First-year nursing students' initial contact with the clinical learning environment: impacts on their empathy levels and perceptions of professional identity

Becoming a Nurse: Professional Identity in Prelicensure Nursing Students

BACKGROUND

A correlation exists between professional identity (PI), hope, and job satisfaction that warrants interventional measures to reverse nurse turnover. Developing, nurturing, and improving nurses' PI can positively address nurse turnover.

PURPOSE

The purpose of this study was to examine the intersections between career motivation, PI formation, and belongingness in prelicensure nursing students.

METHODS

As part of a larger mixed-methods study, a quantitative survey was disseminated to students.

RESULTS

Findings suggest significant connections between the depth of perceived PI, motivation to enter the field, and future orientation(s) that are mediated through classroom instruction. PI was shaped by student relationships, confidence, and autonomy.

CONCLUSIONS

Findings underscore the importance of academic intentionality in incorporating PI early in nursing education. Prioritizing quality bedside experiences to develop meaningful relationships while simultaneously increasing confidence and autonomy to assist the nursing student in connecting with their PI is key.

Cultural adaptation and psychometric evaluation of the Persian version of the motivation for nursing student scale (MNSS)

BACKGROUND

Motivation is a critical factor in the success of nursing students, as it significantly influences their ability to acquire the necessary knowledge and skills for the nursing profession. Insufficient motivation can result in a lack of engagement with learning activities, thereby impeding the development of essential competencies.

AIM

This study aimed to translate the Motivation for Nursing Student Scale (MNSS) into Persian and evaluate its psychometric properties within the context of nursing students in Iran.

METHOD

This methodological cross-sectional study involved a sample of 542 nursing students selected through convenience sampling. The MNSS was translated into Persian following the guidelines recommended by the World Health Organization. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of internal consistency were conducted to evaluate the validity and reliability of the instrument.

RESULTS

The EFA and CFA validated the structure of the instrument, identifying four factors and 20 items, which explained 58.68% of the total variance. The CFA results indicated a well-fitting model with the following indices: CFI = 0.91, GFI = 0.93, IFI = 0.946, TLI = 0.92, RMSEA = 0.061, and SRMR = 0.049. The Cronbach's alpha coefficient and Intraclass Correlation Coefficient (ICC) for the scale were 0.882 and 0.802, respectively.

CONCLUSION

The Persian version of the MNSS demonstrates satisfactory reliability and validity, making it a dependable instrument for measuring the academic motivation of nursing students. This tool can be effectively used to assess the motivation of nursing students in Iran.

Adaptation and Validation of the Nursing Attitude Questionnaire in a Spanish Population

BACKGROUND

Nursing, as an essential component of contemporary healthcare systems, has undergone significant changes in recent decades, resulting in an increase in research across various fields, such as mental health, well-being, and the development of the discipline itself. Currently, gender stereotypes persist, impacting the social image of the profession and influencing the professional identity of nurses and consequently, their work performance and the quality of care provided. Both public and internal perceptions of the profession are critical factors in these dynamics.

OBJECTIVE

to adapt and validate the Nursing Attitude Questionnaire in a Spanish sample, as it has only been validated in two languages to date.

METHODS

This study presents descriptive and validity analyses of several measures utilized, such as Nursing Image (NIS), Medical Empathy (JSE-HP), Professional Values (NPVS) and Communication Skills (HP-CSS).

RESULTS

Confirmatory factor model analyses indicated that a 21-item hierarchical model provided a superior fit (χ2(df = 1.65, NFI = 0.954, SRMR = 0.065), suggesting the presence of a general factor accounting for five first-order factors. Internal consistency was deemed adequate for the total measures (α = 0.789), though variable for the subscales. Correlations among measures provided evidence of convergent and discriminant validity, highlighting consistent correlation patterns between Attitude toward Nursing and other variables. In addition, significant differences were observed in the Professionalism subscale according to sex, albeit with a medium-low effect size. Scales are presented to facilitate future interpretation of the results in similar samples.

CONCLUSIONS

The scale validated in this study exhibited overall good psychometric performance, although certain limitations were identified within the subscales. The established scales represent a novel contribution, providing a valuable tool for the comparison of similar samples.

Secondary traumatic stress and vicarious posttraumatic growth in oncology nurses: the mediating role of empathy

Background

The relationship between secondary traumatic stress (STS), empathy, and vicarious post-traumatic growth (VPTG) in oncology nurses is unclear. Understanding these links is crucial for improving nurse well-being and patient care quality.

Objective

This study aimed to investigate the relationships between STS, empathy, and VPTG among oncology nurses.

Methods

This cross-sectional study was conducted in a multicentric setting. Data collection involved oncology nurses completing questionnaires assessing STS, empathy, and VPTG levels. Data analysis included correlation analyses, multiple stepwise regression analysis, and structural equation modeling (SEM) to examine the interrelationships between these variables. The study adhered to the STROBE checklist.

