The extraordinary makes the ordinary visible - nursing students' experiences of their learning in clinical practice during COVID-19: a qualitative study

Effects of the First Wave of the COVID-19 Pandemic on the Work Readiness of Undergraduate Nursing Students in China: A Mixed-Methods Study

Background

Newly graduated nurses with strong work readiness are more likely to smoothly transition from school to clinical settings. However, even before the pandemic, this transition from nursing graduate to clinical nurse was often challenging. Therefore, this study aims to investigate the impact of the initial wave of COVID-19 on the work readiness of nursing students.

Methods

A convergent mixed-method design was employed. For the quantitative study, an online cross-sectional survey was conducted among 500 graduating nursing students from four Chinese public higher education institutions. The questionnaire comprises three parts: socio-demographic information, the Chinese version of the Work Readiness Scale for Graduate Nurse, and a questionnaire on the socio-behavioral impact of COVID-19 on the general population. In the qualitative study, a semi-structured interview was carried out with 8 students who took part in the survey. The results from both parts were integrated using the "Pillar Integration Process".

Results

The study identified six key pillars: "Graduating nursing students possess fundamental knowledge, skills, and a preparedness in terms of attitude and psychology"; "Specialist knowledge and skills and soft skills for transition from nursing students to clinical nurses need to be strengthened"; "The most obvious impact of COVID-19 on nursing students are the adoption of preventive measures and the limitations in study and daily life due to household confinement"; "Growth in both personal and professional awareness"; "Negative effects of fear and anxiety"; and "Negative effects of household confinement".

Conclusion

Graduating nursing students require additional preparation in specialized nursing knowledge, skills, and soft skills to make a successful transition from students to clinical nurses. It is important to acknowledge that the impact of COVID-19 on students' work readiness has both positive and negative aspects. Therefore, whether during the pandemic or post-graduation, these students will benefit from increased support from universities and hospitals.

Effectiveness and experiences of integrating Mindfulness into Peer-assisted Learning (PAL) in clinical education for nursing students: A mixed method study

INTRODUCTION

Nursing students can find clinical learning to be challenging, unpredictable and stressful. To address this problem, this study integrated Mindfulness into Peer-assisted Learning (PAL) for nursing clinical education and investigated the feasibility and effectiveness on improving student participants' emotional reactions, and explored the perception and experience towards the programme.

METHOD

This quasi-experimental, repeated-measure, mixed methods study was conducted in a convenience sample of 126 Year 2 and Year 3 university nursing students. The participants engaged in an online mindfulness peer-assisted learning (PAL) programme that consisted of mindfulness practice, senior students sharing their experiences, and peer-assisted group learning. Emotional status (in terms of depression, anxiety and stress), burnout and self-efficacy were measured at baseline, 8 weeks after programme commencement and immediately after programme completion. Linear mixed-effects models and an intention-to-treat analysis were used to investigate changes in the dependent variables over time. Thirty-nine participants were also invited to engage in semi-structured interviews to explore their learning experiences in the programme.

RESULTS

The programme significantly improved the participants' self-reported self-efficacy (β = 1.44, 95 % confidence interval (CI): 0.58 to 2.30, p = 0.001) and decreased their level of burnout (β = -2.31, 95 % CI: -3.24 to -1.38, p < 0. 001) but did not significantly alleviate their depression, anxiety or stress across time (p > 0.05). Three themes emerged from the qualitative data, namely 1) nurturing self-care capacity through mindfulness; (2) empowering essential skills for clinical placement; (3) maintaining momentum alongside various challenges and enablers.

CONCLUSION

The mindfulness PAL programme may facilitate nursing students' clinical preparedness. Further trials are recommended to investigate its applicability and use in clinical nursing education.

Nursing students' evaluation of clinical learning environment and supervision models before and during the COVID-19 pandemic: a comparative study

BACKGROUND AND AIM

The COVID-19 pandemic has required a rapid reorganization of clinical training and supervision models for nursing education. The aim of this study was to compare students' levels of perception of the quality of the Clinical Learning Environment (CLE) using two different clinical supervision models.

METHODS

A comparative design was implemented. A convenience sample of second and third-year undergraduate nursing students (n=127) in clinical training in the 2018/2019 Academic Year (AY) received the usual nursing staff supervision model, while during the COVID-19 pandemic in the following year, they (n=69) received an individualized supervision model. Data were collected using three instruments: the Clinical Learning Environmental Quality Evaluation Index (CLEQI); the Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T); and a socio-demographic tool.

