated into Czech. 20 students' (Midwifery=11, Nursing=1, Paramedic=1, Occupational therapy =7) submitted 21 patient safety learning event narratives. Stage 2 (2022): Focus group with 2 nursing and nine midwifery students. Phased thematic analysis involving multiple researchers.

RESULTS

Three themes illustrate the circumstances and impact of placement mentoring/supervision experiences, conceptualised as: 'Clinical and Emotional Companionship', 'Clinical and Emotional Abandonment' and 'Sense of agency - Professional and personal growth'. 'Companionship' reflected the students' feelings of being welcomed, respected, heard, trusted and supported. Conversely 'abandonment' emerged from feelings of being unheard, vulnerable, humiliated, afraid, leaving students feeling abandoned, lonely and 'useless'. Notwithstanding these conditions, students showed the ability to identify patient safety issues with agency evident in reactions such as stepping-in to try to ameliorate a situation, rather than speaking-up. Professional and personal growth was also apparent in their narratives and a conceptual diagram illustrates the students' learning journeys in a patient safety context.

CONCLUSION

The findings and new conceptualisations around abandonment and companionship emerging from this study expand the evidence base regarding the profound impact of clinical experience and mentorship/supervision on learning and students' emotional wellbeing. A sense of companionship appears to play a buffering role even in challenging circumstances of involvement in or witnessing compromised patients' safety. Allowing students a sense of belonging, to vent, grow, feel supported and safe to ask/learn - contributing to 'emotional safety for learning', promotes students' behaviour that may prevent/minimize hazards or ameliorate the aftermath. However, we must not simply blame mentors/supervisors, staff, or the students themselves- they are simply part of a much larger complex environment of professional education encompassing hidden curriculums, power dynamics and professional socialisation.

Experiences of nursing students in A peer mentoring program during their clinical practices. A qualitative study

BACKGROUND

Clinical placements allow nursing students to develop the skills and attitudes necessary to provide care. Peer mentoring programmes seem to facilitate these achievements, but there are very few studies on the effects of peer mentoring on clinical placements and what it can bring to both mentors and mentees.

AIM

To describe the perspectives of nursing students on a peer mentoring programme during their clinical placements.

DESIGN

A qualitative descriptive and exploratory study.

SETTINGS AND PARTICIPANTS

First year and third year nursing students were included.

METHODS

Focus groups were conducted with students after they participated in a peer mentoring programme during their clinical practice rotation.

RESULTS

The support received from the student mentors was very important both academically and personally. Mentors also acknowledged having improved their teaching and leadership skills.

CONCLUSIONS

Our results can be applied to future studies to inform peer mentoring programmes as a complementary teaching tool in clinical placements to improve leadership and empowerment in nursing students.

Relationship between emotional intelligence and academic support perception among nursing interns: The moderating role of bullying behaviors in nursing education

AIM

This study aims to investigate the status of academic support perception among nursing interns and explore the correlation between academic support perception, emotional intelligence, and bullying behaviors in nursing education, especially the moderating role of bullying behavior on the relationship between emotional intelligence and academic support perception.

BACKGROUND

Academic support perception is closely related to the nursing interns' mental health and academic performance. To some extent, it can reflect nursing interns' satisfaction and happiness during their internship, affecting their motivation to continue their studies. However, little is known about the nursing interns' academic support perception in China.

METHODS

A total of 1020 nursing interns participated in this study. A sociodemographic information questionnaire, Bullying Behaviors in Nursing Education Scale, Wong and Law's Emotional Intelligence Scale, and Academic Support in the Practicum Scale were used to collect data.

FINDINGS

Bullying behaviors and emotional intelligence were significantly associated with nursing interns' academic support perception. In addition, bullying behaviors in nursing education moderated the association between emotional intelligence and academic support perception.

DISCUSSION

Nursing interns who possess high emotional intelligence and experience less bullying in nursing education tend to perceive higher academic support in clinical practice. The positive effects of emotional intelligence on nursing interns' academic support perceptions are contingent on the level of bullying behavior experienced in nursing education. Less bullying behaviors in nursing education enhance the impact of emotional intelligence on academic support perception.

CONCLUSION AND IMPLICATIONS FOR NURSING

Strategies should be created to promote emotional intelligence and decrease bullying behaviors in nursing education to improve the perception of academic support among nursing interns.

Standards of proficiency for registered nurses-To what end? A critical analysis of contemporary mental health nursing within the United Kingdom context

Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of 'proficiency' in nurse education-prescribed by the regulator-impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical-legal challenges posed by sanctioned powers to restrict patients' freedom at the same time as the desire (and obligation) to promote patients' self-determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain.

The role of perceived stress and social support in nursing students' satisfaction with their initial clinical placement: A cross-sectional study

AIM

To explore: a) students' perceived stress, social support and satisfaction with their initial clinical placement; and b) identify the relationship between perceived stress, social support and student's satisfaction with their initial clinical placement.

BACKGROUND

Clinical placements are a central element in shaping future nursing professionals. Students' satisfaction with clinical placements influences their learning outcomes and intention to continue their studies. Students experience stress from various sources during their clinical placements and social support has been found to moderate their stress. However, there is a paucity of studies addressing the associations between perceived stress, social support and satisfaction with the initial clinical placement.

DESIGN

Quantitative cross-sectional study.

METHODS

Participants included 165s-year nursing students enrolled in the bachelor's program at a central university in Israel during their initial clinical placement. Data were collected between December 2022 and February 2023 using an online questionnaire that contained four parts: personal details, perceived social support, perceived stress and satisfaction with clinical placement.

RESULTS

Students' perceived stress was found to be negatively correlated to satisfaction with their clinical instructor (r = -0.47, p < 0.001) and with their clinical placement (r = -0.47, p < 0.001). Positive associations were found between satisfaction with the clinical placement and satisfaction with the clinical instructor (r = 0.67, p < 0.001). Significant differences were found in perceived stress and social support according to sociodemographic characteristics. Students perceived stress, social support from family and friends and satisfaction with their clinical instructor explained 54% of their satisfaction with their initial clinical placements.

CONCLUSIONS

Clinical instructors and nurse educators are central to students' initial clinical experience. It is recommended that they assess students' perceived stress in the clinical environment, integrate stress reduction strategies into the curriculum and encourage students to turn to various sources for social support. These can promote students' satisfaction and success in their studies.

Nurses, midwives and students' reports of effective dedicated education units in five European countries: A qualitative study

AIM

To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment.

DESIGN

A multi-country, phenomenological, qualitative study.

METHODS

Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives.

RESULTS

Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment.

CONCLUSIONS

A close educational-service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment.

IMPLICATIONS FOR THE PROFESSION

It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population.

IMPACT

Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes.

PUBLIC CONTRIBUTION

Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.

