Prevalence of Compassion Fatigue and Its Association with Professional Identity in Junior College Nursing Interns: A Cross-Sectional Study

Background: The issue of compassion fatigue among clinical nurses has received considerable attention, particularly during the COVID-19 pandemic. Yet, the current status of compassion fatigue among junior college nursing interns remains unclear. Additionally, professional identity can modulate the impact of compassion fatigue or burnout on psychological well-being; however, whether professional identity still works in this group is also unclear. This study aimed to reveal the current status of compassion fatigue among nursing interns in junior colleges and also investigate the association between compassion fatigue and professional identity. Methods: This cross-sectional survey evaluated the levels of participants' compassion fatigue (The Compassion Fatigue Short Scale) and professional identity (Professional Identity Scale) in 2256 nursing interns. Results: The mean score of compassion fatigue was 44.99, and 19.5% of the participants scored above The Compassion Fatigue Short Scale median scores for compassion fatigue. A moderate negative correlation was detected between compassion fatigue and professional identity. Conclusions: The level of compassion fatigue among nursing interns is low but nearly one in five nursing students is at risk of compassion fatigue. More attention should be paid to nursing interns with a high risk of compassion fatigue. Future studies are warranted to explore which pathways could mediate the relationship between professional identify and comparison fatigue.

Experienced based co design: nursing preceptorship educational programme

BACKGROUND

Patients play a central role in nursing preceptorship relationships, a professional educational relationship between a staff nurse and student nurse that is grounded in providing patient care. Yet the patient experiences and perspectives are largely uncaptured in the literature or represented in current preceptorship education programmes. Furthermore, the lack of student, staff nurse & patient involvement in the design of preceptorship education programmes has been noted.

OBJECTIVE

To use a co-design process to develop an innovative educational programme for developing interpersonal and communication skills among nurses who act as preceptors. We sought to (a) clarify experiences and events from all three members involved in a preceptorship relationship (student nurse, preceptor, and patient (SPP) in order to develop a shared understanding of nursing preceptorship relationships and (b) identify the key informational and educational needs recommended by SPP for the educational programme.

METHODS

Using the principles and the iterative process of Experienced Based Co Design (EBCD), data was collected from qualitative interviews and used to inform a series of co-design workshops and the co-production of the new educational programme.

RESULTS

Twenty-six individuals, including undergraduate student nurses, staff nurses, patients, and a team of nursing, educational and educational technologist experts, contributed to developing a blended learning preceptorship educational programme that consists of three core elements (1) six online reusable learning objects, (2) two role play simulations and (3) a virtual reality storytelling simulated experience.

CONCLUSIONS

The EBCD process ensured that the educational programme was developed to meet SPP viewpoints associated with fostering positive interpersonal relationships in a nursing preceptorship. EBCD is a valuable framework for developing human-centred educational resources that combine experiential knowledge (experiences) and scientific knowledge (literature-based knowledge). It facilitated the identification and the development of Interpersonal and Communications skills (IP & C skills) training required within a nursing preceptorship relationship, creating an authentic and memorable learning programme. The structure of EBCD harnesses SPP involvement throughout the research and development process, ensuring transparency and continuity of message, scope, and outcomes.

Factors affecting preregistered nurses' willingness to serve in geriatric long-term care

AIM

Rapidly ageing population leads to increased demands for long-term care. Taiwan's preparation for its ageing population focuses on engaging healthcare professionals. This study explored pre-registered nurses' current knowledge, experience in geriatric long-term care (GLTC) and willingness to serve in GLTC.

DESIGN

A cross-sectional survey design and a self-developed structured questionnaire were used.

METHODS

A probability proportionate to size sampling strategy was used to collect data from students in junior college and bachelor of nursing science programmes in Taiwan in 2017. Multiple regression was adopted to predict significant factors that influence nursing students' willingness to serve in GLTC.

RESULTS

The willingness to serve in GLTC was positively correlated with their experience of living with older adults, practicum experience, taking GLTC-related courses and interest in GLTC. Willingness to serve older/disabled patients can be enhanced through school courses and practicum experiences, indicating the importance of GLTC-related courses in the training of the professional nursing workforce.

