How do nursing students experience the clinical learning environment and respond to their experiences? A qualitative study

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.

Nurturing ethical insight: exploring nursing students' journey to ethical competence

BACKGROUND

Ethical competence is a key competence in nursing and the development of the competence is a central part in nursing education. During clinical studies, nursing students face ethical problems that require them to apply and develop their ethical knowledge and skills. Little is known about how ethical competence evolves during students' initial clinical placements. This study explored the development of ethical competence in first-year nursing students during their first clinical placements in nursing homes.

METHODS

This exploratory-descriptive qualitative study used focus group interviews to collect data and a phenomenological hermeneutical method for analysis. Twenty-eight first-year nursing students participated in six focus groups. The data were collected between March and April 2024 at Oslo Metropolitan University in Norway.

RESULTS

The naïve reading of the data involved an awareness of the students applying their prior knowledge, modifying their prior knowledge and developing skills that allowed them to manoeuvre ethical practices that, in some cases, appeared excellent and, in other cases, grim. The structural analysis identified three themes: (i) ethical competence forges in practice, (ii) ethical competence evolves at the intersection of knowledge and skills and (iii) ethical competence unfolds through meaningful discussions. A comprehensive understanding of the data was formulated as 'Being on a journey towards ethical competence'. This presents a metaphor illustrating that nursing students embark on a journey towards ethical competence; from their point of departure, their clinical experiences forge the essential waypoints along their path, knowledge and skills fuelling their navigation in rugged terrain towards their destination.

CONCLUSIONS

Nursing students' ethical competence evolved in intricate ways during their initial clinical period. Being informed bystanders or participants in the care of nursing home residents in situations of ethical tension may be a unique position enabling students to evaluate care options differently from those immersed in the ward culture. The findings indicate that organised professional development in nursing homes needs to focus on more reflexively driven ways of supervising students in their first clinical study period. Educational institutions need to continue and further develop reflection-based learning activities and meeting points with students and their peers during their clinical placement periods.

Nursing students' perception of digital technology in clinical education among undergraduate programs: A qualitative systematic review

BACKGROUND

Although past research has highlighted the importance of digital technology in clinical education among undergraduate nursing programs, facilitators and barriers to application still need to be systematically understood.

AIM

The objective of this systematic review is to synthesize existing literature reporting on nursing students' experiences with digital technology in clinical education among undergraduate programs to identify gaps and design future educational programs.

METHODS

We conducted a qualitative systematic review and reported the following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, CINAHL, Web of Science databases were searched for studies published in English. Qualitative studies focusing on nursing students' experiences of digital technology in clinical education were included, and data were synthesized by extracting findings, developing categories, and developing synthesized findings.

RESULTS

Six synthesized findings were concluded:1) nature of digital education, 2) facilitators, 3) barriers, 4) benefits to learning, 5) mixed experience, and 6) challenges.

CONCLUSIONS

The systematic review revealed that the utilization of digital technology in clinical practice is beneficial to the learning of undergraduate nursing students. Facilitators and challenges of digital education, as well as barriers to digital education identified in this review can be used to design more effective digital education activities. Digital technology can be used to supplement traditional teaching, and it is worthwhile to explore more in the area of digital education to promote the cultivation of nursing students' competency.

The Lived Experience of Nursing Students from Student Work in Clinical Environments: A Hermeneutic Phenomenological Study

Introduction

Undergraduate nursing students often work part-time or even full-time while studying at university completing their bachelor's degrees. The aim of this study is to explain the meaning of the lived experiences of nursing students working as students in clinical field.

Methods

A phenomenological study was conducted at the nursing and midwifery school of Tabriz, Iran. Purposefully, 20 baccalaureate nursing students with experience working as student worker nurses were recruited. The sample size was determined according to data saturation. Semi-structured, face-to-face interviews were held with the participants over 3 months (April 2020 to June 2020), and Van Manen's hermeneutic phenomenological approach was used to analyze the data.

Results

Five main themes extracted from the data analysis, including "students' clinical competency", "nurse-student relationships", "shift work", "mislearning", and "chaotic wards". A further 12 sub-themes extracted under the five main themes.

Conclusion

The work of nursing students in clinical environments as student worker nurses is a two-dimensional phenomenon with advantages and disadvantages. The benefits are improving the nursing students' clinical and communication skills, increasing their self-confidence, learning and practicing discipline and nursing responsibilities, and the disadvantages are facing reality shock stress, and mislearning.

Exploring the perceptions of nursing internship students and their faculty mentors regarding the complexities and hindrances associated with implementing the nursing process within the clinical setting: An in-depth qualitative investigation

Background

Utilizing the nursing process within clinical settings serves to enhance the scientific stature of the nursing field. Nonetheless, various research findings suggest that nursing internship students encounter difficulties when it comes to implementing the nursing process and may lack the necessary proficiency.

Objectives

The aim of this investigation is to identify the perceptions of nursing internship students and their faculty mentors regarding the complexities and hindrances associated with implementing the nursing process within the clinical setting.

Design

A qualitative content analysis.

Participants

Nursing internship students and their faculty mentors from the Isfahan School of Nursing and Midwifery.

Methods

In this study, individual interviews were conducted with 13 participants. The data for this study were gathered through these semi-structured interviews and subsequently analyzed using the Granheim and Lundman method. To ensure the validity and reliability of the data, the evaluative criteria of Lincoln and Guba were employed.

Results

The obstacles unveiled in this study can be categorized into three primary domains, each with its own subcategories: 1-Student role ambiguity (1-1 Lack of practical autonomy; 1-2 Insufficient proficiency in the nursing process; 1-3 Motivational deficiency). 2- Organizational Challenges (2-1 Shortage of nursing staff; 2-2 Suboptimal interpersonal dynamics); And 3- Gradual Erosion of the Nursing Process.

Conclusion

Recognizing the paramount importance of the nursing process in enhancing patient care quality is universally accepted. Therefore, it is imperative to systematically identify and tackle the challenges associated with its application. This study highlights that these challenges stem from various factors, including the multifaceted roles assumed by nursing students, organizational shortcomings within healthcare institutions, and the neglect or erosion of the nursing process in specific clinical settings. Addressing these issues is crucial for ensuring the effective utilization of the nursing process within the nursing profession and for optimizing patient care outcomes.

The effect of the preceptorship training program on the participation of clinical nurses in training nursing internship students: a quasi-experimental study

INTRODUCTION

Clinical education is a fundamental part of nursing professional education. One method of education is the implementation of the preceptorship program, in which clinical nurses are responsible for educating nursing students. The present study aimed to determine the effectiveness of the preceptorship training program for the participation of clinical nurses in the education of nursing students.

METHODS

This quasi-experimental study was conducted in 2023 at the teaching hospital in Tehran, Iran. The sample consisted of 66 nurses from a teaching hospital selected using the accessible method and randomly were put into two groups. The workshop addressed the educational needs of preceptors and students, their readiness for their role, and strategies to effectively support students. Prior to the study, the nurses' level of participation was assessed utilizing a valid IMSOC questionnaire that gauged their involvement in guiding nursing students. The participation rate was reassessed after one month using the same questionnaire. The data were analyzed using SPSS version 19.