The role of extended reality in optometry education: a narrative review

The evolution of digitally based pedagogies, such as extended reality (XR) - a group of simulated learning environments that include virtual simulation, virtual reality, and augmented reality - has prompted optometry educators to seek evidence to guide the implementation of these teaching and learning activities within their curricula. Looking more broadly across the medical and allied health fields, there is a wealth of evidence to guide the incorporation of XR, as it is increasingly being integrated into the curricula of other select health professions disciplines. Educators from these disciplines continue to explore and embed XR in practice. This narrative review summarises the findings and appraises the literature on the use of XR in optometry education. It identifies the learning domains in which XR has been implemented in optometry education and proposes areas for further investigation. The review questions the technology-focused approach that has driven the literature within the review and calls for richer pedagogical foundations with suggestions for future research agendas. As such, this narrative review provides optometry educators with new ways of understanding XR and its relationship with the curriculum.

Mentoring Support Quality in Group and Individual Mentoring Approaches during Nursing Clinical Training: A Quasi-Experimental Study

Clinical training is an essential element in nursing education, the outcomes of which are directly related to the quality of mentoring support. This quasi-experimental study aimed to examine whether the group or individual form of the mentoring approach used and the order of application of the mentoring approach contribute to the quality of mentoring support provided to students. The study comprised two measurement points with 130 nursing students, divided into two groups with different orders of application of the mentoring approach. The validated Mentoring Support Quality Evaluation Questionnaire (MSEQ) was used. Students in both groups rated the quality of mentoring support as higher following an individual mentoring approach. A significant interaction was found between the mentoring approach used and the order in which the mentoring approaches were applied (p = 0.002). The individual mentoring approach contributed significantly to a higher quality of mentoring support after the second round of clinical training (p = 0.021), while after the first round, the difference between the group and individual approaches was not as clear. The results suggest that not only the form of the mentoring approach but also the sequence of changes in the mentoring approach should be planned when implementing clinical training.

The mediating role of academic support perception in the relationship between emotional intelligence and bullying behaviours in clinical practice: A cross-sectional study

BACKGROUND

Bullying behaviours experienced by nursing interns in clinical practice are a considerable and serious concern. Understanding the factors that influence such behaviours in clinical practice is crucial for developing effective preventive measures and fostering a supportive learning environment.

PURPOSE

This study aims to investigate the prevalence and influencing factors of bullying behaviours experienced by nursing interns and examine the mediating role of academic support perception in the relationship between emotional intelligence and bullying behaviours in clinical practice.

METHODS

This is a cross-sectional study that used convenience sampling. A socio-demographic information questionnaire, Bullying Behaviours in Nursing Education Scale, Wong and Law's Emotional Intelligence Scale, and Academic Support in the Practicum Scale were used to collect data from nursing interns (n = 813) at seven tertiary hospitals in Changsha, China. Binary logistic regression and mediating analyses were used to explore the factors influencing bullying behaviours in nursing practice and examine the potential mediating role of academic support perception.

RESULTS

The prevalence of bullying behaviours in clinical practice among 813 nursing interns was 82.7 %. Binary logistic regression analyses indicated that attitude toward the nursing profession, emotional intelligence, and academic support perception were significantly associated with bullying behaviours in clinical practice. Academic support perception (β = 0.375, p < 0.001) played a significant mediating role in the relationship between emotional intelligence and bullying behaviours in clinical practice, accounting for 55.7 % of the total effect.

CONCLUSION

Nursing educators and administrators should recognise that improving emotional intelligence and enhancing academic support perception among nursing interns can reduce the occurrence of bullying behaviours in clinical practice.

The Effect of Nursing Students' Liking of Children and Attitudes Toward Clinical Practice on Their Comfort and Worry Levels in the Pediatric Clinic

This research was conducted as a descriptive and cross-sectional study to determine the effects of nursing students' liking of children and attitudes toward clinical practice on their comfort and worry levels in the pediatric clinic. The research was carried out with 270 nursing students who had already taken or were taking the child health and diseases nursing course. Data were collected using a Nursing Student Information Form, the Barnett Liking of Children Scale, the Nursing Students' Attitudes toward Clinical Practices Scale, and the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. Mean values, percentage calculations, and linear regression analysis were used for the analysis of the research data. Participants' mean scores were 52.30 ± 6.16 on the Barnett Liking of Children Scale, 103.72 ± 19.35 on the Nursing Students' Attitudes toward Clinical Practices Scale, 15.61 ± 3.74 on the comfort sub-dimension, and 11.63 ± 4.32 on the worry sub-dimension of the Pediatric Nursing Student Clinical Comfort and Worry Assessment Tool. It was determined that the liking of children and attitudes toward clinical practice explained 43.6% of the clinical comfort level of pediatric nursing students in Model 1 and 45.2% of their clinical worry level in Model 2. It was determined that the liking of children and attitudes toward clinical practice significantly affected the comfort and worry levels of nursing students in the pediatric clinic.

Investigation of nursing students' emotional states toward challenging situations in clinical practice and metaphorical perceptions of the concept of a nurse

AIM

This study aims to determine nursing students' emotions toward the challenging situations they encounter in clinical practice and their metaphorical perceptions of the concept of a nurse.

BACKGROUND

Challenging situations in clinical practice negatively affect nursing students' perceptions of the nursing profession and their professional learning and development.

DESIGN

The study is based on quantitative, metaphorical and picture-drawing analysis.

METHODS

The quantitative and qualitative parts of it were conducted with 200 nursing students attending their first and second years in the 2021-2022 academic year. The Draw a Picture of a Cactus Test was carried out with 30 students in clinical practice. The data were collected using the "Sociodemographic Information Form" and the "Semi-structured Interview Form". Content analysis techniques, descriptive statistics, picture analysis and psychological tests were used to evaluate the data. The study was reported based on Standards for Reporting Qualitative Research (SRQR).

RESULTS

Nursing students involved in the study produced 37 metaphors related to the "concept of a nurse" and three most expressed ones were "mother, lifeguard and helper." The metaphors produced by nursing students were categorized under six roles: "caregiver, educator, supporter, researcher, administrator and therapeutic/rehabilitator". The pictures drawn by the students about the challenging situations in clinical practice and the expressions they used were associated with self-centeredness (n=21), being attentive (n=19), aggression toward peers (n=13), low motivation (n=11) and need for protection (n=11). Nursing students experienced feelings of loneliness, passivity and anxiety when navigating difficult conditions in clinical practice.

CONCLUSIONS

Metaphors and picture drawing allow a unique approach to the concept of nursing and nursing students' emotional states toward challenging situations in their clinical practice.

Global prevalence of bullying and associated factors among nursing students during clinical practice: A systematic review and meta-analysis

OBJECTIVE

This meta-analysis aims to estimate the global prevalence of bullying among nursing students during clinical practice and identify associated factors.

DESIGN

Systematic review and meta-analysis.

