Jordanian Nursing Student and Instructor Perceptions of the Clinical Learning Environment

Nursing students' perceptions of the qualities of clinical instructors in a public university in Jordan: A qualitative study

Background

Nursing clinical education is a key to developing nursing students' knowledge, skills, and competencies. Few studies have attempted to explore students' perceptions regarding the qualities of effective clinical instructors.

Objective

The current study aims to explore nursing students' perceptions of effective clinical instructors' qualities in Jordan.

Methods

A qualitative exploratory approach was used to deepen our understanding of nursing students' perceptions of effective clinical instructors' qualities. A total of 21 nursing students were involved, and data were collected from June to August 2023. Data were analyzed using the thematic analysis approach.

Results

The thematic analysis revealed two main themes. The first theme was professional qualities, comprising four subthemes: professional knowledge and experience, acting as a role model, performing as a caring one, and assembling effective communication. The second theme was building a good rapport. The findings demonstrated that clinical instructor qualities impacted how students perceived their teaching effectiveness, and they identified professional knowledge and competence as crucial qualities of an effective clinical instructor. It was acknowledged that caring behaviors and effective communication skills were essential behavioral attributes for clinical instructors.

Conclusion

Nursing students have valued particular characteristics of effective clinical instructors. These characteristics were knowledge, caring, relationships, role models, and communication. Further research is needed to validate the study's findings.

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.

A concept analysis on the transfer climate in health sciences education

The transfer of learning is complex, with factors such as transfer climate influencing students' transfer of learning. This transfer climate will shape a student's experiences during work-integrated learning and can be modified to enhance the transfer of learning. However, studies on transfer climate are mainly reported from a human resource development context and the outcomes may not be transferable to health sciences education. Furthermore, there is no uniformity in defining and measuring transfer climate. Rodgers' evolutionary concept analysis approach was used to describe the antecedents, attributes, and consequences of a positive transfer climate. An information specialist assisted in developing a Boolean search string and searched 15 databases to identify relevant sources. In total, 156 relevant articles were selected from 1448 sources. Data were charted and thematically analyzed. Antecedents comprise interpersonal relationships and theory-practice correlation. The presence of student support, training programs, student characteristics, clinical facilitator characteristics and a well-resourced clinical environment are the attributes of a positive transfer climate and act as learning transfer mediators. Transfer climate consequently influences student, educational, and organizational performance. A conceptual definition for transfer climate was then proposed. It was subsequently concluded that developing competent healthcare professionals and providing support to students depend on the synergy and good working relationship between health services and educational institutions. The insights into modifiable elements to enhance transfer climate could benefit health sciences educators in reconsidering their clinical training models to ensure sufficient support during students' clinical placements to meet the demands for a better-qualified healthcare workforce.

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

Introduction

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

Methods

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

Results

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

Conclusion

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

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.

Challenges faced by student nurses and midwives in clinical learning environment - A systematic review and meta-synthesis

OBJECTIVES

This systematic review aimed to offer insight and understanding, through synthesis of findings from studies that report on perspectives of student nurses/midwives, clinical instructors, clinical nurses/midwives on the challenges faced by student nurses/midwives in the clinical learning environment (CLE).

DESIGN

All primary qualitative research studies published in the English language that reported on the views of student nurses/midwives, clinical instructors and clinical nurses/midwives on the challenges faced by student nurses/midwives in the CLE were included.

DATA SOURCES

The electronic databases of Medline EBSCO (1946-), CINAHL (1970), Embase Ovid (1974-), ScielO, WHOLIS (2002-), ASSIA (1985-), Web of Science (1956-), PsycINFO (1800s-) and Maternal and Infant Care (1970-) were searched in November 2019.

REVIEW METHODS

Retrieved papers were reviewed independently by two authors for selection by title, abstract and full text, and two authors agreed for inclusion of the papers. The COREQ criteria checklist was used for assessment of methodological quality of the included studies.

RESULTS

The review included 32 studies published over 22 years between 1997 and 2019 involving 853 nursing/midwifery students, clinical instructors, and clinical nurses/midwives from 14 countries. Three key themes emerged: 'The support structure', 'Personal factors', and 'Planning and organisation - influence of extrinsic factors'.

CONCLUSION

Attitude of clinical staff, instructors, and significant others had a major influence on students' clinical learning. Lack of a sense of belongingness and self-motivation to learn, and perceived fear of doing errors were some of the demotivating factors. Lack of resources to facilitate need-based training, staff shortages, workload and inconsistencies between theory and practice were other key challenges in the CLE. Understanding the challenges faced by students in clinical practice can help overcome the barriers leading to development of competent and confident nurses and midwives.

Protocol for a mixed-method systematic review on challenges perceived by final-year undergraduate nursing students in a clinical learning environment

Aims

To determine the challenges perceived by final‐year nursing students in the clinical learning environment.

Design

Data‐based convergent mixed‐method systematic review.