FINDINGS

The two groups were homogeneous in terms of demographic characteristics. The average score for nurses' participation in the education of students before the intervention was 101.84 ± 15.42 in the test group and 107.24 ± 10.53 in the control group; these two groups were not significantly different (P = 0.10). After the intervention, the scores reached 118.90 ± 15.11 in the test group and 106.21 ± 11.96 in the control group, indicating a significant difference (P < 0.001). A comparison of the nurses' participation scores in the test group indicated a significant difference from the pretest to the posttest, with the improvement in all nurses's participation scores (P < 0.001). However, in the control group, this difference was not significant (P = 0.41).

CONCLUSION

The preceptorship training program is effective in light of increasing the participation of clinical nurses in the education of nursing students. This program can improve various aspects, such as motivation, satisfaction, commitment, implementation, and obstacle removal. Considering the importance of clinical training for nursing students and the essential role of preceptors, it is recommended that managers and health trustees in all university hospitals implement a preceptorship training program to increase the participation of clinical nurses in the education of nursing students.

Preparedness for a first clinical placement in nursing: a descriptive qualitative study

BACKGROUND

A first clinical placement for nursing students is a challenging period involving translation of theoretical knowledge and development of an identity within the healthcare setting; it is often a time of emotional vulnerability. It can be a pivotal moment for ambivalent nursing students to decide whether to continue their professional training. To date, student expectations prior to their first clinical placement have been explored in advance of the experience or gathered following the placement experience. However, there is a significant gap in understanding how nursing students' perspectives about their first clinical placement might change or remain consistent following their placement experiences. Thus, the study aimed to explore first-year nursing students' emotional responses towards and perceptions of their preparedness for their first clinical placement and to examine whether initial perceptions remain consistent or change during the placement experience.

METHODS

The research utilised a pre-post qualitative descriptive design. Six focus groups were undertaken before the first clinical placement (with up to four participants in each group) and follow-up individual interviews (n = 10) were undertaken towards the end of the first clinical placement with first-year entry-to-practice postgraduate nursing students. Data were analysed thematically.

RESULTS

Three main themes emerged: (1) adjusting and managing a raft of feelings, encapsulating participants' feelings about learning in a new environment and progressing from academia to clinical practice; (2) sinking or swimming, comprising students' expectations before their first clinical placement and how these perceptions are altered through their clinical placement experience; and (3) navigating placement, describing relationships between healthcare staff, patients, and peers.

CONCLUSIONS

This unique study of first-year postgraduate entry-to-practice nursing students' perspectives of their first clinical placement adds to the extant knowledge. By examining student experience prior to and during their first clinical placement experience, it is possible to explore the consistency and change in students' narratives over the course of an impactful experience. Researching the narratives of nursing students embarking on their first clinical placement provides tertiary education institutions with insights into preparing students for this critical experience.

Nursing students' stressors and coping strategies during their first clinical training: a qualitative study in the United Arab Emirates

BACKGROUND

Understanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses' sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study.

METHODS

A qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes.

RESULTS

During their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students' clinical experiences. We extracted three main themes that described students' stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies.

CONCLUSIONS

This qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum.

Nursing students' and faculty's experiences of first medication administration: A phenomenological inquiry

BACKGROUND

Learning medication administration is essential for nursing students, but the first time can be stressful and shape their clinical development. Previous research primarily focused on student knowledge and technical aspects.

PURPOSE

This phenomenological study helped explore the lived experiences of nursing students and faculty during student's first medication administration in the clinical setting to gain a deeper understanding of their thoughts, feelings, and perspectives.

METHOD

Semi-structured interviews were conducted with female student and faculty informants (N = 12). Using a phenomenological study, data were analyzed using van Manen's hermeneutic six-step research activity method.

RESULTS

Five overarching themes were found: administrating medication, (un)preparedness for complexities in the clinical environment, transformative experience, overcoming fears, and reaping the rewards.

CONCLUSION

First-time medication experiences are greater than an exercise in skill proficiency and may be improved if faculty provides more structured learning experiences and take sufficient time for student preparation in relating medication knowledge to the skill, technology usage, and supporting students' attitudes toward nurse-patient interactions. These are essential aspects of the medication administration learning process as nursing programs shift toward competency-based education. Clinical faculty also need support in their role as educators and to be facilitated to find this time, considering their multiple responsibilities.

Self-directed learning and clinical competence: The mediating role of the clinical learning environment

Introduction

Recognizing the factors affecting clinical competence among internship nursing students is crucial. This study was aimed at determining the effects of self-directed learning on internship nursing students' clinical competence under the mediating role of the clinical learning environment.

Methods

This cross-sectional research was performed on 300 internship nursing students selected by convenience sampling with a structural equation modeling (SEM) approach. Data were collected in one stage with three tools: the Self-Directed Learning Readiness Scale for Nursing Education, Education Environment Measure, and Clinical Competence Questionnaire. Data analysis was performed in SPSS version 21 and Smart-PLS version 3 with partial least squares-SEM. Measurement and structural model data were assessed with a significance threshold of p < 0.05.

Results

A total of 20.5 % of the variance in clinical competence was explained by self-directed and clinical learning environments. Self-directed learning had a significant positive effect on clinical competence (path coefficient = 0.14, 95 % CI: 0.02, 0.26; p = 0.027), and on the clinical learning environment (path coefficient = 0.41, 95 % CI: 0.31, 0.52; p < 0.001). A relationship was observed between the clinical learning environment and clinical competence (path coefficient = 0.38, 95 % CI: 0.25, 0.50; p < 0.001). The indirect effect of self-directed learning on clinical competence was positive and significant (path coefficient = 0.11, 95 % CI: 0.07, 0.17; p < 0.001). Self-directed learning had a significant total effect on clinical competence (path coefficient = 0.30, 95 % CI: 0.19, 0.40; p < 0.001).

Conclusions

According to the results, we recommend that nursing education managers and instructors consider plans to enhance self-directed learning among nursing students and improve the clinical learning environment.

Challenges of nursing students during clinical training: A nursing perspective

Clinical training plays a fundamental role in nursing students' acquisition of professional capabilities. This study aimed to explore the perceived challenges nursing students face during clinical training. An explorative cross-sectional study was applied. A proportionate, stratified, random sample was enrolled in the study with inclusive criteria, including nursing students (2nd - 4th year) and interns who attended their internship in regional hospitals. A validated electronic questionnaire was used for data collection, which consisted of three sections and 29 items. The section that focused on the difficulties experienced by nursing students during their practical training included six elements: teachers, healthcare professionals, the students themselves, tasks, time management, and the location of the training. Another section inquired about the students' perspectives on the benefits of clinical training. A three-point "Likert scale" was applied. The findings indicated that mild (24%), moderate (62%), and severe (14%) degree of challenges were perceived by the study participants. The mean score for the total challenges during clinical training was 2.00 ± 0.28, and there were variations in the perceived challenges among grade levels. In conclusion, there are variations in the perceived challenges during clinical training among different grade levels. These challenges were related to teachers, health workers, the students, tasks, the time, and the place. Enhancing the nursing curricula alignment with practical training objectives is recommended, focusing on the development of technical and interpersonal skills with appropriate guidance, alongside positive clinical settings to help nursing students learn and boost their confidence in their approach.