REVIEW METHODS AND DATA SOURCES

We conducted a comprehensive literature search across ten databases (PubMed, Cochrane, Web of Science, Embase, CINAHL, PsycINFO, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG) from their inception to January 3, 2023. Two researchers independently screened potentially eligible studies, extracted data, and assessed study quality. Data were analyzed using random-effects or fixed-effects models. Subgroup analyses and meta-regression explored the influence of participant and study characteristics on bullying prevalence. Publication bias and sensitivity analyses were also performed.

RESULTS

We included 28 studies (N = 9511) from 13 countries on five continents. The pooled estimate of bullying prevalence among nursing students during clinical practice was 65.60 % (95 % CI 55. 75 to 74.27), with no evidence of publication bias (t = 1.51, p-value = 0.14). Subgroup and moderator analyses highlighted the impact of country, continent, publication year, and assessment tool on bullying prevalence.

CONCLUSION

Nursing students face a high prevalence of bullying during clinical practice. Addressing this issue in nursing education requires prioritizing associated factors, fostering a culture of safety, providing effective training, and promoting individual resilience. These actions can prevent and mitigate bullying, creating a supportive and empowering learning environment for future nurses.

Midwifery professional placement: Undergraduate students' experiences with novice and expert preceptors

BACKGROUND

In recent decades, increased midwifery university places have been offered to address midwifery workforce shortages. As a result, more graduate midwives entered the workforce, in turn leading to more midwifery students precepted by novice midwives when on professional placement. It is not known whether this more junior midwifery workforce impacts student experience.

AIMS

To explore undergraduate midwifery students' experiences with novice and expert midwifery preceptors, and to identify the benefits and challenges of working with novice and expert preceptors, from the perspective of undergraduate student midwives.

METHOD

This study used a qualitative descriptive approach. Nineteen third/fourth-year Bachelor of Nursing/Bachelor of Midwifery (Honours) students attended six focus groups (ranging from 2 to 5 participants). Data were analysed thematically.

RESULTS

Three overarching themes were identified: 'Building relationships'; 'Teaching and learning'; and 'Improvements to professional placement'. Benefits and challenges existed with both novice and expert preceptors. Importantly, feeling welcomed and receiving critical feedback were identified.

CONCLUSION

The student/preceptor relationship is based upon feeling welcomed, and relatability, and is developed more easily with novice preceptors. Expert preceptors provide insightful and valuable feedback and are more able to actively teach. Novice preceptors' consolidation of practice can impact student learning opportunities. Including students in decision-making aids development of critical thinking. Allocation practices which address student learning needs will improve the student professional practice experience. Midwifery students benefit from working with midwifery preceptors of all experience levels. Translating the findings from this project into preceptorship training programs for midwives will improve student satisfaction and outcomes.

Effect of an educational program about mentorship competencies on nurse mentors' performance: a quasi-experimental study

BACKGROUND

Mentorship is a vital part of the nursing profession to improve role transition, job satisfaction, and job retention while facilitating socialization, emotional well-being, and the acquisition of new skills.

AIM

The present study aimed to evaluate the effect of an educational program about mentorship competencies on nurse mentors' performance at Port Said Healthcare Authority hospitals.

METHODS

A quasi-experimental study design (pre-test and post-test one group) was used to conduct the study at seven Healthcare Authority hospitals in Port Said Governorate, Egypt. The study subjects were consisted of a purposive sample of 30 nurse mentors and 60 intern nursing students. Data were collected using three tools consisted of the Mentor Knowledge Questionnaire, Mentor Competencies Instrument (MCI), and Nurse Mentor Performance Assessment. Data analysis was performed using SPSS version 20, Student's t-test was used to measure differences between the pretest and post-test, and Qualitative categorical variables were compared using the chi-square test. A significant level value was considered when the p-value ≤ 0.05, and Cohen's d was used to measure the effect size.

RESULTS

the post-test scores of mentorship competencies and performance after implementation of the educational program significantly improved in the studied nurse mentors 56.1 ± 13.2, 60.5 ± 4.9 compared with pre-test scores with 37.1 ± 4.1, 49.7 ± 6.9 (P < 0.001). As determined by Cohen's d test, the effect size of an educational program is quite large on the nurse mentors' performance.

CONCLUSION

The educational program about mentorship competencies was significantly improve mentorship performance of the studied nurse mentors. The study recommended dissemination and generalization of the new and innovative mentorship program to the different stages of nursing education to foster the continued growth and development of nurse mentors and nurse students. Also, recommended developing a valid mentor assessment instrument consisting of and specific to the Egyptian context to assess the Egyptian mentorship model.

TRIAL REGISTRATION NUMBER (TRN)

The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University (code number: NUR 13/2/2022) [10].

Barriers to nurses health advocacy role

BACKGROUND

Speaking up to safeguard patients is a crucial ethical and moral obligation for nurses, but it is also a difficult and potentially dangerous component of nursing work. Health advocacy is gaining impetus in the medical literature, despite being hampered by barriers resulting in many nurses in Ghana remaining mute when faced with advocacy-required situations. We explored situations that thwart nurses from performing their health advocacy role.

RESEARCH QUESTION

What would cause nurses to take no action when they witness situations that require them to act as health advocates for their clients or communities?

RESEARCH DESIGN

An inductive, descriptive qualitative design was used to collect and analyse data on barriers that prevent nurses from practising their health advocacy role in Ghana. Individual one-on-one in-depth interviews were conducted using a semi-structured interview guide. The data were analysed using qualitative content analysis.

PARTICIPANTS AND RESEARCH CONTEXT

Twenty-four professional nurses and midwives registered with the Nursing and Midwifery Council were recruited from three regional hospitals in Ghana. These public hospitals were chosen from the upper, middle and coastal regions.

ETHICAL CONSIDERATIONS

The UKZN Ethics Review Committee in South Africa and the GHS Ethics Review Committee in Ghana both gave their approval for this study.

FINDINGS

Intrapersonal barriers, interpersonal barriers, and structural barriers emerged as major obstacles that nurses experience when performing their health advocacy role.

CONCLUSIONS

Barriers to health advocacy have undermined nurses' ability to function as health advocates and are preventing them from utilising their health advocacy position in nursing practise. Giving nursing students positive role models in the classroom and in the clinic can help them become more effective health advocates.

Assessing the quality of nursing clinical placement: A quantitative cross-sectional study

AIM

To evaluate the quality of nursing clinical placement among nursing students.

DESIGN

This is a descriptive cross-sectional study.

METHODS

Two hundred eighty two nursing student completed self-administered, online questionnaires. The questionnaire assessed participants' socio-demographic data, and the quality of their clinical placement.

RESULTS

The students had a high mean score for the overall satisfaction of their clinical training placement with high mean score for the item of "patient safety was fundamental to the work of the units" and the item of "I anticipate being able to apply my learning from this placement," while the lowest mean score was related to "This placement was a good learning environment" and "Staff were willing to work with students." Patient or Public Contribution: Quality of clinical placement is critical for improving the everyday quality of care for patients who are in desperate need of caregivers with professional knowledge and skills.

