Educational and personal burnout and burnout regarding collaborating with fellow university nursing students during COVID-19 in 2020-2021

BACKGROUND

Knowledge is lacking about the effects of COVID-19 on nursing students' burnout symptoms. Burnout can lead to negative feelings and behaviours towards learning and poor mental health.

AIMS

To describe and compare nursing/midwifery students' burnout, explore differences and detect predictors at two time points through COVID-19.

METHODS

Students were offered participation in the spring semesters of 2020 and 2021 (N = 2046), during COVID-19. The response rate was 30-33%. By using reliable and valid instruments, the students' stress and burnout were analysed as well as the students' health and perceived support.

RESULTS

Symptoms of academic burnout were higher among 1st and 2nd year BSc students in 2021. On the contrary, 3rd and 4th year students had higher academic and personal burnout than graduate students as well as than 1st and 2nd year students. Regarding academic burnout, 47% of the variability was explained by educational level, support, stress and the interactional effect of stress and support. Collaborational burnout, predicted by the students' educational level and support, explained 7% of the variability in the outcome. Additionally, educational level, and stress, predicted 52% of the variability in personal burnout.

CONCLUSION

Educators or student counsellors need to facilitate effective learning practices and offer academic support, specifically during 3rd and 4th year to boost helpful coping strategies and handle uncertainty and stressors related to crises such as COVID-19.

Medication administration competency for clinical preparedness: Comparing testing modalities and test anxiety in undergraduate nursing students

BACKGROUND

Adverse drug events, which occur at various stages of the medication preparation and administration process, cause over half a million injuries or deaths yearly. Upon graduation, prelicensure nursing students lack the skill and competency required for safe medication administration. Therefore, it is essential to ascertain their medication administration proficiency throughout their curriculum prior to participation in clinical experiences. Historically, this has been a deeply embedded process of high-stakes testing. Aligned is cognitive test anxiety which can severely limit a student's performance. Thus, nursing student competency and control appraisal in medication administration can be linked to the Control Value Theory framework.

OBJECTIVES

The purpose of the research was to determine whether an e-simulated high-stakes medication administration test was associated with less anxiety than a standard high-stakes medication math assessment within and between two nursing tracks over three semesters to capture sequencing of medical-surgical clinical courses.

DESIGN

The prospective, quantitative, longitudinal study received Institutional Review Board approval.

PARTICIPANTS/SETTING

Students were recruited from a traditional BSN track and an online LPN-to-BSN track per course level over three semesters.

METHODS

Participants completed the State-Trait Anxiety Inventory prior to their course level high-stakes assessment modality.

RESULTS

For both tracks, testing anxiety remained a factor with no significant difference in the anxiety level between assessment modalities. There was a trend for anxiety scores to slightly decrease over time with each testing modality, but results were non-significant. There was a trend for traditional BSN students (n = 435) to have slightly lower anxiety scores than the LPN-to-BSN (n = 246) students.

CONCLUSIONS

Researchers must continue investigating teaching, learning, and testing modalities in medication calculation/administration that maintain rigor, enhance student self-efficacy, and provide accurate assessment. These can be aligned with research regarding study skills training and cognitive-behavioral interventions to help mitigate the challenge of cognitive test anxiety.

Student-Led Stress Reduction Support Groups: A Qualitative Program Evaluation

BACKGROUND

Burnout and attrition in nursing have been accelerated by the coronavirus disease 2019 (COVID-19) pandemic. Nursing students experience greater stress than non-nursing students but often lack adequate institutional support to build resiliency. Support groups are an effective strategy for processing stress that are underused in nursing education. An innovative online stress impact course was developed at a college of nursing to address students' stress during the pandemic. The course culminated in a voluntary virtual support group led by a Psychiatric Mental Health Nurse Practitioner graduate student. The aim of this qualitative program evaluation was to determine how graduate nursing students experienced the stress support group.

METHOD

This study used qualitative exploratory analysis of support group reflections from 47 graduate nursing students.

RESULTS

Four themes emerged: (1) Making Positive Connections; (2) Leveraging Skills to Manage Stress; (3) Beneficial; and (4) Facing Trauma.