How do field epidemiologists learn? A protocol for a qualitative inquiry into learning in field epidemiology training programmes

INTRODUCTION

COVID-19 underscored the importance of field epidemiology training programmes (FETPs) as countries struggled with overwhelming demands. Experts are calling for more field epidemiologists with better training. Since 1951, FETPs have been building public health capacities across the globe, yet explorations of learning in these programmes are lacking. This qualitative study will (1) describe approaches to training field epidemiologists in FETP; (2) describe strategies for learning field epidemiology among FETP trainees and (3) explain the principles and practices aligning training approaches with learning strategies in FETP.

METHODS AND ANALYSIS

The research design, implementation and interpretation are collaborative efforts with FETP trainers. Data collection will include interviews with FETP trainers and trainees and participant observations of FETP training and learning events in four FETP in the Western Pacific Region. Data analysis will occur in three phases: (1) we will use the constant comparison method of Charmaz's grounded theory during open coding to identify and prioritise categories and properties in the data; (2) during focused coding, we will use constant comparison and Polkinghorne's analysis of narratives, comparing stories of prioritised categories, to fill out properties of those categories and (3) we will use Polkinghorne's narrative analysis to construct narratives that reflect domains of interest, identifying correspondence among Carr and Kemmis's practices, understandings and situations to explain principles and processes of learning in FETP.

ETHICS AND DISSEMINATION

We have obtained the required ethics approvals to conduct this research at The Australian National University (2021/771) and Taiwan's Ministry of Health and Welfare (112206). Data will not be available publicly, but anonymised findings will be shared with FETP for collaborative interpretation. Ultimately, findings and interpretations will appear in peer-reviewed journals and conferences.

The state of clinical education and factors affecting effective clinical education: the point of view of nursing and midwifery students

BACKGROUND

Clinical education is the basis of education in medical sciences. Clinical education, as the essence of education in nursing and midwifery, promotes social health, improves health care, and reduces mortality. Considering the position of nursing and midwifery, investigating the views of students in this field can be an effective step in improving clinical education. Therefore, the present study was conducted to investigate the status of clinical education and the factors affecting effective clinical education from the point of view of nursing and midwifery students.

METHODS

A descriptive-analytical study was conducted among nursing and midwifery students at Qazvin University of Medical Sciences in 2022-2023. Using available sampling, 242 students were included in the study. Students were included in the study if they completed at least one unit of in-person internship. Refusing to continue the study for any reason and having a practical nurse certificate were the criteria for exclusion from the study. The data collection tools included a demographic information questionnaire, a questionnaire to assess the status of clinical education, and a questionnaire on factors affecting effective clinical education. The data were analysed with descriptive and inferential statistics and SPSS 20 software.

RESULTS

The mean age of the participants in this study was 21.66 ± 2.25. A total of 180 (74.4%) of the participants were women, and the rest were men. The results showed that the general condition of clinical education is at an average level (103.16 ± 19.21). It was also found that the clinical education status of midwifery students was better than that of nursing students, and this difference was significant (p = 0.003). Among the fields of clinical education, the highest score belonging to the field of objectives and planning was reported on the average level (34.39 ± 6.66). Among the factors affecting effective clinical education, the highest score was given to the field of personal characteristics of the student (33.97 ± 5.99). The results showed that there is a significant relationship between the grades of the general state of clinical education with the academic semester (p = 0.001) and interest in the field of study (p < 0.040).

CONCLUSIONS

Based on the findings of the present study, clinical education is at an average level. Among the factors affecting effective clinical training, the field of personal characteristics of the student is more effective in clinical training. Providing educational facilities according to the number of students, using modern teaching methods, and determining and communicating the duties of professors and students can help to improve clinical education.

Exploring the barriers to Registered Nurses undertaking clinical teaching in clinical settings: A qualitative descriptive study

AIM

The study aimed to explore and describe the barriers affecting Registered Nurses in undertaking clinical teaching in clinical settings. The exploration was based on the experiences of Registered Nurses at a selected teaching hospital in Namibia. The researcher intended to identify strategies that could be used to mitigate the negative effects of barriers to effective clinical teaching.

DESIGN

A qualitative explorative, descriptive and contextual research design was used.

METHODS

Purposive sampling was used to select 16 participants. Data were collected through in-depth, semi-structured interviews, which were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.

RESULTS

Clinical teaching is negatively affected by several barriers that hamper clinical teaching and nursing students' learning outcomes. Seven main themes were identified: (1) participants' understanding of clinical teaching; (2) organizational barriers; (3) patient barriers; (4) Registered Nurse barriers; (5) student barriers; (6) training institution barriers; and (7) strategies to mitigate barriers to clinical teaching.

CONCLUSION

The findings revealed that several barriers negatively affect clinical nursing education and hamper the clinical teaching and learning of nursing students.

PATIENT OR PUBLIC CONTRIBUTION

This study may assist in the development of targeted interventions that address the barriers that hinder clinical teaching at teaching hospitals. Additionally, this study could assist in improving the health care that is provided by nursing students to patients. The findings may assist with improved quality by reducing nursing students' theory-practice gap and by promoting collaboration between Registered Nurses and nurse educators in clinical settings.

Nursing students' rights in clinical practice in South Korea: a hybrid concept-analysis study

PURPOSE

This study aimed to derive a conceptual definition and attributes for nursing students' rights in clinical practice in South Korea.

METHODS

This concept-analysis study was conducted at a nursing school in South Korea. The participants were recruited using purposive sampling. The inclusion criteria were being a fourth-year nursing student and having two or more semesters of practical experience. The hybrid model used in this study had three stages. First, 12 studies were reviewed during the theoretical stage. Second, 10 in-depth interviews were conducted during the fieldwork stage. Third, in the analytical stage, the concept of nursing students' rights related to clinical practice was defined and the attributes were derived.

RESULTS

The analysis established five attributes of nursing students' rights: the right to learn, the right to be protected from infections and accidents, the right to be cared for and supported, the right to be respected, and the right to be recognized as a member of a nursing team. A key theme that emerged from this study was having the right to learn in a safe and supportive environment.

CONCLUSION

It is necessary to develop a measurement tool based on the above five attributes and to verify its effectiveness.

Instruments evaluating the quality of the clinical learning environment in nursing education: An updated systematic review

OBJECTIVES

The clinical learning environment offers meaningful learning opportunities for nursing students to apply theoretical knowledge to practice on actual or simulated patients. A previous systematic review assessed the quality of several instruments that evaluated the quality of clinical learning environments. This updated systematic review aimed to identify: any additional instruments that have been researched in the last 5 years, ii) the psychometric properties of available instruments and iii) the estimated comparable psychometric properties of the available instruments.

DATA SOURCES

Medline, CINAHL and Cochrane databases REVIEW METHODS: Databases were searched from January 2016 to January 2023. Studies were included if they: a) validated instruments evaluating the experience and quality of clinical learning environments; b) assessed the pre-licensure nursing student experience; c) were published in English; and d) were published after April 2016. Two independent reviewers conducted title and abstract screening, full text screening, data extraction and methodological quality assessment. Any disagreements were resolved by consensus. A summary of the findings was tabulated using the same format as the initial review.