Attitudes and perceptions of undergraduate nursing students towards the nursing profession

BACKGROUND

Nursing students either possess positive or negative attitudes and perceptions about the nursing profession. Their attitudes towards the profession depict the quality of care they will offer to patients upon qualification. This study aimed to determine the attitudes and perceptions of undergraduate nursing students towards their profession.

METHODS

This equal-status mixed methods study involved a census sample of 165 nursing students from year one to year four in two public universities in Uganda. Attitude Scale for Nursing Profession was used to collect quantitative data in the period between 20/11/2021 and 22/01/2022. Focus group discussions were held to collect qualitative data about the perceptions.

RESULTS

Majority of the students (81.8%) had positive attitudes towards the nursing profession. There was a significant difference in attitudes based on year of study and entry scheme (R2 = 0.12, F = 2.21, p = 0.01). Nursing was perceived as a poorly remunerated, unpopular profession with bias towards recruitment of lower cadres.

CONCLUSION

The results of this study showed that the attitudes of undergraduate nursing students towards the nursing profession were positive but their perceptions about the nursing profession were negative. An interventional study is recommended to facilitate a more positive change among nursing students.

Student nurses' experiences of workplace violence: A mixed methods systematic review and meta-analysis

OBJECTIVES

To identify the prevalence of student-directed violence on clinical placement and description of their related experience during clinical placements.

DESIGN

Mixed methods systematic review and meta-analysis conducted following Joanna Briggs Institute guidelines and reported according to Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

DATA SOURCES

CINAHL, Embase, Medline, Proquest, PsycINFO and Google Scholar.

REVIEW METHODS

Included studies were peer reviewed, published primary studies where pre-registration nursing students were surveyed about their experiences of physical, verbal, or sexual aggression, bullying or racism during clinical placement. Studies were quality assessed but not excluded based on the result. A convergent segregated approach to synthesis and integration was undertaken. Prevalence data were extracted and pooled using both random and quality effects models; separate analyses were conducted by violence type, source, and region. Qualitative data were thematically analysed.

RESULTS

14,894 student nurses from 42 studies were included across the meta-analyses. There was substantial heterogeneity in the included data. Pooled prevalence rates ranged from racism 12.2 % to bullying 58.2 %. Bullying (38.8 %) and physical aggression (10.2 %) were most perpetrated by nurses whereas sexual aggression was perpetrated mostly by patients (64.2 %) and physicians (18.6 %). Qualitative findings identified students' descriptions of reasons for, effects of, strategies for dealing with and higher education establishments' responsibilities with regards to workplace violence.

CONCLUSIONS

Student nurses commonly experience violence during their clinical placements. Given the potential debilitating physical and psychological sequelae of all forms of violence then this study further emphasises the need to use multiple strategies to prevent violence and to better equip student nurses to manage potentially violent incidents, their responses to violence, and to whistle blow or report when they are subject to violence.

Nursing students' experiences and expectations of clinical learning: A qualitative study

BACKGROUND

Clinical learning is an important component of nursing education that can support the development of competence. Nursing students have expectations before clinical learning, however if these expectations are not matched with their experiences, then development can be hampered.

OBJECTIVE

To explore nursing students' expectations and experiences of their clinical learning experiences.

DESIGN

Qualitative descriptive design.

SETTINGS

The study was conducted at a large teaching hospital in Namibia.

PARTICIPANTS

Fifteen first to fourth year undergraduate nursing students who were allocated to a teaching hospital in Namibia.

METHODS

The participants were purposively sampled among the teaching hospital's undergraduate nursing students. Data were collected between June to November 2021 through in-depth, semi-structured interviews that lasted between 35 and 45 min each. Data were analyzed using thematic analysis.

RESULTS

The data analysis identified four themes: clinical outlook and role, supporting/role modelling, clinical teaching and learning, and linking theory and practice.

CONCLUSION

The expectations and experiences of nursing students regarding the clinical environment were mixed. The findings demonstrated the need to moderate students' expectations, as well as to reorganize the clinical learning environment to enhance students' learning. Further studies should look at the standardization of student expectations based on the context of their clinical learning environment, and how this can improve learning experiences.

Relationship between self-consciousness and empathy for cancer patients among nursing students: The moderating effects of clinical practice satisfaction

BACKGROUND

Patients with cancer experience physical and mental difficulties that can be relieved with the support and empathy of healthcare professionals. Empathy can be affected by self-consciousness. The clinical performance and interpersonal competence of nursing students are related to their satisfaction with clinical practice.

OBJECTIVE

This study explored the moderating effect of clinical practice satisfaction of nursing students on the relationship between self-consciousness and empathy for patients with cancer.

DESIGN

Cross-sectional descriptive study.

SETTING

Three colleges of nursing in South Korea.

PARTICIPANTS

A total of 136 senior nursing students across three universities.

METHODS

The participants completed an online questionnaire on demographic and education-related characteristics, self-consciousness, and empathy competency. We used the Korean versions of the Self-Consciousness Scale and Empathy Construct Rating Scale. The overall response rate was 42.5 %. SPSS PROCESS macro was used to test the moderating role of satisfaction with clinical practice.

RESULTS

Private self-consciousness was significantly associated with clinical practice satisfaction and empathy. The relationship between practice satisfaction and empathy was significantly positive. In addition, the satisfaction of the nursing students with clinical practice moderated the association between private self-consciousness and empathy for patients with cancer. Empathy was more affected by private self-consciousness among senior nursing students who were less satisfied with clinical practice than among those who were more satisfied with clinical practice.

CONCLUSION

To improve empathy for patients with cancer, educational strategies must be created to improve the private self-consciousness and satisfaction with the clinical practice of nursing students.

Undergraduate paramedicine students' experiences of feedback during clinical placement on-road: A scoping review

Feedback on performance enhances student confidence and clinical skills and promotes safe clinical practice. Experiences of feedback are well documented across many health disciplines; however, less is known about paramedicine students' experiences of feedback on-road in an emergency ambulance. The aim of this scoping review was to identify what is known about paramedicine students' experiences of feedback during clinical placement on-road in an emergency ambulance. A review of studies between 2000 and 2021 was undertaken, guided by the Joanna Briggs Institute Methodology for JBI Scoping Reviews and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. Databases included CINAHL, EMBASE, EBSCO, MEDLINE, Web of Science, Cochrane, ERIC (ProQuest), ProQuest (Nursing and Allied Health), Trove, and Open Accessd Theses and Dissertations. Three studies were identified. Feedback is valued by paramedicine students; however, it can be personal and destructive in nature. Paramedics are enthusiastic and supportive and provide clear feedback. Paramedics face challenges supervising students and may lack preparation to provide feedback. There is limited evidence on paramedicine students' experiences of feedback during clinical placement. Further exploration is needed to gain further understanding.

