Developmental trajectories of professional preparedness among senior nursing students during clinical placement: A longitudinal study

BACKGROUND

Newly graduated nurses' lack of professional competence is associated with inadequate preparation during their clinical placement as nursing students. Clinical placement is a critical stage in the development of nursing students' professional preparedness. However, research on the trajectory of nursing students' professional preparedness during clinical placement has not yielded findings with the same specificity.

OBJECTIVES

The aim of this study is to estimate differences in professional preparedness levels at different clinical placement stages, to identify distinct patterns of professional preparedness trajectories during clinical placement, and to evaluate predictors of these trajectory group memberships.

DESIGN

A quantitative longitudinal study.

SETTINGS

Participants were recruited on a voluntary basis using convenience sampling at a tertiary hospital in Nanning, China.

PARTICIPANTS

224 senior nursing students were initially invited to participate in the study. A total of 178 nursing students successfully completed the follow-up assessments at baseline, as well as at 1 month, 4 months, and 8 months into their clinical placement.

METHODS

Participants completed four online surveys, during which their professional preparedness level was measured using the Perceived Professional Preparedness questionnaire for senior nursing students. Professional preparedness scores at different time points were compared using one-way repeated measures ANOVA and latent growth model. Group-based trajectory model was applied to identify professional preparedness trajectories. Multiple logistic regression was adopted to determine the predictors of trajectory group memberships.

RESULTS

The entire sample of Senior nursing students experienced a significant increase in professional preparedness during clinical placement. The best-fitting group-based trajectory model delineated three distinct trajectories: low-slowly increase trajectory (27.53 % of sample), moderate-rapidly increase trajectory (47.19 % of sample) and a high-stably increase trajectory (25.28 % of sample). Male, good and excellent academic performance, and very high degree of professional interest are the predictors of the moderate-rapidly increase trajectory. While male, good and excellent academic performance, high and very high degree of professional interest and participating in medical-related part-time employment are the predictors of the high-stable increase trajectory.

CONCLUSIONS

Senior nursing students exhibit different levels of professional preparedness throughout their clinical placement. Simultaneously, three different trajectories were identified among the sample of nursing students. Therefore, in future research, greater attention should be directed towards the professional preparedness levels of nursing students with different trajectories, and early identification and targeted interventions should be prioritized.

Male nursing students' experiences of their clinical internships: A qualitative study

Background

Nursing has traditionally been a predominantly female profession; however, there has been a gradual increase in the proportion of male nursing students in recent years. Male nursing students may encounter distinct challenges within clinical settings, potentially impacting their physical and mental well-being.

Aim

This study aims to explore the clinical internship experiences of male nursing students and provide them with adequate support for their successful adaptation to clinical roles.

Methods

This study used a descriptive design and qualitative approach. The participants were enrolled using a convenience sampling method. Data were collected using individual face-to-face semi-structured interviews.

Results

Male nursing students' experiences of their clinical internships were described through the following themes: (1) dynamics of working as a nurse, (2) not just a male nursing student, (3) gender-based stereotypes, (4) balance between forte and failing, (5) difficulties and challenges when working in hospitals, and (6) lessons learned and knowledge needs.

Conclusions

Our research findings have significantly enhanced our comprehension of male nursing students' experiences and offered valuable recommendations for both nursing education and clinical practice. Simultaneously, these results provide essential information support for nursing educators and hospital administrators.

Male Students' Perceptions of the Nursing Profession: A Qualitative Study

Introduction

This study aims to explore the thought, feelings and perceptions of male nursing students and male nursing professionals in the nursing profession.

Methods

This present study used a qualitative research design to explore the feelings, thoughts, and opinions of male nursing students (first to fourth years) and male nursing professionals about their perception of the nursing profession. The study recruited 11 male nursing students and 11 male nursing professionals using a purposive sampling method. Data were collected via semi-structured individual interviews using qualitative open-ended inquiries consisting of seven questions. The data were analysed using thematic perspectives.

Results

The analysis revealed three themes: (a) perceiving gender varieties, (b) taking apparent advantage of masculine characteristics, and (c) taking an equal perspective. Male students' replies to their professional gender attitudes were that there was no distinct line among the gender-related advantages and disadvantages according to whether they were first to fourth-year students.

Conclusion

Male nursing students and professionals believe that nursing is equally appropriate for both men and women, and they could employ masculine characteristics to thrive in their professional development.

Interviewer bias when using multiple mini-interviews in selecting student nurses in a Chinese setting

BACKGROUND

Interviewer effects may cause unfairness in assessments in multiple mini-interviews (MMIs). Due to cultural differences, the bias factors of interviewers may vary between the East and the West. MMIs are a relatively new type of assessment setting in China and few studies have been conducted to examine the interviewer effects of MMIs in this context.