Shaping clinical imagination as new graduate nurses in maternal-child simulation

BACKGROUND

Combined with traditional placement, simulation has been used as an experiential learning opportunity to integrate theory and practice in maternal-child nursing.

METHOD

van Manen's phenomenology of practice uncovered the lived experience of new graduate nurses adopting maternal-child simulation in their practice. Narrative methods included a three-phased approach to phenomenological interviews to capture the new graduate's entry into practice.

RESULTS

Thematic analysis revealed four main themes: acting like a nurse, forming a clinical imagination, embodying the role of the novice nurse, and embracing in-situ simulation.

DISCUSSION

The essence of being a nurse required immersion into the ethics of caring and creation of an optimal simulation debriefing using a skilled and thoughtful approach to trigger imaginative thinking. While an inventory of simulation in nursing education was deemed necessary to understand the current blend of traditional placement and simulation in practice education, the new graduate nurses in the study looked for specialty training, and exposure to advanced roles in the simulation experiences.

CONCLUSION

An integrated traditional placement with the use of simulation fostered clinical imagination where the new graduate nurse visualized and embodied the role of the novice nurse. Future research is required to describe the impact of simulation on practice readiness.

Should we use preceptorships in undergraduate nursing education?

BACKGROUND

Clinical learning experiences are the cornerstone of undergraduate nursing education as they allow students to apply theory to practice and help them develop as competent practitioners who are prepared for the realities of diverse, complex, and ever-changing practice environments.

PROBLEM

The traditional clinical teaching model, where small groups of students work with educators who are on-site facilitating learning, has numerous issues and thus there have been calls for reform. This Creative Controversy focuses on one reform option, the alternative clinical teaching model of preceptorships, which has gained popularity in recent years.

APPROACH

Current evidence surrounding preceptorships in undergraduate education was examined and critiqued.

CONCLUSION

Despite their popularity, there is a lack of robust evidence surrounding preceptorships and the motivations for using this model remain questionable. Future study is needed so preceptorships are implemented according to evidence-based teaching practices and not clouded by inappropriate motivations. The author challenges readers to question their practices and work to positively contribute to the science and practice of nursing education.

Students' experiences of clinical immersion in operating room and emergency department

Specialty areas, such as the operating room and emergency department, are being hit especially hard by the nursing shortage in the United States. Recruitment and retention is a challenge in these specialty units and may, in part, be due to limited or no exposure in nursing school. Kolb's theory of experiential learning was used to guide this project. The purpose was to investigate students' experiences and intent to pursue employment after a clinical immersion course in either the operating room or emergency department. Six Bachelor of Science in Nursing students participated in a five-week course that included 10 h of web-based education and 80 h of clinical practicum. The objectives of the course were to identify the role and responsibilities of the nurse in the specialty area, explore the standards and recommended practices established by the specialty professional organization, and collaborate with the healthcare team in the specialty area to provide safe, quality care. A thematic analysis of focus group transcripts and students' weekly reflections was conducted. The results of this project suggest immersing students in a specialty area may be a first step in alleviating the shortage in these areas.

Rural Public Health Workforce Training and Development: The Performance of an Undergraduate Internship Programme in a Rural Hospital and Healthcare Centre

Workforce shortages in the field of public health and healthcare are significant. Due to the limitations of career opportunities and compensation, rural hospitals and healthcare centres usually have on-going career openings for all departments. As a result, university departments of public health and healthcare management, and rural hospitals and health centres may need to establish internship and training programmes for undergraduate senior-year students in order to provide opportunities and human resource opportunities for both students and public health professions. The research examined the performance, feedback, and opinions of a university-based one-year-long on-site internship training programme between a university public health and healthcare undergraduate department and a regional hospital and healthcare centre in a rural region in the United States. Individual interview data were collected from management trainees and focus group activities data were collected from hospital departmental supervisors who have completed this one-year-long on-site internship training programme. The results offered an assessment of performance and evaluation of how a one-year-long internship programme could be beneficial to hospitals and health centres in the areas of human resources, manpower management, and skill training to prospective professionals in rural and regional communities. Also, the study provided a blueprint and alternative for universities and partnered sites to redesign and improve their current internship programmes which may better fit their needs for their actual situations.