RESULTS

An additional 18 studies were found, which used seven different clinical learning environment evaluation instruments. Internal consistency and structural validity were the most frequently reported psychometric properties. In almost all studies, methodology for these properties were of sufficient quality according to the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) tool evaluation. Other properties were inconsistently reported, with differing qualities in the methodology. Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) remains the most translated and validated instrument across several countries.

CONCLUSIONS

Instruments developed and validated using a systematic, transparent and high-quality methodology assist in accurately assessing the skills, attitudes and decision-making abilities of the preregistration level nursing student. These tools can be used in clinical placement accreditation and quality improvement of nursing education. The methodology for evaluation of the psychometric properties of instruments should be clearly described.

Clinical Instructors' Perspectives on the Assessment of Clinical Knowledge of Undergraduate Nursing Students: A Descriptive Phenomenological Approach

This study aimed to determine clinical instructors' perceptions of the assessments used to evaluate the clinical knowledge of undergraduate nursing students. This study uses a descriptive phenomenological approach. Purposive sampling was used to recruit sixteen clinical instructors for semi-structured interviews between August and December 2019. All interviews were audio recorded and transcribed verbatim. Data were analyzed using a modified Colaizzi's seven-step method. Four criteria were used to ensure the study's validity: credibility, transferability, dependability, and confirmability. Three themes were identified in the clinical instructors' views on evaluating the clinical performance of student nurses: familiarity with students, patchwork clinical learning, and differing perceptions of the same scoring system. The study results suggest a need for a reliable, valid, and consistent approach to evaluating students' clinical knowledge. If the use of patchwork clinical internships for student nurses is unavoidable, a method for assessing student nurses' clinical performance that requires instructor consensus is necessary.

From disobedience to struggle for adaptation: ​​nursing students' experiences of attending the clinical learning environment during Covid-19 pandemic

BACKGROUND

The Covid-19 pandemic has affected the clinical education of nursing students all over the world. Considering the importance of clinical education and clinical learning environment (CLE) in the education of nursing students, identifying the challenges and problems faced by these students during the covid-19 pandemic helps to plan more effectively in this regard. The aim of this study was to investigate the experiences of nursing students in CLEs during the Covid-19 pandemic.

METHODS

A descriptive qualitative research was conducted, which used a purposive sampling technique to recruit 15 undergraduate nursing students from Shiraz University of Medical Sciences between July 2021 and September 2022. Data were collected through in-depth semi-structured interviews. For data analysis, conventional qualitative content analysis based on Graneheim and Lundman approach was used.

RESULTS

The data analysis led to emergence of two themes of "disobedience " and "struggle for adaptation". The disobedience theme consists of two categories: "objection to attend CLE" and "patient marginalization". The theme of struggle for adaptation includes two categories: "using support sources" and "applying problem-oriented strategies".

CONCLUSION

At the beginning of the pandemic, the students were unfamiliar due to the disease, as well as fear of contracting themselves and infecting others, so they tried not to be in the clinical environment. However, they gradually tried to adapt to the existing conditions by applying support resources and using problem-oriented strategies. Policymakers and educational planners can use the results of this study to plan for solving the challenges of students during future pandemics and improve the condition of CLE.

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

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

Experiences of Student Nurses Regarding Experiential Learning in Specialized Psychiatric Hospitals in South Africa, a Qualitative Study

BACKGROUND

Experiential learning in specialized psychiatric hospitals is as essential as other learning in any discipline in nursing education as it allows student nurses to correlate theory to practice. Experiential learning in the mental health environment has been identified as a significant factor in promoting a more favorable attitude among student nurses toward mental health nursing.

AIM

The study explored student nurses' personal experiences regarding experiential learning in specialized psychiatric hospitals.

METHODS

A qualitative approach using explorative, descriptive, and contextual designs was used, and 51 student nurses were purposively sampled. Data were collected through six focus group interviews and analyzed using a thematic approach. Measures to ensure trustworthiness were also enhanced. Ethical considerations were adhered to throughout the study.

RESULTS

One theme and four sub-themes on the experiences of student nurses regarding experiential learning in specialized psychiatric hospitals were revealed, namely: theme: personal factors; sub-themes: fear of mental healthcare users, anxiety about clinical assessment, lack of interest in psychiatric nursing science, and stress due to social problems.

CONCLUSIONS

Based on the findings, student nurses experience many things during experiential learning, including personal factors. A further qualitative study should be conducted on strategies to support student nurses during experiential learning in the specialized psychiatric hospitals of Limpopo Province.

Experiential Learning for Prelicensure Nursing Students: A Pediatric Special Needs Respite Program

BACKGROUND

A respite program at a southeastern university was developed to provide respite services to local families of children with special needs and to integrate a hands-on clinical experience for nursing students.

METHOD

To assess the nursing students' perceptions of participating in the respite program experience, a survey was administered to prelicensure nursing students.

RESULTS

Analysis of survey data revealed all participants were satisfied with the respite experience, perceived they will be able to apply knowledge obtained, and acknowledged opportunities to enhance soft skills. Survey results can be used to affirm positive student perceptions associated with a respite clinical learning experience.

CONCLUSION

Valuable data describing experiences of undergraduate nursing students who participated in the respite program was obtained. This innovative learning experience meets a community need for children with special needs while providing experiential learning with diverse populations. [J Nurs Educ. 2023;62(3):180-182.].

Developing the SVN CLEI: A Novel Psychometric Instrument for Evaluating the Clinical Learning Environment of Student Veterinary Nurses in the UK

Student veterinary nurses (SVNs) in the United Kingdom can spend over half their training time within the clinical learning environment (CLE) of a training veterinary practice before achieving clinical competency. Sociocultural complexities and poor management within the CLE may have a significant impact on the learning experiences of SVNs, as has been found in studies involving student human nurses. The aim of this research was to develop and validate the SVN CLE Inventory (CLEI) using principal component analysis (PCA), via a cross-sectional design, based on inventories already established in human nursing CLEs. The SVN CLEI was distributed to SVNs via an online survey over a 3-month period, generating 271 responses. PCA resulted in a valid and reliable SVN CLEI with 25 items across three factors with a total variance explained of 61.004% and an overall Cronbach's alpha (α) of .953 (factor 1: clinical supervisor support of learning [α = .935]; factor 2: pedagogical atmosphere of the practice [α = .924]; factor 3: opportunities for engagement [α = .698]). Gaining student feedback is a requirement set out by the Royal College of Veterinary Surgeons Standards Framework for Student Veterinary Nurse Education and Training, and the SVN CLEI can be used to complement the current evaluation of the training veterinary practice CLE. This will facilitate development of a more comparable, consistent, and positive experience for SVNs during clinical training in the UK.

Experiences of first year undergraduate nursing students using Instagram in their clinical practicum during COVID-19 pandemic: A qualitative study

BACKGROUND

Social media provides us with easy access to information. For students, it is an additional learning resource used in different types of theoretical and practical teaching methodologies.

OBJECTIVES

The aim of this paper was to describe the perspective of undergraduate nursing students on the use of Instagram during their clinical practicums in the midst of the COVID-19 pandemic.

DESIGN

A qualitative descriptive and exploratory study based on an interpretative framework.

SETTINGS AND PARTICIPANTS

First-year undergraduate nursing students at the Universidad Europea de Madrid were included.

METHODS

In-depth interviews and researchers' field notes were used to collect the data. Purposive sampling and inductive thematic analysis were applied. During the interviews, themes such as accompaniment during practicums or training opportunities were identified.