RESULTS

The mean total scores of both scales had increased in the second survey (CLEQI: M=57.88±11.8 vs. M=60.88±9.3, p=0.035; CLES+T: M=148.4±23.3 vs. M=154.5±21.9, p=0.037). The nursing students reported high levels of CLE quality with both supervision models, even though the individualized supervision model was rated significantly higher by the students than the staff supervision model.

CONCLUSIONS

Students supported by a personal supervisor during clinical training had a more positive experience and rated the quality of the tutorial strategies, learning opportunities, safety and nursing care, leadership style of the ward manager and overall CLE more highly.

Unveiling final-year students and new graduates' concerns, preparedness, and learning experiences during the pandemic in Qatar: A cross-sectional survey

Background

The emergence of COVID-19 interrupted education worldwide and educational institutions were forced to switch to an online learning (E-learning) environment.

Objectives

To explore the perceived educational experiences, worries, and preparedness to enter clinical practice among final-year nursing students and new graduate nurses after studying during the COVID-19 pandemic.

Design

A cross-sectional survey design.

Setting

and participants: An online survey of final-year undergraduate bachelor of nursing students at a single university in Qatar and new graduates across 14 health facilities in Qatar was undertaken between May 2022 and July 2022.

Methods

Participant demographics, experiences of E-learning and perceptions of readiness for practice were collected using validated instruments and open-ended questions. Descriptive statistics and thematic exploration were used to analyze the data.

Results

Fifty-nine final-year students and 23 new graduates with an average age of 23.95 years (SD = 3.89) responded to the survey. Face-to-face clinical placement learning was preferred by 50 % of students and 66.1 % of graduates. During COVID-19, the majority of the participants indicated that strategies like practice kits and online simulations were implemented. While 61 % of new graduates felt well-prepared in their nursing skills, and 87 % felt confident, less than half of the students still in their final year of education felt prepared or confident. Increased stress and a perceived impact on education quality were reported due to changes in learning modalities. Despite these challenges, 81.1 % of students and 95.7 % of graduates felt they had developed sufficient professional values, with most looking forward to becoming registered nurses. The qualitative themes that emerged related to 1) adjusting to online learning, 2) experiencing restrictions in clinical learning skills, 3) feeling less confident and 4) experiencing increased stress.

Conclusions

Despite experiencing emotional and educational challenges, the participants in this study felt that their education prepared them for clinical practice. Innovative strategies and unique educational experiences used by educators enhanced participants' clinical skills and readiness for practice.

Moving forward the Italian nursing education into the post-pandemic era: findings from a national qualitative research study

BACKGROUND

During the CoronaVIrus-19 (COVID-19) pandemic, nursing education has been dramatically transformed and shaped according to the restrictions imposed by national rules. Restoring educational activities as delivered in the pre-pandemic era without making a critical evaluation of the transformations implemented, may sacrifice the extraordinary learning opportunity that this event has offered. The aim of this study was to identify a set of recommendations that can guide the Italian nursing education to move forward in the post-pandemic era.

METHODS

A qualitative descriptive design was undertaken in 2022-2023 and reported here according to the COnsolidated criteria for REporting Qualitative research guidelines. A network was established of nine Italian universities offering a bachelor's degree in nursing for a total of 6135 students. A purposeful sample of 37 Faculty Members, 28 Clinical Nurse Educators and 65 Students/new graduates were involved. A data collection was conducted with a form including open-ended questions concerning which transformations in nursing education had been implemented during the pandemic, which of these should be maintained and valued, and what recommendations should address the transition of nursing education in the post-pandemic era.

RESULTS

Nine main recommendations embodying 18 specific recommendations have emerged, all transversally influenced by the role of the digital transformation, as a complementary and strengthening strategy for face-to-face teaching. The findings also suggest the need to rethink clinical rotations and their supervision models, to refocus the clinical learning aims, to pay attention towards the student community and its social needs, and to define a pandemic educational plan to be ready for unexpected, but possible, future events.

CONCLUSIONS

A multidimensional set of recommendations emerged, shaping a strategic map of action, where the main message is the need to rethink the whole nursing education, where digitalization is embodied. Preparing and moving nursing education forward by following the emerged recommendations may promote common standards of education and create the basis on for how to deal with future pandemic/catastrophic events by making ready and prepared the educational systems.