Don't spend, eat less, save more: Responses to the financial stress experienced by nursing students during unpaid clinical placements

Using an online survey, this study explored the impact of participation in unpaid clinical placements on the financial wellbeing of 160 nursing students attending an Australian university. The research found that the majority of respondents struggle financially during clinical placements, yet are financially adequate or secure outside of semester or during normal periods of study. Increased transport costs and loss of income are the most significant financial stressors during this time, with additional meals, work-appropriate clothing, purchasing additional resources and materials, and childcare costs other causes of financial stress. Most students used savings, budgeting, borrowing, and changed expenditure patterns to cope with the financial impact of unpaid placement. These findings have important implications for the ability of students to successfully complete their nursing degree and draw into question the equity of unpaid clinical placements as a formal degree requirement. However, while participation in unpaid clinical placements can impact financial well-being in the short term, participation does have the potential to increase the financial resilience of students over time, as students learn and grow from these experiences. To achieve this, however, greater attention must be placed on the financial support and personal finance education available for nursing students.

Pre-registration nursing student's quality of practice learning: Clinical learning environment inventory (actual) questionnaire

BACKGROUND

Clinical learning is a vital component of nurse education and assessing student's experiences can provide useful insights for development. Whilst most research in this area has focused on the acute setting little attention has been given to all pre-registration nurses' experience across the clinical placements arenas.

OBJECTIVES

To examine of pre-registration nursing students (first, second and third year) assessment of their actual experiences of their most recent clinical learning clinical learning experience.

DESIGN

A cross sectional survey involving a descriptive online anonymous questionnaire based on the clinical learning environment inventory tool.

SETTINGS

One higher education institution in the United Kingdom.

PARTICIPANTS

Nursing students (n=147) enrolled in an undergraduate nursing degree.

METHODS

This questionnaire included demographic questions and the Clinical Learning Environment Inventory (CLEI) a 42 item tool measuring student's satisfaction with clinical placement. SPPS version 22 was employed to analyse data with descriptive and inferential statistics.

RESULTS

Overall students were satisfied with their clinical learning experience across all placement areas. This was linked to the 6 constructs of the clinical learning environment inventory; personalization, innovation, individualization, task orientation, involvement, satisfaction. Significant differences in student experience were noted between age groups and student year but there was no difference noted between placement type, age and gender.

CONCLUSIONS

Nursing students had a positive perception of their clinical learning experience, although there remains room for improvement. Enabling a greater understanding of students' perspective on the quality of clinical education is important for nursing education and future research.

Experiences of nursing students and educators during the co-construction of clinical nursing leadership learning activities: A qualitative research and development study

BACKGROUND

Student voice posits that students' unique perspectives on teaching and learning can be used in conjunction with those of educators to create meaningful educational activities.

OBJECTIVE

The study aimed to describe nursing students' and educators' experiences during the co-construction of educational activities involving clinical nursing leadership.

DESIGN

Qualitative research and development model.

SETTING

The study was conducted at a French-Canadian nursing faculty that provides a 3-year undergraduate program.

PARTICIPANTS

Five undergraduate nursing students, four nursing educators, and the principal investigator formed the co-construction team.

METHODS

Data collected included all documents (written and audio) related to the co-construction process: three 2-hour team meetings, PI's fieldnotes and a focus group discussion that occurred once the co-construction process was completed. Thematic analysis was performed guided by Paillé and Muchielli's (2010) method.

RESULTS

Data analysis revealed two interrelated themes: (1) unique, purposeful collaboration and (2) change that makes a difference. A space described as safe, without hierarchy and that included the "right" people helped the team achieve their objective of creating new educational activities on clinical nursing leadership. The two new learning activities developed by the team were perceived as useful for future nursing students. At the individual level, team members appreciated how co-construction helped them understand teaching and learning from new perspectives.

CONCLUSIONS

A structured, efficient co-construction process contributed to positive changes in the nursing program and participants. Additional research is required to enhance understanding of the factors that facilitate and hinder student-educator collaboration outside the classroom.

Lack of respect, role uncertainty and satisfaction with clinical practice among nursing students: the moderating role of supportive staff

BACKGROUND AND AIMS

Clinical learning placements provide a real-world context where nursing students can acquire clinical skills and the attitudes that are the hallmark of the nursing profession. Nonetheless, nursing students often report dissatisfaction with their clinical placements. The aim of this study was to test a model of the relationship between student's perceived respect, role uncertainty, staff support, and satisfaction with clinical practice.