Results

A total of 391 oncology nurses participated in the study. They showed moderate to low levels of VPTG and high levels of STS. STS exhibited a negative association with VPTG, while empathy demonstrated a positive direct association with both VPTG and STS. Moreover, SEM indicated that empathy mediated the relationship between STS and VPTG, with a partial mediating effect of 0.127. Factors such as receiving psychological training, educational attainment, STS, and empathy collectively explained 24% of the variance in VPTG.

Conclusion

Our findings highlighted the negative correlation between STS and VPTG among oncology nurses. Additionally, empathy was found to mediate the relationship between STS and VPTG, suggesting it plays a significant role in influencing VPTG.

Implications for practice

To aid oncology nurses, interventions should focus on reducing STS and enhancing empathy. Strategies like resilience workshops, peer support, and stress management can foster VPTG. Creating a supportive work environment is crucial for nurses' well-being and quality patient care.

Preregistration nursing students' motivation for speaking up for patient safety: An integrated literature review

AIM

The aim of this review was to uncover what motivates preregistration nursing students to speak up for patient safety during work integrated learning (WIL) and to develop an evidence-based safety motivation framework for use by educators, clinicians, and preregistration nursing students.

DESIGN

This study used an integrative literature review design guided by Whittemore and Knafl's methodological framework.

DATA SOURCES

Five research databases, CINAHL, MEDLINE, PubMed, Scopus, and Web of Science, were searched for relevant peer reviewed research literature published in English between January 2011 and January 2024. The use of MeSH terms "undergraduate nursing student," or "preregistration nursing student" and "speaking up," "patient safety," and "motivation," resulted in 489 search returns. Following application of filters and inclusion criteria fifty-four (n = 54) studies were identified as being relevant to the research aim.

REVIEW METHODS

The fifty-four (n = 54) research studies were reviewed using the JBI Critical Appraisal tool relevant to the study methodology. The JBI critical appraisal tools are checklists used to determine research quality, validity, results, and meaning. Following appraisal, 27 studies were included in the integrative literature review.

RESULTS

Authentic learning, view of self as a nurse, and positive work integrated learning experiences were found to be the primary motivators for preregistration nursing students to speak up for patient safety during work integrated learning. These three motivators provided the foundation for an evidence-based framework, underpinned by self-determination theory, that can be used to enhance preregistration nursing students' motivation to speak up for patient safety.

CONCLUSIONS

The integrative review design enabled the development of the evidence-based Safety Motivation Framework to support preregistration nursing students' during work integrated learning however missing from the literature was information about the lived experience of this group of students when speaking up for patient safety.

Meaningful Connections: Exploring the Relationship Between Empathy and Professional Identity Formation

OBJECTIVE

To describe the literature on the connections between empathy and professional identity formation (PIF) in pharmacy and other health professions education. A PRISMA-Scoping Review methodology was used for this study. Searches were conducted in PubMed and CINAHL from 2010 to January 12, 2023, with English added as a limiter. Articles had to address empathy and PIF, whether implicitly or explicitly. "Theory talk" was modified and utilized with 6 levels of connectedness to assess article quality.

FINDINGS

A total of 419 articles were reviewed for inclusion into the study with a total of 45 articles being included. Seventeen (37.8 %) and 12 articles (26.7 %) included a definition for empathy and PIF, respectively. Thirty-eight articles (84.4 %) implicitly discussed a connection between PIF and empathy. Educational initiatives that fostered connections between empathy and PIF focused on classroom activities, clinical rotation activities, and assessments. Key elements to enhance empathy and PIF development across articles focused on mentorship, role models, and reflective practice, alongside intentional curricular integration. Similarly, barriers to empathy and PIF are multifaceted.

SUMMARY

Despite educational initiatives in the literature that attempt to foster connections between empathy and PIF in classroom activities, clinical rotation activities, and assessments, most connections are implicit, as opposed to explicit. This may be due to the multiple barriers, such as the hidden curriculum, which make the connection between empathy and PIF difficult. This area needs further research and development given the importance of empathy in all health care provider interactions.

Lebanese nursing students' perceptions of barriers to the implementation of person-centered care in clinical settings: A qualitative study

AIM

This study aims to investigate how Lebanese nursing students perceive the challenges of implementing person-centered care in clinical settings.

DESIGN

A qualitative descriptive design was adopted for this study.

METHODS

At one of Lebanon's top universities, a qualitative descriptive study design was used with 18 nursing students from various academic levels. Content analysis was used to generate the results after three focus group discussions. The Consolidated Criteria for Reporting Qualitative Research were used to report this study.

RESULTS

The content analysis gave rise to four main themes, namely, "overload", "challenges with education", "unawareness", "establishing connection", and "lack of initiatives related to policy". The results showed a number of obstacles that Lebanese nursing students believed were in the path of providing person-centered care. These obstacles included organisational issues like time restraints and an intense workload, as well as interaction difficulties with patients and healthcare teams, and educational issues like insufficient instruction in person-centered care concepts during nursing programs.