Nursing students' satisfaction with clinical placements: The contribution of role modeling, epistemic authority, and resilience-a cross- sectional study

BACKGROUND

Clinical learning is an essential and irreplaceable component of nursing studies. Satisfaction with clinical placements may improve students' learning outcomes as well as their retention in nursing studies. Satisfaction with clinical placements has mostly been associated with environmental factors. The associations between students' satisfaction with clinical placement and students' resilience, clinical instructors' (CI) epistemic authority and perception as a role model have yet to be fully explored.

OBJECTIVE

To explore the associations between students' satisfaction with clinical placement and resilience, as well as CI epistemic authority and perception as a role model.

DESIGN AND METHODS

A cross-sectional survey design with a convenience sample of 131 Israeli nursing students in advanced years of studies, at a large university in central Israel. Data were collected through a self-administered structured questionnaire.

RESULTS

Strong positive correlations were found between students' satisfaction with the clinical placement and their perception of the CI as an epistemic authority and as a role model. Additionally, strong positive correlations were also found between students' satisfaction with the clinical placements and the three sub-categories included in the perception of their CI as a role model (personal traits, clinical skills, and teaching skills). Resilience and CI's teaching skills explained 75.3% of students' satisfaction with their clinical placement.

CONCLUSIONS

Nurse educators and CIs should be aware of their significant role in students' professional development and satisfaction with clinical placements. Special attention should be given to the refinement of clinical skills and teaching skills during CI training, along with deeper awareness of one's personal traits. CIs have the potential to be significant professional role models for their students, while enhancing students' resilience and promoting clinical competencies and quality care. These lead to higher student satisfaction and retention in studies as future nurses.

Implementation of a Registered Nurse Primary Care Clinical Mentoring Academy

Registered nurses (RNs) are pivotal team members for improving the quality of care in communities; however, they are underutilized in primary care. Two schools of nursing in Alabama partnered to develop and implement a project to build a resilient primary care RN workforce. A major component of this project is the Primary Care Clinical Mentoring Academy (PCCMA), which was designed to prepare RN clinical mentors to implement positive student learning experiences in the primary care setting. The PCCMA follows a comprehensive curriculum implementing both didactic instruction and interactive activities related to primary care competencies; interprofessional education and collaborative practice; and primary care RN mentor roles and responsibilities. Participants reported that the PCCMA was effective and useful, and they perceived that it would improve their overall job performance as a clinical mentor. The PCCMA is an effective way to produce confident and capable RN mentors in primary care. [J Contin Educ Nurs. 2022;53(7):312-320.].

Clinical Training during the COVID-19 Pandemic: Experiences of Nursing Students and Implications for Education

The COVID-19 pandemic has caused difficulties in the organization of clinical classes for nursing students. It is therefore important to explore students’ experiences related to participation in clinical classes during the pandemic and to draw conclusions that will allow for the introduction of innovations enabling the development of the required professional competencies as part of training during current and future pandemic restrictions. In this study, we aimed to explore the experiences of nursing students related to clinical education during the COVID-19 pandemic and to identify practical implications for this education in the future. A qualitative study was performed based on individual interviews among Polish nursing students (n = 20). The study is reported using the COREQ checklist. Content analysis was applied, and five main categories were identified, including ‘the key role of clinical mentor’, ‘theory-practice gap’, ‘ambivalent emotions and ethical challenges’, ‘to be part of the team’, and ‘strengthened professional identity’. The results of our research indicate that higher education institutions should implement clear strategies to support students, both in terms of psychological support and compensation of professional skills, the development of which might be limited during the pandemic. Modern technologies, including medical simulations, virtual reality, artificial intelligence, and telemedicine should be used in the practical teaching of nursing students to educate them on how to cope with difficult, new situations, build decision-making skills, and solve problems.

Experiences of faculty and staff nurses working with nursing students during clinical placement in residential aged care facilities: a systematic review of qualitative evidence

OBJECTIVE

The objective of this review was to synthesize evidence on the experiences of faculty and staff nurses working with nursing students in clinical placement in residential aged care facilities.

INTRODUCTION

Nursing education helps prepare students to provide quality care to older adults. Nursing programs across the globe are championing the integration of content on the care of older adults into their curricula as well as recognizing the value of clinical placements that focus exclusively on this population. Staff nurses who work in residential aged care facilities often work alongside students. In this role, they can support faculty and mentor students. This review explored faculty and staff experiences of nursing student placements in such facilities.

INCLUSION CRITERIA

This review considered qualitative studies that address the experiences of faculty and staff nurses working with nursing students in residential aged care facilities. Studies published in English from 1995 onward were included.

METHODS

The literature search was conducted in CINAHL, MEDLINE, Embase, and ERIC. The search for unpublished articles included Proquest Dissertations and Theses and Google searches of the Canadian Nurses Association and American Nurses Association websites. Papers were screened by two reviewers independently against the inclusion criteria. Those meeting the criteria were appraised using the JBI critical appraisal checklist for qualitative research. Key findings from included studies were extracted using a standardized tool and classified as unequivocal, credible, or not supported. This review followed the principles of meta-aggregration in line with the JBI approach.

RESULTS

Six studies, published between 2001 and 2017, were included in the review. A total of 32 findings were extracted and aggregated into nine categories. From the nine categories, four synthesized findings were developed: i) students enhance the environment, whereby faculty and staff perceive that student presence enhances the residential aged care work and living environment, ii) effort is required by faculty and staff to make the experience work, reflecting a need for faculty and staff to accept and work with negativities, iii) residential aged care facilities provide rich learning experiences, indicating an appreciation for available learning opportunities, and iv) importance of a residential aged care-academic partnership for a collaborative approach in creating positive experiences for faculty and staff working with students in this setting.

CONCLUSION

Faculty and staff experiences highlight that residential aged care has the potential to provide students with valuable learning experiences, including how to provide comprehensive and quality nursing care to older adults. A lack of resources in residential aged care inspires faculty and staff to be creative in how they work with students. However, working with students can be challenging for faculty who lack interest and expertise in caring for older adults in this setting. Additionally, staff can become frustrated when they perceive that students do not value the learning opportunities that are available or do not appreciate the expertise required to work with older adults. Partnerships between residential aged care facilities and academic programs can ensure that faculty and staff have the support and resources required to optimize the clinical placements for students.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020168698.

The impact of bullying on the mental health and academic achievement of nursing students

PURPOSE

This study aimed to determine the prevalence of bullying and identify the perpetrators of bullying among nursing students. Further, the impact of bullying on their mental health and academic achievement was also examined.

DESIGN AND METHODS

A cross-sectional correlational design was adopted. A total of 180 undergraduate nursing students completed an electronic questionnaire.

RESULTS

Approximately half of the participants had experienced at least one or more bullying behaviors on a daily or weekly basis during nursing education. Classmates were the most frequently reported perpetrators of bullying behaviors. Bullying experience was associated with poor psychological health and perceived stress. A lower grade point average emerged as a significant predictor of exposure to bullying behaviors.

PRACTICE IMPLICATIONS

There is a need to create policies that delineate the legal implications of bullying to protect students. Faculty members and clinical service providers should work together to reduce the prevalence and impact of negative acts against students.