RESULTS

The use of Instagram helped students to feel closer to professors, identifying it as an opportunity to remedy the possible lack of connection between theory and practice. Moreover, Instagram helped them build an image of nursing in clinical practicum environments. By using Instagram, undergraduate nursing students were able to better integrate and apply the knowledge acquired at university during their clinical practicums in hospitals.

CONCLUSIONS

Our results can be applied to future studies on the use of social media platforms as teaching tools in clinical practicum settings and to observe the evolution of the image and role of nursing and its relationship with social media.

Psychometric evaluation of the Arabic version of the Perceived Stress Scale in clinical practicum: Validity and reliability in the Moroccan nursing students

BACKGROUND

During clinical practicum, nursing students are subjected to stressors that can affect their well-being, academic performance, and technical skills. The purpose of this study was to evaluate the psychometric properties of the Arabic version of the Perceived Stress Scale of Clinical Practicum (PSS-CP) in a sample of Moroccan nursing students.

MATERIALS AND METHODS

In this study, a translation and back-translation method and comparisons were made with the original version. The study population consisted of 215 nursing students. The construct validity of PSS-CP was measured using exploratory (EFA) and confirmatory factor analysis (CFA). Convergent validity was demonstrated by correlation with the Arabic version of the Depression, Anxiety, and Stress Scale (DASS-21). For reliability, Cronbach's alpha and test-re-test reliability (with a 10-day interval) were used. Data were analyzed using IBM SPSS Statistics V. 23.0 (SPSS) and AMOS V.21.0 (SPSS) software.

RESULTS

The results showed that the PSS-CP is a reliable and valid scale with good internal consistency and test-re-test reliability. In terms of convergent validity, the PSS-CP showed a positive and significant correlation with the DASS-21 scale items. The results of this study led to a two-factor model consisting of 29 items.

CONCLUSION

The PSS-CP is a valid and reliable instrument for assessing clinical stressors among nursing students in Morocco.

In Nightingale's footsteps: A qualitative analysis of the impact of leadership development within the clinical learning environment

AIM

To identify and describe the impact areas of a newly developed leadership development programme focussed on positioning leaders to improve the student experience of the clinical learning environment.

BACKGROUND

There is a need to consider extending traditional ways of developing leaders within the clinical learning in order to accommodate an increased number of students and ensure their learning experience is fulfilling and developmental. The Florence Nightingale Foundation implemented a bespoke leadership development programme within the clinical learning environment. Identifying the areas of impact will help to inform organisational decision making regarding the benefits of encouraging and supporting emerging leaders to undertake this type of programme.

METHOD

For this qualitative descriptive study, eight health care professionals who took part in a bespoke leadership development programme were interviewed individually and then collectively. The Florence Nightingale Foundation fellowship/scholarship programme is examined to determine impact.

RESULTS

Two key themes were described in relation to impact of the programme. These were 'Personal Development' and 'Professional Impact'. The two key themes comprised several subthemes. The notion of time and space to think was subsumed within each theme.

CONCLUSION

Data highlights that the Florence Nightingale Foundation programme had a distinct impact on participants by transforming thinking and increasing self-confidence to enable changes to make improvements both within their organisations and at national level.

IMPLICATIONS FOR NURSING MANAGEMENT

Health care managers must continue to invest in building leadership capacity and capability through programmes that can help position individuals to realize their potential to positively influence health outcomes and wider society.

Exploring facilitators and barriers for successful transition among new Saudi graduate nurses: A qualitative study

AIM

This study aims at exploring Saudi newly graduated nurses' perspectives on the facilitators and barriers for successful transition from being a student to being a nurse.

DESIGN

A phenomenological qualitative methodology was employed.

METHODS

Focus group discussions were carried out among 35 Saudi nurses at one major university hospital in Saudi Arabia.

RESULTS

Under the theme of barriers to transition three main subthemes emerged, namely "Fear of making medical errors," "Intense Workload and Expectations," "Bullying and lack of support," while under the facilitators of transition the subthemes which emerged were "Supportive preceptor," "Training workshops," "Need for transition programs." This research found that formal and informal techniques for strengthening institutional variables and improving individual factors are critical for new graduate nurses' effective transition into professional responsibilities.

Factors influencing the professional identity of nursing interns: a cross-sectional study

BACKGROUND

Improving the professional identity of nursing intern is significant for enhancing the number of new registered nurses and easing the shortage of nursing personnel. The clinical internship is a key period for the formulation of professional identity. However, we know little about the factors influencing the nursing interns' professional identity during clinical internship. Therefore, this study explore the influencing factors of nursing interns' professional identity during clinical internship. This study will provide evidence and suggestions for generating effective strategies contributing to professional identity improvement of nursing interns.

METHODS

This was a cross-sectional study. The convenience sampling was used to recruit 398 nursing interns from a teaching hospital in Hunan, China. The demographic characteristics information was collected by a self-developed questionnaire. The nursing interns' professional identity and potential influencing factors (e.g., work atmosphere, teacher capacity) were measured by questionnaires with good psychometric properties. The appropriate indicators were used for descriptive statistics, and t test, analysis of variance, Pearson's correlation analysis and multiple linear regression were used to analyse the influencing factors.

RESULTS

In this study, the influencing factors of nursing interns' professional identity are education level, first choice of major, residential status, work atmosphere, and teacher capacity. The results showed that: (1) the nursing interns with a higher education level reported a lower level of professional identity; (2) the nursing interns whose first choice of major was not nursing discipline reported a lower level of professional identity; (3) the nursing interns live in rural areas (compared to urban areas) reported a higher level of professional identity; (4) the nursing interns in better work atmosphere reported a higher level of professional identity; (5) the nursing interns under the guidance of the teachers equipped with better teaching capacity reported a higher level of professional identity.

CONCLUSION

The education level, first choice of major and residential status are influence factors of nursing interns' professional identity. The nursing educators need to pay attention to nursing interns whose first choice is not nursing, and in a bachelor program, who may have a lower level of professional identity. It is crucial to enhance the nursing interns' professional identity by improve the work atmosphere and clinical teachers' capacity, to promote nursing interns to choose nursing as a profession and reduce the shortage of nursing workforce.

Nursing students' perceptions on clinical learning environment and mental health: a multicenter study

OBJECTIVE

this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature.

METHOD

data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study.

RESULTS

there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores.

CONCLUSION

the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students' perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study

BACKGROUND

Clinical practice is a core component of nurse education. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, satisfaction, as well as influence their choice of future career. To examine nursing students' perception of clinical learning environment and mentoring in hospital where they perform their clinical placement and the connection of these factor with intention to work as a nurse once graduated.

METHODS

Nursing students enrolled in clinical practice at least 6 months in hospitals in China were surveyed between January-March 2021. Percentages, frequencies, mean, standard deviation, t-test, ANOVA, and regression analysis were used to analyse the data.

RESULTS

Of the five scales in the CLES+T, 'Leadership style of the ward manager' scored the highest mean while 'Pedagogical atmosphere at the ward' scored the lowest. Nursing students with lower educational level, those supervised by fixed preceptor, and those intent to be a nurse in the future were significantly more satisfied with the CLES+T. Most of the nursing students are intent to work as a nurse in the future. CLES+T total scores and sub-dimensions (Premises of nursing on the ward) have significantly effectiveness on the intention to be a nurse in the future.