METHOD

A cross-sectional, descriptive survey was completed by 278 second- and third-year undergraduate nursing students. Specifically, we tested the moderating role of supportive staff and the mediating role of role uncertainty.

RESULTS

We found that lack of respect was positively related to role uncertainty, and this relationship was moderated by supportive staff, especially at lower levels. Also, role uncertainty was a mediator of the relationship between lack of respect and internship satisfaction; lack of respect increased role uncertainty, which in turn was related to minor satisfaction with clinical practice.

CONCLUSION

This study explored the experience of nursing students during their clinical learning placements. Unhealthy placement environments, characterized by lack of respect, trust, and support increase nursing students' psychosocial risks, thus reducing their satisfaction with their clinical placements. Due to the current global nursing shortage, our results may have important implications for graduate recruitment, retention of young nurses, and professional progression.

Psychometric evaluation of the French version of the Clinical Nursing Competence Questionnaire (CNCQ-22): A cross-sectional study in nursing education in Burkina Faso

BACKGROUND

Clinical nursing competence (CNC) is the essence of the nursing profession. It has received attention as a central component of nursing education; however, most instruments of measure were developed in high income countries and essentially in English. To gauge the CNC of nursing students attending Bachelor of Science in Nursing programs, a specialized scale is needed. This study aimed to validate a French version of the 22-item Clinical Nursing Competence Questionnaire (CNCQ-22), designed and implemented in Taiwan.

METHODS

A cross-sectional descriptive survey was carried out to assess the psychometric properties of the CNCQ-22. A total of 255 pre-graduate nursing students of three nursing campuses of Burkina Faso (École Nationale de Santé Publique) participated in the study from June to October 2009. In addition to descriptive analysis, the reliability of the instrument, test-retest, and convergent and discriminant validity were examined.

RESULTS

Most participants were pre-registered nursing students (66.3%), predominantly male (68.2%), and their mean age was 30.54 (±5.66) (range 21-48). The original English version of the CNCQ-22 was translated into French and yielded an internal consistency coefficient of 0.89. The instrument revealed solid stability through a test-retest that yielded a Spearman's rho of 0.61 and supported good convergent and discriminant validity. Exploratory and confirmatory factor analyses resulted in a three-factor solution.

CONCLUSION

The French version of the CNCQ-22 demonstrates promising psychometric integrity and can be considered as a reliable and valid instrument to evaluate CNC in a French nursing education context. An accurate assessment of CNC provided by an adapted, easy-to-use CNCQ-22 may help nursing educators and academics improve the quality of training.

Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: A qualitative study

BACKGROUND

Despite the fact that high quality clinical placement is an integral component of pre-registration nursing education for the development of the future nursing workforce, the literature identifies an ongoing struggle to 'get it right'.

OBJECTIVE

To examine qualitative data gathered through the Quality Clinical Placements Evaluation project to identify what pre-registration nursing students deemed helpful and not helpful influences on their first year Professional Experience Placement.

DESIGN

A total of 553 first year undergraduate nursing students from 2010 to 2012 were enrolled in the programme and all were invited to complete a validated survey to measure the quality of their first clinical placement. A total of 361 completed surveys were returned. This paper examines the data provided through open-ended questions within the survey related to most helpful and least helpful aspects of their clinical experience.

METHODS

An inductive analysis approach using NVIVO allowed inherent areas to emerge from the raw data forming three key themes that influenced the experience of students.

RESULTS

Feeling welcomed, individual versus team attitudes, and student expectations of supervising ward nurses were the themes identified that were perceived by the student as important to the success of learning and the quality of the experience overall.

CONCLUSION

The findings echo previous research into the student experience of clinical placement; however the focus regarding the need for students to have a quality relationship with the supervising nurse is an area that warrants further exploration. Furthermore, we argue that students should be purposely engaged in the tertiary sector and provided guidance and strategies related to forming and maintaining relationships with those that supervise their clinical placement, in order to ensure consistent positive experiences. The outcomes from this study suggest that a missing component is teaching undergraduates how to manage relationships in clinical settings.