Aesthetic Expression as a Means to Nurture "Self" in a Basic Nursing Care Practicum

ABSTRACT

Nursing students develop their professional "self" through clinical placement experiences. Aesthetic expression can be used as a means to reflect students' personal knowing and to convey self as nurtured during their clinical journey. In a postconference session of the Basic Nursing Care Practicum course, six students were asked to draw pictures reflecting their clinical experience and then share their stories. It appeared that nursing students learned the meaning of nursing and caring, and through these meanings, their actual self as nurses was also developed.

Obesity bias in diagnostic radiography students: A survey of attitudes, perceptions and technical confidence

INTRODUCTION

Obesity bias exists in healthcare professionals and students from numerous disciplines and negatively impacts the quality of care, outcomes, engagement, and satisfaction of their patients. With obesity rates continuing to rise in the United Kingdom (UK), more patients will be affected than ever, and it is becoming an increasingly important issue to tackle. This study aims to assess the attitudes to obesity of student diagnostic radiographers and determine if obesity bias exists in this population.

METHOD

Student radiographers (n = 140) at a single university in the UK were invited to complete an online survey comprising measures designed to assess levels of bias and attitudes towards obesity, including the Attitude Towards Obese Persons (ATOP) scale. Likert-type scales were used to collect quantitative data, and data analysis included descriptive statistics, frequencies, and Spearman's rank correlation coefficient.

RESULTS

Responses were received from n = 38 students. The mean ATOP score for participants was 70.37 (SD = 19.26). With 26 % (n = 10) scoring below 60, demonstrating strong negative attitudes towards obese individuals. Additionally, students (76.3 %; n = 29) indicated that they observed high levels of obesity bias whilst on clinical placement. There was a statistically significant correlation between levels of weight bias and students' confidence in working with obese patients (r(36) = 0.4, p 0.01). Students who are less confident working with obese patients had higher levels of obesity bias.

CONCLUSIONS

Obesity bias exists in radiography students at levels comparable to those that have been found previously in other healthcare professionals and students. Furthermore, radiography students lacked confidence in their technical ability to work with obese patients and lower confidence levels were associated with higher levels of obesity bias.

IMPLICATIONS FOR PRACTICE

The findings of this study provide preliminary knowledge upon which future research can be built.

Psychometric evaluation of the Chinese version of motivation for nursing student scale (MNSS): A quantitative and cross-sectional design

BACKGROUND

Academic motivation is the psychological factor that promotes learning activities. The persistence of learning activities in nursing education is directly influenced by academic motivation. However, there are currently no specialist instruments for nursing students in China.

OBJECTIVE

To translate the Motivation for nursing student scale (MNSS) into Chinese and evaluate its validity and reliability among nursing students in China.

DESIGN

A quantitative and cross-sectional design.

SETTING

The survey was conducted at a medical university in Jinzhou, China between March and May 2022.

PARTICIPANTS

A total of 688 Chinese nursing students were surveyed by questionnaire in this study.

METHOD

The Chinese version of MNSS adopted Brislin's transition model and conducted expert consultations to validate the facial validity and testing of the transition version. Reliability and validity were tested using exploratory factor analysis, confirmatory factor analysis, and internal consistency reliability.

RESULTS

Nursing experts confirm the high content validity of the Chinese version of the 20-item scale. An exploratory factorial analysis revealed a four-factor solution, with a total variance of 64.1% and confirmatory factor analysis results showed a satisfactory fit (χ2/df=2.738, RMSEA =0.073, SRMR = 0.0719, CFI = 0.914, IFI = 0.915, NFI =0.872, RFI =0.849,). Cronbach's alpha coefficient for the scale was 0.869, and the split-half reliability is 0.727.

CONCLUSION

The Chinese version of MNSS has satisfactory reliability and validity and is a reliable instrument to assess the academic motivation of Chinese nursing students.

Comparing Preferred and Actual Clinical Learning Environments and Perceptions of First-Year Nursing Students in Long-Term Care: A Cross-Sectional Study

The clinical learning environment, which includes the culture of clinical units, the mentoring process, and the different health organizations, influences the learning process of nursing students. However, scarce literature has been published on the impact of the clinical learning environment on first-year nursing students in long-term care. We aimed to assess first-year nursing students 'preferred' and 'actual' clinical learning environments when conducting their first placements in nursing homes within an innovative placement model that comprised the active participation of academic mentors. The validated Spanish version of the Clinical Learning Environment Inventory (CLEI) instrument was used in our study, and 99 first-year nursing students participated. The highest mean scores for the CLEI-Actual were found for the Satisfaction (22.7) and Involvement scales (19.09). The lowest mean scores were found for the Personalization (17) and Individualization (17.27) scales. The multiple correlation (R) between the Satisfaction and the other CLEI scales was 0.61 (p > 0.001), which means that in this study the association between student satisfaction and their perception of the clinical learning environment was strong. First-year students conducting their first clinical placements in nursing homes can have a positive learning experience considering a well-designed and organized pedagogical strategy, including constant support and feedback from academic and clinical mentors.