OBJECTIVES

We adopted a multi-faceted Rasch measurement (MFRM) to measure interviewer effects in assessments in Hong Kong.

METHODS

Data were collected from a nursing school in Hong Kong. There were 431 candidates and 12 interviewers engaged in a six-station MMI setting. The scores collected from the interviews were analyzed in terms of 1) interviewer stringency/leniency, 2) candidate gender, 3) interview time, and 4) rating category in the station. The Student's t-statistic values were calculated to investigate the marking tendencies of individual interviewers.

RESULTS

The research findings suggest that interviewers differ in their degree of stringency/leniency, but the number of candidates examined by each interviewer does not affect interviewer stringency/leniency in terms of the interviewer's assessment. There is not sufficient evidence indicating that candidate gender and interview time are bias factors affecting assessment score in this study. Among the six rating categories examined, honesty/integrity is the most stringent category, while self-awareness is the most lenient category. Interview bias from individuals was identified. When we consider the interview scores given by individual interviewers, it is evident that some interviewers may have been biased toward a certain gender or rating categories.

CONCLUSIONS

MMIs are useful when selecting student nurses in a Chinese setting. However, interviewer bias may exist. We used an MFRM to better understand interviewer bias across various dimensions. The present study contributes to the development and use of MMIs in non-Western countries and can be used as a reference to extend this research to other locations.

Male Student Challenges in a Maternity Nursing Clinical Course in a Middle Eastern Country: Strategies for Improved Performance and Future Implications for Nursing Education and Practice

Introduction

As the number of males, entering nursing and midwifery increase in number, challenges faced by these males during training sessions also is on rise. Since these challenges vary from culture to culture, it is essential to understand the experiences and challenges of male nursing students during their nursing education.

Aim

To explore the challenges faced by male nursing students in learning maternal health nursing and the remedial strategies to improve their performance as identified by the students.

Design

A descriptive qualitative research design using focus group discussion method was used.

Methods

Twenty-two (22) undergraduate male nursing students enrolled in the Maternal Health Nursing Course during the Academic Years 2017 and 2018 were purposively selected to participate in the study through five (5) focus groups each comprising between four to six students.

Results

Three themes emerged from the study: (a) cultural constraints in the clinical learning process; (b) traditional gender-biased role expectations, and (c) alternative teaching strategies. In terms of “ cultural constraints,” the students felt the Arabic culture was the main barrier in direct patient care in midwifery practice. In relation to “ gender-biased role expectations,” the students reported that they felt “ not accepted and isolated” in midwifery clinical areas. Thirdly, the “ alternative teaching strategies” relate to the student's remedy to the cultural constraints and the gender bias faced that undermined their learning and overall performance in maternity nursing course . These alternative ways of learning included, “ increased involvement of nurses and midwives in teaching learning”; “ cultivating positive relationship between the clinical instructor and students,” and the “ use of high fidelity simulation to learn skills in midwifery education.”

Conclusion

The study findings revealed that male student nurses face significant challenges in maternity nursing course.

Perspective and Experience of Male Nursing Students in 3-year Vocational College During Their Clinical Practicum: A Qualitative Study in Shanghai, China

Background

With the expansion of nursing enrollment, more and more male students are joining the nursing program. Nevertheless, the number of male nurses who actually stay in clinical work in China continues to be low. Clinical practicum is a critical period during which nursing students transform to the role of registered nurses. However, few studies have researched the perspective and experience during clinical practicum among male nursing students in 3-year vocational colleges in China.

Objectives

To explore the perspective and experience of Chinese male nursing students during clinical practicum in the third year. One of the main objectives is to provide implications for future nursing education and to help male nursing students for better adaptation to clinical roles.

Methods

The qualitative study used a purposive sampling method and collected data through in-depth, semi-structured interviews. The participants were 20 male students from a 3-year vocational college in Shanghai. They completed the basic nursing course in college and underwent a clinical practicum in the 3rd level hospitals in China between July 2020 and March 2021. A Seven-stage Colaizzi process was used for data analysis.

Results

Three themes were revealed through content analysis: opportunities and challenges brought by gender factors in hospital humanistic environment, gaining experience and growth during clinical practicum, and future career planning.

Conclusions

The presented findings further our understanding of the perspective and experience of male nursing students during clinical practicum. It is very important and necessary for providing implications for future nursing education. At the same time, effective support from society, such as social unions, mass media, government, can help better address male nursing students' needs and complete the role transform of registered nurses.