CONCLUSIONS

Given the significant correlation of between learning environments and nursing students intention to be a nurse in the future, ward managers need to build a good clinical teaching atmosphere and promote opportunities for theoretical and practical connections among students through effective feedback mechanisms, which can enable students to experience a better clinical learning environment and meaningful experiences to build their professional roles and competencies, thus helping to enhance students' willingness to pursue nursing careers in the future.

The Influence of Reducing Clinical Practicum Anxiety on Nursing Professional Employment in Nursing Students with Low Emotional Stability

Nursing students experience anxiety during clinical practicum, which may interfere with their learning in clinical practice and nursing employment after graduation. This study explored: (1) the factors of the difference in anxiety levels between pre- and post-practicum in nursing students; (2) identified their anxiety events in a clinical environment; and (3) the correlation between emotional stability and 5-year nursing professional employment. The study was designed as a mixed method. A longitudinal secondary analysis method and a qualitative approach with open questionnaire were conducted. The emotional stability subscale of Lai’s Personality Inventory and the Beck Anxiety Inventory, as well as open questionnaires were administered. Research data were collected through the purposive sampling of 237 nursing students (mean age was 20.96, SD = 1.29) of 4.2% male and 95.8% female in a central Taiwan hospital in 2013, and the participants were followed up in 2021 to show 70% in clinical service. Most of the nursing students exhibited significantly decreased anxiety levels in the post-practicum period. Compared to nursing students with high emotional stability, those with low emotional stability exhibited higher differences in their anxiety levels between the pre- and post-practicum periods. Low emotional stability is critical in a pre-practicum BAI score. However, the high pre-practicum BAI score would decrease to normal range after enrolling to practicum setting. So, as to their 5-year nursing professional employment after graduation. Teachers foster a positive learning atmosphere that emphasizes the importance of “we are family” to students. Teachers and advisors need to make efforts in leading the low emotional stability nursing students to learn effective coping and adapting strategies in clinical practicum.

Coping with the Experience of Bad Sleep and Fatigue Associated with the Nursing Clinical Practicum

Nursing students experience anxiety during clinical practicum, which may interfere with their learning of clinical practice. This study explored the practicum anxiety symptom experience of clinical nursing students. The methodology was mixed research design consist of questionnaire and a qualitative research design following a grounded theory approach. Research data were gathered via theoretical sampling from 37 female college nursing students practicing in a Central Taiwan hospital and analyzed using the content analysis method. The mean age of the subjects was 20.7 ± 1.35 years old. The practicum-related anxiety symptom experience was made up of core dimensions associated with the nursing clinical practicum, such as bad sleep and fatigue, and covered six themes. Students first encountered anxiety-inducing situations in the clinical setting, and then they began coping through self-adaptation and teachers' help. In cases of coping failure, students began to have a bad sleep in the night and then felt tired and fatigued all day. These themes became a repeating cycle during the clinical practicum. This conceptual model shows that students experienced bad sleep and fatigue as a result of anxiety symptoms during the clinical practicum. Bad sleep and fatigue are critical anxiety symptoms for nursing students in clinical practice. Nursing teachers should pay attention to bad sleep and fatigue in nursing students and help students to improve their mental and physical health.

The first COVID-19 new graduate nurses generation: findings from an Italian cross-sectional study

Background

Nursing education has been disrupted by the onset of the COronaVIrus Disease 19 (COVID-19) pandemic, potentially impacting learning experiences and perceived competencies at the time of graduation. However, the learning experiences of students since the onset of COVID-19, their perceived competences achieved and the employment status one month after graduation, have not been traced to date.

Methods

A cross sectional online survey measured the individual profile, the learning experience in the last academic year and the perceived competences of the first COVID-19 new nursing graduates in two Italian universities. Details relating to employment status and place of employment (Covid-19 versus non-COVID-19 units) one month after graduation were also collected and the data compared with those reported by a similar cohort of new graduates pre-pandemic in 2018–2019. All those who graduated in November 2020 and attended their third year after the onset of the COVID-19 pandemic were eligible. The online survey included individual, nursing programme and first working experience variables alongside the Nurse Competence Scale (NCS). Descriptive and inferential statistical analyses were performed.

Results

A total of 323 new graduates participated. In their last academic year, they experienced a single, long clinical placement in non-COVID-19 units. One month after graduation, 54.5% (n = 176) were working in COVID-19 units, 22.9% (n = 74) in non-COVID-19 units and 22.6 (n = 73) were unemployed. There was no statistical difference among groups regarding individual variables and the competences perceived. Fewer new graduates working in COVID-19 units experienced a transition programme compared to those working in non-COVID-19 units (p = 0.053). At the NCS, the first COVID-19 new graduate generation perceived significantly lower competences than the pre-COVID-19 generation in the ‘Helping role’ factor and a significant higher in ‘Ensuring quality’ and ‘Therapeutic interventions’ factors.

Conclusions

The majority of the first COVID-19 new graduate generation had been employed in COVID-19 units without clinical experience and transition programmes, imposing an ethical debate regarding (a) the role of education in graduating nurses in challenging times with limited clinical placements; and (b) that of nurse managers and directors in ensuring safe transitions for new graduates. Despite the profound clinical placement revision, the first COVID-19 new graduate generation reported competences similar to those of the pre-COVID-19 generation, suggesting that the pandemic may have helped them to optimise the clinical learning process.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-00885-3.

Dignity of Nursing Students in Clinical Learning Environments

As an important professional value, dignity has always been an ethical concern in nursing education and practice. However, the dignity of nursing students in clinical environments has remained a little-discussed topic. This study aims to explore and describe nursing students' dignity in clinical learning environments. This study is a qualitative descriptive work in which data were collected via semi-structured, in-depth, individual interviews and subsequently analyzed according to conventional content analysis. Based on the inclusion criteria of the study, nursing students were selected from different departments of university hospitals in the south of Iran from October 2019 to December 2020 (n = 21). Sampling continued to the point of data saturation. This study has been approved by the institutional review board of the university. Two themes emerged from the data collected in the interviews: trust-based relationships and formation of professional identity. The findings of the study show that nursing students need to be supported by their instructors and perceive that the personnel and patients believe in their ability. In an effectively supportive, trust-based atmosphere, these factors can contribute to maintaining nursing students dignity. Also, showing respect for their personal identity, projecting a positive image of nursing, and giving them authority to perform executive and clinical tasks in hospital departments play a major role in the formation of nursing students' professional identity and development of their dignity. Accordingly, it is recommended that in cultural contexts and clinical learning environments, more attention should be given to nursing students' dignity.