CONCLUSION

Graduate student-led support groups are a feasible and effective strategy to mitigate stress and improve nursing student resiliency. [J Nurs Educ. 2023;62(12):711-715.].

Storytelling: Manifesting Integral Interconnectedness in Holistic Nursing Education

This paper presents a middle-range theory of storytelling in nursing education. Both explanatory and predictive, the theory further develops the existing conceptual work on the topic of storytelling. It places storytelling as a pedagogical technique within the realm of holistic nursing theory and philosophy. Storytelling is seen as a manifestation of the process of integral interconnectedness. The theory suggests a mechanism by which storytelling, as mediated by narrative transportation and neuroplasticity, can be effective in promoting desirable outcomes for holistic nursing students, including the achievement of affective and cognitive educational objectives. The theory describes the relationship of storytelling to narrative transportation and neuroplasticity. Within the concept of storytelling, the Temporal Bidirectionality of Story and Experience and the Story Creation-Interpretation-Recreation Cycle of telling and listening are explained. This theory was developed using deductive reasoning combining existing nursing and non-nursing theories. Recommendations for research and application are included.

Academic performance beyond the metrics: A qualitative content analysis of nursing students' perceptions

AIM

To explore the undergraduate nursing students' perceptions about the factors influencing their academic performance.

BACKGROUND

Academic performance is the measure for the achievement of learning objectives and skills development. Thus, the literature on nursing education has already pointed out the factors associated with this construct. However, it is essential to understand the in-depth influencers of academic performance from the perspective of nursing students. For this, it is essential to analyze not only numerical indicators, but also to understand the perceptions of undergraduate students about the factors that can influence this performance.

DESIGN

Descriptive study with qualitative approach.

METHODS

Twenty-two undergraduate nursing students were recruited from a Brazilian public university. Interviews were collected and submitted to Content Analysis, thematic modality, and discussed according to references of critical and humanist education.

RESULTS

Two thematic categories emerged from the interviews representing the students' perceptions: 1. The student - history and relationships, with the thematic axis quality of previous education, intrafamily processes and roles, family support, socioeconomic aspects, interpersonal relationships, copping with difficulties, mental health, and physical well-being; and 2. Academic experiences and their challenges, with the thematic axis academic adaptation, professor's didactics and preparation, structure and support provided by the University, management of study time, and participation in extracurricular activities. The students saw them as intervening factors in their academic performance, physical and psychological well-being, established interpersonal relationships (including the relation with peers and professors), family structure, socioeconomic aspects, academic conditions, and the transition to higher education.

CONCLUSION

From the perspective of students, socio-historical aspects and constructs established in relationships with colleagues and professors at the university are directly related to their academic performance and directly influence their ability to achieve the proposed learning objectives and acquire essential competencies for their education.

The Death Café: Effectiveness of a hospice care educational program for nursing undergraduates based on LIFE experience-A qualitative study

BACKGROUND

Nursing students' knowledge of hospice care is limited to textbooks due to the inadequate education and training system in China and student's willingness to participate in hospice care.

OBJECTIVES

To deepen nursing students' understandings toward life and death, to improve their knowledge about hospice care, and to promote their willingness for hospice care practice.

DESIGN

This study used a qualitative descriptive study design.

SETTINGS

The study was conducted at a medical university in Sichuan province, China.

PARTICIPANTS

71 nursing sophomores participated in this study.

METHODS

The Death Café teaching program was implemented which requires students to recall their memories about death and to imagine how they felt about dying, as if they were having a conversation in a death-themed café. During the implementation phase, a small-group interactive teaching approach was utilized. During the reflection phase, the students were asked to finish an essay answering four questions without standard right answers. The essays that students finished were used for evaluating the effectiveness of the Death Café program. The answers of the first two questions were presented as a word cloud. Graneheim and Lundman's qualitative content analysis method was used to analyze answers of the third and fourth questions.

RESULTS

Word cloud analysis indicated that at the beginning of the program participants showed more negative emotions (i.e., fearful). Students' attitudes toward death changed from negative to positive through imagining death when role-playing the different stages of life. The program enhanced students' understanding of life and taught the students effective ways to cope with death. Students clarified the objectives and necessary preparation for providing hospice care and gained new understandings for improving their hospice skills.