"I am called girl, but that doesn't matter" -perspectives of male nurses regarding gender-related advantages and disadvantages in professional development

Background

Exploration of professional development experiences of male nurses can help develop evidence-based strategies to attract males into nursing. The study aims to investigate the advantages and disadvantages of being a male in nursing profession that male nurses and male nursing students experience in their professional development.

Methods

A descriptive qualitative research was designed. Purposive sampling was applied and 24 males (12 nursing students and 12 clinical nurses) participated. Semi-structured individual interviews were used in data collection. Thematic analysis was used in data analysis.

Results

Professional development of male nurses was related to three interplayed identities: a man, a nurse, and a minority. Three themes emerged relating to the professional development of the males: “feeling role strains” “taking perceived advantage of masculine traits” and “taking an egalitarian viewpoint”. There was no clear line between the gender-related advantages and disadvantages as factors influencing professional development can be turned by the males from barriers to facilitators.

Conclusions

Male nurses perceive nursing as equally suitable for males and females and make use of masculine traits to thrive in their professional development.

An exploration of the influences on under-representation of male pre-registration nursing students

BACKGROUND

Worldwide, men are under-represented in the nursing profession. In Scotland less than 10% of pre-registration nursing students are male. Reasons for this imbalance need to be understood.

OBJECTIVES

To explore the views of male pre-registration nursing students, nursing lecturers and school teachers about this imbalance.

DESIGN

Mixed methods study using focus groups and online survey.

SETTINGS

Focus groups in four locations across Scotland. Online survey sent to teachers across Scotland.

PARTICIPANTS AND METHODS

Eight focus groups with 33 male nursing students; four focus groups with 21 university and college nursing lecturers; 46 school teachers returned the online survey.

RESULTS

Although nursing was considered a worthwhile career with job stability and many opportunities, it was also viewed as not being a career for men. Assumptions about the profession and femininity were challenging for men and use of the term 'male nurse' was felt to be anomalous. In some circumstances the provision of intimate care to particular patient groups caused difficulty. Positive encouragement from others, a positive role model or knowledge of nursing from significant others could be helpful. However concerns about low earning potential and negative media publicity about the NHS could be a disincentive. Being mature and having resilience were important to cope with being a male nursing student in a mainly female workplace. Some more 'technical' specialties were felt to be more attractive to men.

CONCLUSIONS

Nursing is viewed as a worthwhile career choice for men, but the gendered assumptions about the feminine nature of nursing can be a deterrent.

Knowledge and Attitudes Towards Obesity and Bariatric Surgery in Chinese Nurses

Background

Obesity has become a global epidemic. Surgical treatment of obesity and metabolic disorders in China is increasing rapidly, but it is still a new discipline even to health professionals. As an important member of the multidisciplinary team, the knowledge and attitudes of nurses provide crucial health care to the patients and support to surgeons.

Objectives

To study the Chinese nurses’ knowledge of obesity and metabolic disorders, and attitudes towards bariatric surgery and to improve their capability of work in this new discipline.

Methods

This is a multicenter study, with the questionnaire distributed to cooperative hospitals in the form of an electronic questionnaire by the First Affiliated Hospital of Jinan University in April 2018. A questionnaire was designed to investigate nurses’ demographic, knowledge, and attitude towards obesity, weight loss, and bariatric surgery.

Results

A total of 5311 questionnaires were received, with an effective rate of 91.8% (4878 questionnaires); 65.2% of nurses had a normal BMI. Nurses generally had a high knowledge of obesity and related cardiovascular diseases (98.6%) and type 2 diabetes mellitus (90.2%). However, there was a lack of knowledge in other related aspects, for example its relations to carcinoma (49.5%), gastroesophageal reflux disease (40.1%), and psychological disorders (49.1%), which are controversial issues in bariatric surgery. It was found that education (p < 0.05) had an important influence to nurses’ knowledge about the comorbidities of obesity. Female nurses had a higher tendency to choose weight loss than males, but male nurses did physical exercise more frequently than females (p < 0.05). Their acceptance of safety (25.1%) and efficacy (22.9%) of bariatric surgery is low, with concerns predominantly about postoperative complications and adverse effects. Surgical nurses had a more optimistic attitude towards surgery (p < 0.05).

Conclusions

Chinese nurses have poor knowledge of obesity-related metabolic disorders and also have poor acceptance of surgical treatment modalities. Our findings suggest that it is crucial to enhance the continuing education of Chinese nurses for obesity, metabolic disorders, and bariatric surgery.