Online Virtual Nursing Placements: A Case Study on Placement Expansion

Introduction

A need to increase student placements, in a culture that is under unprecedented demand, means that practice providers and partner higher education institutions need to find new and innovative ways to ensure quality learning experiences for students. Virtual placements are just one way of providing student placements, and this study presents a case for this.

Objective

This research aims to explore the student’s experience of virtual blended placements and to consider future sustainability.

Method

This is a qualitative, exploratory study observing the attitudes, thoughts, and feelings of student nurse experiences of online virtual nursing placements. Key cases were identified, and two participants were asked to reflect upon their experiences of the blended virtual learning placement. Student evaluations, and virtual placement day plans, form part of the data collection, and results are presented in a theory building and comparative approach, adopting pattern matching.

Results

Three themes emerged from the narratives, supported by student evaluations and day plans. Students reviewed the placement positively in that they were able to achieve their required practice proficiencies. Second, they discussed the way in which the virtual days were facilitated and that building relationships with professionals and peers while on placement was of high importance.

Conclusion

This case study presents a novel and unique student experience within a 0–19 community nursing service, which through 3 days of practice placement supported by two virtually taught days, students were able to reach their practice proficiencies. This virtual placement model offers a unique way to reduce the pressures on frontline staff and enriches the students’ experiences.

What Helps, What Hinders? Undergraduate Nursing Students' Perceptions of Clinical Placements Based on a Thematic Synthesis of Literature

Introduction

Clinical placements are a mandatory component of nursing students’ education internationally. Despite clinical education being a key to nursing students’ achievement of nursing competencies, few studies have reviewed students’ narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys.

Methods

A systematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students’ experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research.

Results

Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as “Preparation,” “Welcomed and wanted” and “Supervision experiences”. A conceptual model of clinical placement elements conducive to nursing students’ learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed.

Conclusion

The conceptual model presents positive elements that influence students’ clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strategies to support students and supervisors alike, an important step forward in moving beyond the current clinical placement rhetoric.

"Feel the fear and do it anyway" … nursing students' experiences of confronting poor practice

AIM

The two aims of this study were, first, to explore nursing students' experiences and perspectives of reporting poor care and second, examine the process by which they raised concerns.

BACKGROUND

The nursing literature is replete with studies which explore nursing students' experiences of clinical placement. However only a small number explore students experiences of challenging poor care and how this is enacted in the practice setting.

SETTING AND PARTICIPANTS

Fourteen nursing students from undergraduate pre-registration nursing programs across three universities, two in the United Kingdom (UK) and one in Australia.

DESIGN AND ANALYSIS

This paper reports findings from narrative interviews about students' clinical experiences of reporting poor care. Data were audio recorded, transcribed verbatim and analyzed using a constant comparison approach. Emerging themes were identified, discussed and verified by the researchers.

RESULTS

Four montages from the narratives highlight the overarching themes: bullying, patient advocacy, lack of empathy and poor care. They demonstrate how, driven by an ethical imperative, students speak up when they witness poor care despite the difficulties of doing so: in some cases, the students in this study were prepared to continue speaking out even when initial concerns were dismissed.

CONCLUSION

Both practice and university teams have a responsibility to support students' development as ethical and courageous practitioners, able to recognize when care falls below an acceptable standard.

Nursing students' experience with clinical placement in nursing homes: a focus group study

Background

A renewed interest in nursing homes as clinical placement settings for nursing students has been prompted by the growing healthcare needs of an ageing population. However, if future nurses are to be enthusiastic about working in this healthcare context, it is essential that higher education institutions that educate nurses and nursing homes that provide placement experiences to students do so with a supportive, positive, and enriched approach.

Methods

To explore first-year nursing students’ placement experience in nursing homes, we conducted an exploratory qualitative study in three city-based nursing homes in western Norway. Thirteen first-year nursing students participated in the study. Three focus group interviews were conducted to explore the students’ placement experiences. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR).

Results

The analysis describes five themes relating to first-year students’ placement experience in nursing homes; (1) variations in utility of pre-placement orientation and welcome at placement site; (2) a challenging learning environment; (3) spending considerable placement time with non-registered nurses; (4) considerable variability in supervision practices; and (5) a vulnerable and demanding student role.

Conclusions

The research provides insight into the contextual characteristics encountered by first-year students that influence the quality of their placement experiences. Consequently, these characteristics impede access to important role models who lend support to a student’s growth and professional development, preventing full utilisation of the learning potential offered in nursing homes. Hence, we propose that targeted efforts are warranted to foster positive placement experiences and enhance students’ clinical education in nursing homes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00690-4.

The relationship between clinical placement duration and students' satisfaction with the quality of supervision and learning environment: A mediation analysis

Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified, such as the clinical learning environment, the supervision provided by supervisors, and the level of cooperation with the nurse teacher. The objective was to examine whether the relationship between the clinical placement duration and overall satisfaction with clinical training is mediated by the supervisory relationship and learning environment. A secondary analysis was conducted using the data from a cross-sectional study conducted in 17 higher educational institutions in nine European countries with the Clinical Learning Environment, Supervision and Nurse Teacher scale (n = 1903 pre-registration nursing students). Satisfaction with the supervisor and a good learning environment mediated the relationship between clinical placement duration and overall satisfaction as perceived by the students. Nursing students with longer clinical placement durations were more satisfied with clinical training as a result of both their satisfaction with their supervisor and their perceptions of good learning environment. The optimal duration a nursing student should remain in the different practice settings is approximately 7 weeks.

Nursing degree students' clinical placement experiences in Australia: A survey design

AIM

This study aimed to evaluate Australian nursing students' views of placements at seven tertiary education institutions with the use of the Placement Evaluation Tool (PET).

BACKGROUND

Clinical placements are a core element of healthcare education programs around the world (Chuan and Barnett, 2012) with undergraduate nursing students required to complete a prescribed number of hours as part of their degree. The quality of nursing clinical placements varies with a range of positive and negative learning experiences.

DESIGN

A survey design was used with a contemporary survey tool- the Placement Evaluation Tool (PET). Using Qualtrics software (Qualtrics, 2005) the on-line survey was distributed to approximately 6265 undergraduate nursing students at six Australian universities and one Technical and Further Education (TAFE) college where Bachelor of Nursing degree students were enrolled. Three Australian States were covered. Sites were selected where a project team member was employed.

METHODS

A total of 1263 nursing students completed the Placement Evaluation Tool (PET) - 19 items (rated 1-5), one global rating (rated 1-10) - following placement in three Australian States (July 2019-February 2020). Most - 618 (48.9%) completed a placement in acute care with placements positively rated overall.