Percepciones de estudiantes de enfermería sobre el Ambiente de Aprendizaje Clínico y la salud mental: estudio multicéntrico

Resumen Objetivo: este estudio tuvo como objetivo evaluar las percepciones de estudiantes de enfermería de universidades públicas de tres países de la Unión Europea sobre la salud mental y los Ambientes de Aprendizaje Clínico, tema poco estudiado en la literatura. Método: la recolección de datos se realizó mediante un formulario de datos demográficos, la Escala de Evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería y el Mental Health Continuum Short Form. Se incluyeron en el estudio un total de 571 participantes de Turquía, Lituania y Portugal. Resultados: hubo una diferencia significativa entre los tres grupos con respecto al Ambiente de Aprendizaje Clínico y al estado de salud mental (p < 0,001). La supervisión fue el elemento más valorado. Los estudiantes portugueses obtuvieron los puntajes promedio más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería (p<0,001). La edad, el sexo y la salud mental influyeron en los puntajes de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. Conclusión: los resultados indicaron que los estudiantes de Enfermería portugueses obtuvieron los puntajes más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. También se reveló que las percepciones de los estudiantes sobre el Ambiente de Aprendizaje Clínico se vieron afectadas por la edad y el género, y que sus percepciones sobre la salud mental fueron influenciadas por los puntajes de la escala de evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería.

Nursing students’ perceptions on clinical learning environment and mental health: a multicenter study

Objective:

this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature.

Method:

data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study.

Results:

there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores.

Conclusion:

the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students’ perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

The experiences of adult nursing students completing a placement during the COVID-19 pandemic

BACKGROUND

The emergency measures implemented by the Nursing and Midwifery Council in response to the COVID-19 pandemic provided nursing students in their final 6 months of study with the opportunity to complete a paid consolidation clinical placement and thus increase their personal responsibility for the care they delivered under supervision.

AIM

To explore the experiences of third-year nursing students who completed their final clinical placement during the COVID-19 pandemic.

METHODS

Semi-structured interviews were conducted via a virtual platform.

FINDINGS

Three themes were identified: the importance of support mechanisms, the development of confidence, and innovative learning opportunities. Students reported improved confidence in the transition period to registered practitioner and felt well supported, which enabled them to take greater responsibility.

CONCLUSION

This study provided insight into the experience of nursing students during the COVID-19 pandemic, and found that support mechanisms, and a sense of belonging, helped to increase their confidence in clinical practice.

Health-Related Quality of Life and Undergraduate Nursing Students: A Narrative Review

Background:

Undergraduate nursing students are vulnerable to stressful university learning environments and poor working conditions in clinical rotations. This can result in students leaving nursing programs or abandoning the profession following graduation. As a result, the health-related quality of life of nursing students is an important indicator to monitor student quality of life adequacy. Preventing premature student nurses' departure from the profession is necessary to reduce the nursing shortage.

Objective:

To describe the body of knowledge about the health-related quality of life for undergraduate nursing students during their qualification process.

Methods:

This was a narrative review through a six-database search, including Cochrane, CINAHL, Pubmed, Medline, PsycINFO and Livivio, from between January 1990 and June 2018, with updates in the search followed until November 2019. To assess study quality, the STROBE checklist was used.

Results:

Eight studies were included in a narrative synthesis. All studies were of cross-sectional design, and none included follow-up procedures. Most of the studies recruited participants from nursing courses and only one study recruited students from a national register. Sample sizes ranged from 110 individuals to 4,033 participants in the register-based study. Common health-related dimensions evaluated included stress, social support, mental health, fatigue, quality of life, and drug abuse. Stress, the most commonly studied dimension, was associated with clinical placements, final exams, and non-prescribed drugs. Social support networks were positively associated with coping abilities and self-esteem.

Conclusion:

There is low-quality evidence of the impact of nursing courses upon student health-related dimensions (stress, self-esteem, health-related behaviors). Nurse educators should be aware of these associations and support routine screening of students and their health-related dimensions. Interventions, such as consultation and study redesign, might increase the level of health-related dimensions. Nursing schools should further collaborate to investigate these associations and tailored interventions to positively affect health-related dimensions in nursing students.

Development and Validation of the Nursing Students' Rights Awareness Scale in Clinical Practice: A Scale Development Study

Nursing students perform clinical training in a variety of clinical practice fields, so their rights are important. Efforts are needed to accurately identify and measure the awareness of nursing students' rights. This study aimed to develop and evaluate the psychometric properties of nursing students' rights awareness scale. The study procedure was carried out in four stages: the concept analysis, item development, scale development, and scale evaluation stage. First, in the concept analysis stage, the attributes of the concept were derived. Second, in the item development stage, preliminary items were derived, and the content validity was verified. Third, in the scale development stage, a preliminary and main survey were conducted, and item reduction was implemented. Fourth, in the scale evaluation stage, construct validity and reliability were verified. The collected data were analyzed using the SPSS 24.0, and item analysis was conducted using skewness, kurtosis, and item-total correlation scores. The construct validity was assessed by exploratory factor analysis, convergent validity, and divergent validity. The reliability was analyzed using Cronbach's alpha coefficient and composite reliability. The final version of the scale was tested on 240 nursing students from three cities in South Korea. From the construct validity, three factors and 14 items were selected. The factors included "the rights to be protected, cared for, supported, and respected" (eight items), "the rights to be recognized as a member of a nursing team" (three items), and "the rights to learn" (three questions). The reliability of the scale was also verified. Through this study, the scale was developed to identify the rights of nursing students in clinical practice. The implication of this study is that it has laid the foundation for measuring the rights of nursing students applicable in clinical settings for the first time. The limitation of this study is that data were collected in some regions. Therefore, it is necessary to verify the validity and reliability of the scale in various cultures.

Supervising students in a complex nursing practice- a focus group study in Norway

Background

The supervisory role of registered nurses and intellectual disability nurses will be even more essential in the future, to support the education of competent newly graduated candidates. To our knowledge few studies have explored nursing student supervisors’ perspectives on supervision across primary- and hospital healthcare services and also across nurse educational programs. The aim of the current study was to investigate supervisors’ perspectives on supervising from different clinical settings, and across registered nurses’ and intellectual disability nurses’ clinical practice.

Methods

The study had an exploratory and descriptive design. The study was conducted within one university college catchment area in Southeastern-Norway. Eight focous group interviews were conducted in primary healthcare (n = 4) and hospital (n = 4) wards. A total of 31 registered nurses and three intellectual disability nurses participated. Hsieh and Shannon’s conventional content analysis was used to analyze the data.

Results

Participants across primary- and hospital healthcare agreed that clinical practice was complex, and required that students gained competence in both technical and non-technical skills. Moreover, needed skills were described both as general and arena specific, and as both basic and advanced. Participants perceived that technical and non-technical skills together, ideally should lead to students being able to «see the person» behind the patient.

Conclusions

Supervisors emphasized the challenges of supervising students in a complex nursing practice. Students should gain both procedural competence and an ability to provide person-centred care, and this challenged the supervisors’ own competence. Our findings indicate a need to support supervisors, to enable them to meet these challenges.

Are intensive care units good places for nursing students' learning compared to other settings? Findings from an Italian national study

OBJECTIVE

To explore students' perceived quality of the intensive care unit learning environment during their rotations; to compare these perceptions with that reported by students attending other settings and to assess correlations between the perceptions regarding the quality of the environment and the competences learned.

RESEARCH METHODOLOGY

A secondary analysis of data collected by a national cross-sectional study carried out in Italy. A total of 9607 nursing students participated; they ranked the intensive care units' quality, as assessed by the Clinical Learning Quality Evaluation Index; the perceived competences learned were also ranked with a Likert scale; from 0 = None to 3 = Very much.