A Mixed Methods Review of Male Nursing Students' Challenges during Nursing Education and Strategies to Tackle these Challenges

BACKGROUND

Calls to action have been placed for recruitment of more men to address nursing shortage and to achieve a better balance and diversity in workforce. Studies also indicated patients' demand for male nurses. Despite this, male nursing students experience challenges during their education resulting in their attrition. No reviews have explored this research area. This review explored the challenges of male nursing students during their education and identified strategies used to tackle these challenges.

METHODS

Literature was searched within three databases using indexed search phrases and 1 mixed-methods, six quantitative, and 36 qualitative studies (n = 43), published from December 1990 to May 2018, were reviewed. The qualitative and quantitative data were separately extracted and analyzed using thematic synthesis and narrative summaries, and then compared using joint displays.

FINDINGS

"Call me a nurse" and "Male nurses understand us better: Need more men in nursing" were the prominent themes. An array of educational and clinical challenges was identified. Students used appraisal-focused, problem-focused, and social support strategies to tackle these challenges.

CONCLUSION

Considering the identified challenges, the lack of support and efforts from educators and institutions, we reiterate calls to action for strategic policies to help male nursing students adapt to educational and clinical learning environments and to increase their recruitment and retention in nursing.

Is research on professional identity formation biased? Early insights from a scoping review and metasynthesis

OBJECTIVE

Despite a recent surge in literature identifying professional identity formation (PIF) as a key process in physician development, the empiric study of PIF in medicine remains in its infancy. To gain insight about PIF, the authors examined the medical literature and that of two other helping professions.

METHODS

The authors conducted a scoping review and qualitative metasynthesis of PIF in medicine, nursing and counselling/psychology. For the scoping review, four databases were searched using a combination of keywords to identify empiric studies on PIF in trainees. After a two-step screening process, thematic analysis was used to conduct the metasynthesis on screened articles.

RESULTS

A total of 7451 titles and abstracts were screened; 92 studies were included in the scoping review. Saturation was reached in the qualitative metasynthesis after reviewing 29 articles.

CONCLUSION

The metasynthesis revealed three inter-related PIF themes across the helping professions: the importance of clinical experience, the role of trainees' expectations of what a helping professional is or should be, and the impact of broader professional culture and systems on PIF. Upon reflection, most striking was that only 10 of the 92 articles examined trainee's sociocultural data, such as race, ethnicity, gender, sexual orientation, age and socio-economic status, in a robust way and included them in their analysis and interpretation. This raises the question of whether conceptions of PIF suffer from sociocultural bias, thereby disadvantaging trainees from diverse populations and preserving the status quo of an historically white, male medical culture.

Subjectivity about Turnover Intention among Male Nurses in South Korea: A Q-Methodological Study

PURPOSE

Around the world, male nurses face a variety of difficulties within clinical settings; accordingly, a large number of male nurses consider changing their occupation. In particular, male nurses in a number of Asian countries with a Confucian heritage experience difficulties. Thus, the purpose of this study was to explore individual differences in turnover intention among male nurses in one such country, South Korea, and on that basis to suggest concrete strategies for reducing turnover among male nurses in Confucian cultures.

METHODS

Q methodology, which is used to analyze human subjectivity, was applied. Q statements were derived from 207 candidate statements gathered from various documents and interviews; 40 statements were finalized. A purposive sample of 41 male nurses were selected as likely to have diverse opinions on turnover intention of male nurses. The collected data were analyzed using PQMethod software.

RESULTS

Four distinct types of subjectivity about turnover intention among male nurses were identified: (1) "Pursuing occupational values," (2) "Dissatisfaction with treatment," (3) "Seeking a relaxed and stable life," and (4) "Conflict related to organizational culture."

CONCLUSIONS

This study suggests various ways of reducing turnover and increasing retention among male nurses based on the four identified perspectives, especially in Confucian-heritage regions.

How clinical nurses in South Korea perceive the status of the nursing profession: A Q-methodological approach

Professional self-image among nurses is shaped by subjective perceptions, feelings, and tacit views. A perceived positive status reflects and influences the nurse's self-esteem, professional empowerment, and nursing performance. The aim of this study was to examine the perceived status of the nursing profession among clinical nurses in South Korea. Q-methodology was used with data collected from September to December 2014. Forty-four Q statements were selected and scored by the 31 participants on a 9-point scale with normal distribution. The data were analyzed using the pc-QUANL program. Thirty-one nurses were classified into 3 factors based on the following viewpoints: as professional (I am proud of my nursing job), subprofessional (I am not proud of my nursing job), and developmental (advocating for change and improvement). The major finding of this study included clinical nurses' subjective perception toward the status of nursing profession. The results indicated that to raise the status of nursing profession, nurses need to understand the value of nursing and their contribution to patients and public.