RESULTS

The total PET mean score was 78.3% with 29.8% being 'extremely satisfied' (10 out of 10 - Item 20). However, 11.0% were dissatisfied with global ratings of four or less, whilst ratings between States differed significantly (p = <0.001). One third of respondents answered a free text statement relating to placement experiences, with significantly more comments from older students (p = <0.001) and from those with ratings in the lower range (p = <0.001). Three core themes emerged: 1. Staff Attitudes to Students, 2. Environment and 3. Lifestyle.

CONCLUSIONS

Whilst students' clinical experiences in Australia tend to be positive a minority reported exposure to negative staff attitudes, in unsafe environments, with lifestyle detriments. Further work is required to understand and enhance student experiences.

Stepping out of the shadows: Creating a graphic novella to address bullying in nursing education

The prevalence of bullying in nursing and nursing education is of serious concern. Not only is bullying an issue at the interpersonal level, it is also pervasive at structural and institutional levels. Addressing bullying requires attention to all levels. In previous published work, we emphasized the importance of transparent and easily accessible processes and reporting mechanisms for students if or when they witness or experience bullying in nursing education. In this paper, we describe one of a number of education initiatives designed to inform stakeholders (students, faculty members, clinical instructors, registered nurses, clinical education leaders) about the prevalence of bullying, the nature of bullying, the consequences of bullying, and some strategies to address bullying in nursing education. We chose a creative approach in the form of a graphic novella (aka comic) because we believed that this medium would be visually appealing and user friendly and would therefore draw stakeholders, especially students, to the sensitive nature of the content embedded within it.

From Learning on Mannequins to Practicing on Patients: Nursing Students' First-Time Experience of Clinical Placement in Jordan

Introduction

Although clinical nursing placement is an indispensable component of student nurses' education, data on students' first clinical experiences is scarce in developing countries.

Objectives

The study aim is to uncover nursing students' first-time clinical placement experience and identify related influencing factors in Jordan.

Methods: Focus group discussions (n=4) were used.

Results

The results showed that the transition from learning with mannequins to practicing on real patients in the clinical placement involved both effective learnings through hands-on practice to dealing with clinical challenges. Students perception of nursing ranged from positive comments such as “humanistic” and “nursing almost medicine” to negative images such as “nursing is all about bedside care” and “nursing has poor social status.”

Conclusion

Students' experience in their first clinical placement is multifaceted, and incorporation of student's perspective in the first clinical placement is a crucial component of educational planning.

Social Study Resources and Social Wellbeing Before and During the Intelligent COVID-19 Lockdown in The Netherlands

The first intelligent COVID-19 lockdown resulted in radical changes within the tertiary educational system within the Netherlands. These changes posed new challenges for university students and many social welfare agencies have warned that it could have adverse effects on the social wellbeing (SWB) of university students. Students may lack the necessary social study-related resources (peer- and lecturer support) (SSR) necessary to aid them in coping with the new demands that the lockdown may bring. As such, the present study aimed to investigate the trajectory patterns, rate of change and longitudinal associations between SSR and SWB of 175 Dutch students before and during the COVID-19 lockdown. A piecewise latent growth modelling approach was employed to sample students' experiences over three months. Participants to complete a battery of psychometric assessments for five weeks before the COVID-19 lockdown was implemented, followed by two directly after and a month follow-up. The results were paradoxical and contradicting to initial expectations. Where SSR showed a linear rate of decline before- and significant growth trajectory during the lockdown, SWB remained moderate and stable. Further, initial levels and growth trajectories between SSR and SWB were only associated before the lockdown.

Longitudinal Trajectories of Study Characteristics and Mental Health Before and During the COVID-19 Lockdown

The COVID-19 lockdown has significantly disrupted the higher education environment within the Netherlands and led to changes in available study-related resources and study demands of students. These changes in study resources and study demands, the uncertainty and confusion about educational activities, the developing fear and anxiety about the disease, and the implementation of the COVID-19 lockdown measures may have a significant impact on the mental health of students. As such, this study aimed to investigate the trajectory patterns, rate of change, and longitudinal associations between study resources-demands and mental health of 141 university students from the Netherlands before and during the COVID-19 lockdown. The present study employed a longitudinal design and a piecewise latent growth modeling strategy to investigate the changes in study resources and mental health over a 3 month period. The results showed that moderate levels of student resources significantly decreased before, followed by a substantial rate of increase during, lockdown. In contrast, study demands and mental health were reported to be moderate and stable throughout the study. Finally, the growth trajectories of study resources-demands and mental health were only associated before the lockdown procedures were implemented. Despite growing concerns relating to the negative psychological impact of COVID-19 on students, our study shows that the mental health during the initial COVID-19 lockdown remained relatively unchanged.

'Anyone can have a mental illness': A qualitative inquiry of pre-registration nursing students' experiences of traditional mental health clinical placements

Nurses play a crucial role in mental healthcare provision. Like many countries, Australian nursing students are educated in comprehensive pre-registration programmes which include mental health clinical placements. Placements play a vital role in students' education, providing the opportunity to engage with consumers and develop mental health nursing knowledge and skills. There is limited knowledge of student perspectives on traditional placements in contemporary recovery-oriented mental health services. This interpretive qualitative inquiry aimed to explore nursing students' experience of traditional mental health clinical placement and how it influenced their practice and their understandings of recovery from mental illness. Data were collected from focus groups with n = 31 nursing students in a large metropolitan public mental health service. Thematic analysis resulted in three themes of experience: humanizing people with mental illness; learning about recovery; and shifting perspectives on mental health nursing. Through a positive placement experience where they felt supported and included by staff, students came to see consumers as people rather than diagnoses, developed greater understanding of mental health nursing work and were more likely to consider mental health nursing as a career choice. Peer-support workers were an important influence on students' understandings of recovery and have a key role to play in educating students on placement. Students need to be prepared and supported by university and clinical staff to deal with vicarious trauma that may occur on placement. Mental health placements play a crucial role in attracting students into the field, and it is imperative they remain part of comprehensive pre-registration education.

What Academic Factors Influence Satisfaction With Clinical Practice in Nursing Students? Regressions vs. fsQCA

Clinical practices are considered one of the cornerstones in nurses' education. This study provides a framework to determine how factors in the academic environment, influence nursing student's satisfaction with their practices. A cross-sectional analytical study was conducted in a convenience sample of 574 nursing students at a private university in Valencia, during the 2016/2017 academic year, 79% (456) were women. Two statistical methodologies were used for data analysis: hierarchical regression models (HRM) and fuzzy sets qualitative comparative analysis (fsQCA). The HRM indicate that the students' mean score influences all dimensions of satisfaction. Furthermore, in the fsQCA, the type of service and center, as well as the type of management, the preference in the choice of the practice center and the number of students per period per clinical educator influence satisfaction with clinical practices. These results could be used to understand how academic factors influence nursing students' satisfaction with their clinical practices and to create intervention programmes that improve it. This will help prepare students to be the future nursing workforce.

A new approach to the prevention of nursing care rationing: Cross-sectional study on positive orientation

AIMS

To assess the effects of nurses' life satisfaction and life orientation on the level of nursing care rationing.