RESULTS

A total of 323 (3.5%) participants attended their rotation in an intensive care unit. They perceived the quality of the environment to be significantly higher (n = 2.11 out of 3) than those rotating in non-intensive care unit wards (n = 1.91; p < 0.001). The competences learned by intensive care unit students were significantly higher than that reported by students attending non-intensive care unit wards (n = 2.31 out of 3 vs 2.06 out of 3; p < 0.001).

CONCLUSION

Intensive care units are highly appreciated by students, both in terms of their quality learning environment and their capacity to promote learning compared to other settings. Therefore, intensive care units should be considered as a place for clinical rotation to promote positive attitudes regarding critical care patients.

Feedback in clinical settings: Nursing students' perceptions at the district hospital in the southern part of Namibia

Background

Feedback was the backbone of educational interventions in clinical settings. However, it was generally misunderstood and demanding to convey out effectively. Nursing students were not confident and did not feel free to practise clinical skills during practical placements because of the nature of the feedback they received whilst in these placements. Moreover, they experienced feedback as a barrier to completing practical workbooks.

Objective

The purpose of this article was to report on a qualitative study, which explored nursing students’ perceptions of the feedback they received in clinical settings, at a district hospital.

Method

This study was conducted at a district hospital located in southern Namibia. An explorative qualitative design with an interpretivist perspective was followed. A total of 11 nursing students from two training institutions were recruited by purposive sampling and were interviewed individually. All interviews were audio recorded with a digital voice recorder followed by verbatim transcriptions, with the participants’ permission. Thereafter, data were analysed manually by qualitative content analysis.

Results

Themes that emerged as findings of this study are feedback is perceived as a teaching and learning process in clinical settings; participants perceived the different nature of feedback in clinical settings; participants perceived personal and interpersonal implications of feedback and there were strategies to improve feedback in clinical settings.

Conclusion

Nursing students appreciated the feedback they received in clinical settings, despite the challenges related to group feedback and the emotional reactions it provoked. Nursing students should be prepared to be more receptive to the feedback conveyed in clinical settings.

Nursing supervisors' perspectives on student preparedness before clinical placements- a focus group study

METHODS

The study was conducted in a county in Southeastern-Norway, with 317.000 inhabitants, and within one hospital and one university college catchment area. Focus group interviews were conducted in the periode August to December 2018. Data were analyzed using Hsieh and Shannon's conventional content analysis.

RESULTS

34 nursing supervisors participated, three intellectual disability nurses and 31 registered nurses, working in four different primary healthcare wards and four different hospital wards. Participants' age ranged from 23 to 58 years, one male only. Through the analysis we derived the category 'Shared responsibility for preparation' with subcategories a) Individual initiative, and b) University college facilitation.

CONCLUSIONS

Findings indicate that there is a gap between nursing supervisors' expectations and reality regarding students' preparedness for clinical placements. Moreover, nursing supervisors did not seem to focus on their own role in student preparedness.

Students' Perspectives on Learning Practical Nursing Skills: A Focus Group Study in Norway

Practical nursing skills are complex and involve technical, theoretical, and practical aspects, caring perspectives adjusted to both patient and circumstances, as well as ethical and moral considerations. Patients' length of stay in hospitals is decreasing, and more advanced patient treatment is conducted in primary healthcare settings. Hence, education and nursing skills need adjustment in line with the rapidly evolving field of practice. Studies emphasize a need to uncover whether the technical aspect of nursing skills, in general, is challenging in students' learning. The aim of this study was to explore students' perspectives on practical nursing skills and how they can best learn these. Three focus group interviews were conducted with registered nurse students and intellectual disability nurse students in their last semester (n = 11). Conventional, inductive content analysis in line with recommendations from Hsieh and Shannon was used to analyze the data. Two main categories with subcategories were identified: (1) the content of practical skills, with subcategories (a) human-to-human relations, (b) organizational competence, and (c) technical mastering and (2) building competence, with subcategories (a) need for supervision, (b) planning the learning situations, and (c) relevance for practice. Students experienced that practical skills did not only include technical aspects but also the ability to establish a relationship to the patient and to organize their working day. Supervising was assumed as essential both when training in the simulation center and in clinical placement, as well as planning of the training, respectively. Students experienced that some skills learned in the university college were less relevant in clinical practice and that certain skills were difficult to perform in practice due to the type of clinical placement. Hence, there is a need to review the approach to and content of practical nursing skills' learning in healthcare undergraduate programs, to prepare students for clinical practice, and to ensure that they build the competence needed in healthcare services.

Experiences of undergraduate nursing students during clinical practice at health facilities in Western Cape, South Africa

BACKGROUND

This study explored the experiences of undergraduate nursing students during clinical practice at healthcare facilities in the Boland Overberg area in Western Cape, South Africa. Few studies have been done on experiences of nursing students during clinical practice. However, there are still inadequacies, which lead to the deterioration of clinical practice quality.

OBJECTIVES

To explore and describe the experiences of undergraduate student nurses during clinical practice in healthcare facilities in Boland Overberg, in Western Cape, South Africa.

METHOD

A qualitative, exploratory descriptive design was applied. Data collection was done using focus-group interviews to ascertain the undergraduate student nurses' experiences during clinical practice in healthcare facilities in the Boland Overberg area in Western Cape Region. Thirty-eight undergraduate nursing students from Boland Campus were selected, using purposive sampling. The sample size was based on data saturation. Colaizzi's method of coding and thematic content analysis was used to interpret the data. Ethical principles were adhered to.

RESULTS

After data analysis, the following themes emerged: clinical learning environment, challenges and inability to reach objectives.

CONCLUSION

During clinical practice in healthcare facilities, students were confronted with dilemmas which must be addressed with proper planning to decrease the challenges in clinical education of future nurses. The findings can be used in planning of nursing education, could provide help to develop effective clinical teaching strategies in nursing education and to support these undergraduate nursing students.

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.

Development and psychometric testing of nursing students' perceptions of clinical stressors scale: an instrument design study

BACKGROUND

In clinical environments, nursing students experience a range of stressors that can affect their health, learning, and quality of patient care. This study aimed to develop a Nursing Students' Perceptions of Clinical Stressors Scale (NSPCSS) and to evaluate its psychometric properties.

METHODS

This exploratory, sequential mixed-method study was conducted in 2 phases. In the qualitative (item generation) phase, NSPCSS items were generated using the data collected from semi-structured interviews and a literature review. In the quantitative (psychometric evaluation) phase, face, content, construct, convergent, and discriminant validity and reliability of the scale were tested. To evaluate construct validity, exploratory and confirmatory factor analyses were performed on the data collected from 430 nursing students. Reliability was also assessed through internal consistency and composite reliability.

RESULTS

In this study, 6 factors were extracted from 30 itemes through exploratory factor analysis: (1) instructor's limited competence in clinical environments, (2) inappropriate clinical environment, (3) inadequate knowledge and skills, (4) inefficient education in clinical planning, (5) instructor's inappropriate conduct, and (6) concerns about the characteristics of nursing career. These factors accounted for 58.8% of the total variance. The results of the confirmatory factor analysis suggested the goodness-of-fit indices was acceptable. Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7.

CONCLUSIONS

The NSPCSS is a valid and reliable instrument for assessing clinical stressors among nursing students.