Methods

Three electronic databases (Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature) will be used in the identification stage. The first search will use the search string for each database to identify relevant studies. The articles retrieved will be screened by year of publication, article type and language. Abstracts and full‐text of selected studies will be screened for eligibility independently by a minimum of two reviewers. The reference lists will be manually screened to identify additional publications. The quality assessment will be conducted by two reviewers using the Mixed Methods Appraisal Tools. Quantitative and mixed‐method studies will be transformed into qualitative. A thematic approach will be used to synthesize and report the data. Ethics approval and funding have been approved in April 2020.

Discussion

This study will synthesize the types of challenges perceived by final‐year undergraduate nursing students in different clinical learning environments across the country.

Impact

The proposed study findings will help nursing education stakeholders and faculty provide assistance to final‐year nursing students in their transition year to become registered nurses.

Palestinian Refugee Youth in Jordan: Parental Practices, Neighborhood Cohesion and Assistance, and Adolescent Wellbeing

In this study, a total of 335 Palestinian refugees (M = 15.5 years, SD = 1.05, 49% males), recruited from four United Nations Relief and Work Agency (UNRWA) schools at the Al-Baqa'a and Jabal Al-Hussein refugee camps in Jordan, rated their neighborhood physical environment and neighborhood support and cohesion, separately rated their mothers' and fathers' parenting on several dimensions, and reported on their adjustment to these circumstances (internalizing symptoms, self-concept clarity, and norm breaking). Living in more dangerous physical environments was associated with higher levels of refugee youths' internalizing symptoms and norm breaking, but effects were not significant when parenting was considered. Our study showed that higher levels of psychological control-disrespect (significantly for fathers and marginally for mothers) and marginally, higher levels of maternal harsh punishment were associated with more teen internalizing symptoms. In addition, fathers' greater psychological control and lower levels of support had a marginally significant effect on teens' greater norm breaking. For behavioral control, only mothers' greater behavioral control was associated with refugee youths' greater self-concept clarity but not with paternal behavioral control. Thus, fathers' psychological control and mothers' behavioral control had the biggest association with adolescent outcomes.

Palestinian Refugee Youth in Jordan: Parental Practices, Neighborhood Cohesion and Assistance, and Adolescent Wellbeing

In this study, a total of 335 Palestinian refugees (M = 15.5 years, SD = 1.05, 49% males), recruited from four United Nations Relief and Work Agency (UNRWA) schools at the Al-Baqa’a and Jabal Al-Hussein refugee camps in Jordan, rated their neighborhood physical environment and neighborhood support and cohesion, separately rated their mothers’ and fathers’ parenting on several dimensions, and reported on their adjustment to these circumstances (internalizing symptoms, self-concept clarity, and norm breaking). Living in more dangerous physical environments was associated with higher levels of refugee youths’ internalizing symptoms and norm breaking, but effects were not significant when parenting was considered. Our study showed that higher levels of psychological control–disrespect (significantly for fathers and marginally for mothers) and marginally, higher levels of maternal harsh punishment were associated with more teen internalizing symptoms. In addition, fathers’ greater psychological control and lower levels of support had a marginally significant effect on teens’ greater norm breaking. For behavioral control, only mothers’ greater behavioral control was associated with refugee youths’ greater self-concept clarity but not with paternal behavioral control. Thus, fathers’ psychological control and mothers’ behavioral control had the biggest association with adolescent outcomes.

Development and Psychometric Assessment of Nursing Student's Satisfaction with First Clinical Practical Education Questionnaire: Modified Version

BACKGROUND

The present study aimed to develop an instrument for assessing nursing students' satisfaction with First Clinical Practical Education (SFCPE), and then to test the validity and reliability of the instrument.

MATERIALS AND METHODS

In this methodological research, the views of a panel of 15 clinical professors, in terms of the clinical nursing principles and skills training, were used to develop the instrument. The content validity of the instrument was evaluated quantitatively and qualitatively based on the panel's views. The data was collected from the questionnaire completed by 380 second- and third-semester nursing students in 15 medical universities of Iran. The Exploratory Factor Analysis (EFA) was later performed to determine the construct validity of the instrument. The reliability of the instrument and stability analysis were evaluated using the internal consistency test by calculating Cronbach's alpha and by the test-retest method, respectively.

RESULTS

Throughout the development phase, 16 items were added to the SFCPE instrument, and a 42-item instrument was later developed. During the qualitative and quantitative content validity reviews, the number of added items decreased to 38 items. Finally, a 37-item instrument consisting of seven factors was developed. The Cronbach's alpha coefficients of 0.95 and 0.75-0.9 were obtained for the whole instrument and the factors, respectively. Pearson's correlation coefficient was within the normal range (0.71-1).

CONCLUSIONS

The developed SFCPE is a valid and reliable instrument that can be used for assessing the satisfaction of nursing students in terms of clinical nursing principles and skills.