Issues concerning recruitment, retention and attrition of student nurses in the 1950/60s: a comparative study

AIM

To investigate student nurse recruitment and attrition in the 1950' and 1960s and undertake comparisons to modern day concerns. The study was set in one hospital in the U.K.

BACKGROUND

In the period studied nursing was unpopular as a profession and there were difficulties surrounding recruitment. Attrition rates were high.

METHOD

Documentary analysis of 641 training records dating 1955 to 1968 was undertaken. Attrition rates, reasons for non-completion and employment following successful completion were determined.

RESULTS

Most recruits were young, unmarried, females and had overseas addresses. The majority (n = 88) had prior nursing experience. Over 69% (n = 443) successfully completed their training. Attrition rates were over 30% (n = 198), the main reason being academic failure. Following completion over 40% (n = 183) undertook midwifery training (n = 183) or secured a staff nurse post (n = 153).

CONCLUSIONS

Issues relating to recruitment, retention and attrition in the 1950s and 1960s put into context present day issues. Recent attrition rates from pre-registration nurse education have fallen, nevertheless some of the issues of yesteryear remain problematic. In the present study significant numbers of entrants left due to domestic and ill-health problems resonates with many modern day studies. Also failure to complete due to academic shortcomings continues to be a concern.

Empowering nursing preceptors to mentoring undergraduate senior students in acute care settings

Nurse preceptors play an important role in the transition of nursing students from classroom to clinical practice not only in the United States but also internationally. However, many preceptors feel a lack of confidence in their role as mentors to nursing students rather than experienced nurses because of inadequate preparation or formal training. A study looking at the educational needs of nurse preceptors would be invaluable to academic educators because they choose strategies and develop content for a handbook to serve as a quick reference. Thus, the mentorship experience for preceptors would be enhanced by incorporating the needs and preferences of the preceptors into their training and resource materials. The purposes of this study were to identify the needs of the nurses who precept students rather than nurses who mentor other nurses and to evaluate if the current handbook was a useful reference for preceptors during a practicum in acute care settings.

METHOD

A multiprocedural mixed method study was used. Data were collected through a questionnaire that was adapted with the permission of the author. Descriptive statistics and a chi-square test were used to compare differences in the means. The preceptorship handbook helped preceptors mentor undergraduate senior nursing students. In addition, the currently developed preceptorship handbook was recognized as a useful reference in mentoring nursing students by 100% of the participants.

An outcome-based evaluation of nursing competency of baccalaureate senior nursing students in Taiwan

Limited literature is available for demographic and learning factors related to performance of baccalaureate nursing students. The study aimed at examining mean differences in nursing competency between the first week and the sixth week of a nursing clinical practicum as well as evaluating mean differences in nursing competency by demographic and learning factors at the sixth week of a nursing clinical practicum controlling for baseline scores of nursing competency. A comparative study design was conducted using the competency inventory for baccalaureate senior nursing students based on learning outcomes. Participants were surveyed at the first week and the sixth week of a nursing practicum with 95% mean response rate. Paired t test was used to compare within-subjects differences in mean nursing competency. ANCOVA and Kruskal-Wallis test, and Mann-Whitney U test were conducted to compare between-subjects differences in mean nursing competency. There are significant mean differences in nursing competency in general clinical skills, lifelong learning, clinical biomedical science, caring, and critical thinking and reasoning between the 1st week and the 6th week of nursing practicum. Likewise, type of nursing program, prior schooling, type of nursing license, interest in nursing, and extracurricular activity experience were significantly related to mean total nursing competency. Similarly, demographic attributes (location of school, type of nursing program, prior schooling, type of nursing license, a family member working as a medical practitioner or a nurse, interest in nursing, attributes of preferred workplace after college) and learning factors (extracurricular activity experience, played an active role in classroom discussions and asked questions, academic class rank, and English grade, clinical biomedical science, nursing science, and nursing practicum) were significantly related to six-subscale scores of nursing competency. There are mean differences in nursing competency across several demographic and learning factors. These factors should be given greater emphasis by nurse educators in planning the academic and clinical phases of professional education.

Exploring the issue of failure to fail in a nursing program

A study using a qualitative descriptive design was undertaken to explore the issue of "failure to fail" in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.