BACKGROUND

Best practice within human resource management argues that striving for a positive orientation within the workforce may create a friendly work environment that could promote the employee's development and job satisfaction in a health care organisation.

METHODS

A total of 547 nurses were enrolled and assessed using three self-report scales: the Basel Extent of Rationing of Nursing Care-R (BERCA-R), the Satisfaction with Life Scale (SWLS) and the Life Orientation Test (LOT-R). Then, the data were submitted into bivariate analyses.

RESULTS

More pessimistic nurses with low and moderate levels of life satisfaction, and those with a neutral life orientation, presented with significantly higher BERCA-R scores than those who were more optimistic and who had high levels of life satisfaction.

CONCLUSIONS

Nursing care rationing depends on psychological factors of life satisfaction and life orientation. Low levels of satisfaction with life and a more pessimistic life orientation negatively contribute towards a higher prevalence of nursing care rationing.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing management policies, including intervention management, should consider ensuring positive orientation is in place to increase job satisfaction and optimism in health care workers.

Clustering clinical learning environment and mentoring perceptions of nursing and midwifery students: A cross-sectional study

AIMS

This study aimed to explore nursing and midwifery students' evaluation of the clinical learning environment and mentoring and to identify distinct student profiles relating to their perceptions.

DESIGN

This study employed a cross-sectional design.

SETTINGS

The study population included nursing and midwifery students in a university hospital in Finland.

PARTICIPANTS

All nursing and midwifery students who completed their clinical placement were invited to take part in the study in the academic year 2017-2018.

METHODS

The data (N = 2,609) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale. The data were analysed using a K-mean cluster algorithm to identify nursing and midwifery students' profiles.

RESULTS

The findings from this study indicate four distinct profiles (A, B, C, & D) of nursing and midwifery students in relation to the clinical learning environment and mentoring. Profile A (N = 1,352) students evaluated their clinical learning environment and mentoring to the highest level (mean varied from 9.44-8.38); and Profile D (N = 151)- to the lowest (mean varied from 5.93-4.00).

CONCLUSION

The findings highlight that nursing and midwifery students evaluate their clinical learning environment and mentoring more highly when: they have a named mentor, student and mentor discuss learning goals, there is a final assessment in clinical learning, the mentor's guidance skills support student learning, the clinical learning supports the student's professional development and pre-clinical teaching in an educational institution supports learning in the clinical placement.

IMPACT

Clinical learning plays an important role in nurse and midwifery education. Mentoring of clinical practice was shown to have a great influence on students' perceptions of their success in clinical learning. We suggest that clinical practice should be strengthened by the building of collaboration between nursing teachers and registered nurses.

Design and Psychometrics of the Mentoring Questionnaire among Bachelor's Degree Students in Nursing

BACKGROUND

Regarding the importance of mentoring in nursing and lack of attention to this issue, as well as the lack of a suitable questionnaire to assess mentoring, this study was carried out to design and analyze psychometric properties of mentoring among bachelor's degree students in nursing.

MATERIALS AND METHODS

In a mixed method study, the validity and reliability of the Mentoring Questionnaire were measured after designing it. The study sample included all undergraduate nursing students of one of the nursing schools in Tehran, Iran. In the qualitative phase, item generation, face, and content validity were performed. In the quantitative phase, construct validity and reliability were performed. The Cronbach's alpha coefficient and Interclass Correlation Coefficient (ICC) test were exploited for data analysis and reliability assessment, respectively.

RESULTS

The number of items designed for the Mentoring questionnaire was twenty. Finally, the Mentoring Questionnaire was designed with 16 items. The Cronbach's alpha coefficient of the Mentoring Questionnaire was 0.96. In addition, the results of the ICC showed the high reliability of the Mentoring Questionnaire (ICC = 0.99). The indices derived from Exploratory Factor Analysis (EFA) revealed that the Mentoring Questionnaire had appropriate construct validity.

CONCLUSIONS

Given the results of this study, as well as the importance of mentoring measurement among nursing students and the lack of access to a valid questionnaire, it can be concluded that the Mentoring Questionnaire is a useful tool for bachelor's degree nursing students.

Overcoming the challenges of role transition for trainee advanced clinical practitioners

Advanced clinical practitioners (ACPs) are being recruited in England to improve care continuity and safety, meet complex needs and ease workforce pressures. These roles are open to experienced, registered health professionals from a variety of backgrounds. This significant career change typically involves a transitional training programme. This article explores the challenges presented by this transition and how they can be overcome. Attaining the postgraduate qualification can be daunting for those who have been outside academic education, especially the initial degree module. The generalist ACP role can be confused with that of clinical nurse specialist, and an ambiguous role identity can cause problems for management, expectations and morale. Trainee ACPs gain wide experience from ward rotations, although they can specialise in some areas. Thus, trainees experience de-skilling as they go from being an expert in one role to a novice in another, as well as potentially developing imposter syndrome. Trainees may be anxious about being expected to fulfil the competencies of a qualified ACP, and their trainee status should be evident in their uniform. Those entering advanced practice can face interpersonal hostility and institutional resistance. Any bullying should be addressed directly, and potential misconceptions should be clarified. There is no overarching national regulatory body for ACPs, and relevant guidelines can diverge. While a clinical supervision assesses a trainee's performance, a separate mentor should support their learning and develop their competence and confidence, especially in the first year. Mentorships should be defined and structured. Trainees can be supported by experienced qualified ACPs. Flexible individual induction plans, with information spaced throughout the year, can help overcome these challenges, and these should make the most of the trainee's achievements in their previous role.

Optimistic thinking, satisfaction with life and job and nursing care rationing: Multicentre study in Poland

AIMS

The aim was to examine whether the level of optimism and job and life satisfaction is a differentiating factor from the level of implicit rationing of nursing care in a sample of Polish registered nurses.

BACKGROUND

Satisfaction with life and job is reflected by greater effectiveness of nurses at work and creates a positive work environment, which in turn may modulate the level of implicit rationing of nursing care.

METHODS

A cross-sectional multicentre research design was adopted, employing a representative sample of 1,010 registered Polish nurses identified between the beginning of January and the end of June 2019. Four self-report scales were used in this study: Basel Extent of Rationing of Nursing Care, Satisfaction with Life Scale, Satisfaction with Job Scale and Life Orientation Test-Revised. The results were analysed using the k-means method, Student's t test and two-way ANOVA.

RESULTS

Optimistic thinking, and satisfaction with job and life exerted a significant effect on the level of implicit rationing of nursing care among Polish nurses. Nurses from the group 'pessimistic' were at higher risk of nursing care rationing than those from the group 'optimistic'.

CONCLUSION

Strengthening of the personal competencies, providing support and responding to all identified needs might increase job satisfaction of nurses and hence reduce the risk of nursing care rationing.

IMPLICATIONS FOR NURSING MANAGEMENT

Leadership modelling and training in positive thinking might be the methods to support nurses and to prevent nursing care rationing.