The calm before the storm? Burnout and compassion fatigue among undergraduate nursing students

Studies have consistently highlighted the deleterious impact of burnout and compassion fatigue on professional nurses' well-being and willingness to remain in the profession. Yet, as to what extent these noxious conditions are suffered among nursing students is still unclear. In this study 436 undergraduate nursing students completed surveys assessing their experiences of emotional exhaustion, depersonalization, lack of personal accomplishment, burnout, secondary traumatic stress, and compassion satisfaction (factors of burnout and compassion fatigue). There were no significant differences found between 3rd and 4th year students' reports of detrimental conditions and those of the 1st or 2nd year students. Furthermore, 4th year students reported significantly higher levels of personal accomplishment compared to 1st and 2nd year students. Semi-structured in-depth interviews with 3rd and 4th year students revealed that their clinical exposure during these years (especially during the 4th year) may enhance their other-orientation as well as promote role actualization, which may serve as protective features. Students did, however, express concern regarding an inevitable onset of burnout at some point during their professional careers. It is suggested that a key to understanding the onset and experience of burnout and compassion fatigue among nurses is to continue to examine the transition from student to professional nurse and the cultural atmosphere of nursing education compared to professional practice.

Generational clashpoints in nursing preceptorship

The success of the preceptorship approach to teaching-learning depends on the formation of positive working relationships. Preceptors and nursing students are frequently of different generations and often have differing world-views. A phenomenological study, guided by van Manen's approach, was conducted to develop an understanding of how generational differences influence the formation of the preceptor-student relationship and the overall success of the experience. Three main themes were revealed: being affirmed, being challenged, and being on a pedagogical journey. A key subtheme of being challenged was colliding generational worldviews; in this article, our purpose is to explore this particular subtheme. The data suggest that generational clashpoints are occurring during preceptorship experiences, and the implications of these are serious, particularly from a nursing recruitment and retention perspective. It is vital that proactive measures be taken to inspire the future generation of nurses, rather than stifling their spirit and assertiveness.

Preceptorship and affirmation in the intergenerational world of nursing practice

Research has shown that while preceptorship offers a reality-oriented learning environment and facilitates competence of students, there are inherent rewards and stressors associated with the experience. Students and preceptors can be from different generations, and as such, they may often come to the learning space with differing values and expectations. The nature of the preceptorship experience in this intergenerational context was explored in a recent phenomenological study with seven preceptors and seven nursing students in an undergraduate nursing program in Eastern Canada. Overall the experience was found to be inclusive of three main themes: being affirmed, being challenged, and being on a pedagogical journey. In this paper we explore the first of these themes, being affirmed. Highlighting the positive aspects of the preceptorship experience in the intergenerational context is necessary to promote a culture of openness and respect for generational differences within clinical nursing practice settings and to improving the overall quality of the educational experience.

Evidence of clinical competence

This cross-sectional research used a qualitative questionnaire to explore clinical competence in nursing. The aim was to look for evidence of how clinical competence showed itself in practice. In the research, the views from both education and working life are combined to broadly explore and describe clinical competence from the perspective of students, clinical preceptors and teachers. The questions were formulated on how clinical competence is characterised and experienced, what contributes to it and how it is maintained, and on the relation between clinical competence and evidence-based care. The answers were analysed by inductive content analysis. The results showed that clinical competence in practice is encountering, knowing, performing, maturing and improving. Clinical competence is an ongoing process, rather than a state and manifests itself in an ontological and a contextual dimension.

Student nurses' experiences of anxiety in the clinical setting

It is known that some student nurses who experience anxiety during clinical experiences leave nursing education programs. If nurse educators can better understand the anxiety of student nurses during clinical experience, they will be able to develop educational interventions to minimize students' anxiety. Decreasing anxiety has a two-fold effect. First, when anxiety is decreased, learning may be increased. Second, decreasing anxiety may help alleviate the nursing shortage because more students complete their nursing education. This qualitative phenomenological study examines student nurses' perception of anxiety in the clinical setting. Situated cognition learning theory is the theoretical framework. The main method of data collection is unstructured face-to-face interviews with 7 student nurses. The data was analyzed using a thematic analysis. The themes are reported in the rich descriptive words of the subjects. Implications for practice are discussed.