CONCLUSIONS

The Death Café program can address students' negative emotions and perceptions of death. Students gained personal benefits and professional benefits of coping with life and death from the program.

Correlation between cultural competence, xenophobia, and attitudes towards brain drain in nursing students

This study aimed to determine the correlation between cultural competence, xenophobia, and attitudes to brain drain in nursing students. Individuals with high levels of intercultural competence have more successful social and emotional interactions with people from various cultural backgrounds. A cross-sectional and correlational design was used. This study was conducted on 473 nursing students from two different provinces neighboring the Syrian border between October 28th and December 28th, 2021. An information form and nurse cultural competence, xenophobia, and attitude scales for brain drain were used to collect data. A negative nonsignificant correlation between cultural competence and xenophobia and a positive nonsignificant correlation between cultural competence and attitude towards brain drain were found. The students had high levels of cultural competence and positive attitudes towards brain drain, and a moderate level of xenophobia. Socio-demographic characteristics affected cultural competence, xenophobia, and attitudes towards brain drain.

The influence of emotional intelligence on academic stress among medical students in Neyshabur, Iran

BACKGROUND

Although, several novel strategies related to coping with stress dominate the possible vicissitudes that may occur, academic stress and its mental and physical outcomes remain a serious public concern among college students. Available data on how/where intervention-based novel strategies and emotional intelligence skills can influence students' ability to deal with stress and crisis situations is still unclear. This study aims to investigate the effectiveness of an educational intervention based on emotional intelligence on the level of academic stress components among Iranian medical students.

METHODS

This research has been done in two descriptive and quasi-experimental sections in the academic year 2018-2019. To determine the effect of emotional intelligence components on stress levels, this descriptive study was performed on 200 students. Then, a quasi-experimental study was then conducted to determine the impact of an emotional intelligence component-based educational intervention on academic stress-coping skills. Data were collected through a personal information questionnaire, Bradbury and Graves's emotional intelligence questionnaire, and Gadzella's academic stress questionnaire.

RESULTS

Most of the participants were female (72.3%) married (72%), non-native (62.1%), and second or third academic years (78.5%). The mean number of academic years of employment was 9.5. The mean age of students were 23 ± 3.5 years old. Intervention based on emotional intelligence significantly (p < 0.05) improved students' emotional intelligence skills and decreased their academic stress and reactions to stressors in the intervention group.

CONCLUSION

It appears that emotional intelligence training is a feasible and highly acceptable way to develop coping skills with academic stress; therefore, such training is essential to be considered as part of university education to improve students' education quality and their skills to study without academic stress.

Impact of the COVID-19 pandemic on physical activity, smoking, alcohol use, and mental well-being-A longitudinal study of nursing students at Wroclaw Medical University in Poland

Introduction

From the moment the first cases of coronavirus disease were detected in December 2019 until the announcement and duration of the pandemic, it was a negative experience for people around the world in various spheres of life. In connection with it, there have been many changes in our daily lives related to lifestyle, physical activity, or the mental sphere. The aim of the following paper is to determine the correlation between the COVID-19 pandemic and alcohol drinking, smoking, physical exercise, and lifestyle among nursing students in Poland.

Methods

The study was conducted among nursing students at Wroclaw Medical University before and during the COVID-19 pandemic. The survey consisted of completing the same anonymous online questionnaires five times by the same research group. The majority of respondents were women in the age between 18 and 30 years old and the significance level of data analysis was set at p < 0.05.

Results and discussion

In October 2020, we recorded a large number of respondents experiencing anxiety/fear or being more stressed. Between the measurements, the highest average level of alcohol addiction (p < 0.001) was in October 2021 (8.71). Moreover, the percentage of respondents who felt as before increased (p = 0.021). As the pandemic continued, there was a systematic decline in the physical activity level (p < 0.001). In conclusion, the COVID-19 pandemic had a serious impact on the daily lives of the students.

What Role Does "Emotional Medicine" Play in Oncology Nursing?

The Susan D. Flynn Oncology Nursing Fellowship is an eight-week immersive experience that allows rising senior nursing students to gain clinical experience and promotes professional development in oncology nursing.

Innovations in teaching during the COVID-19 pandemic: comparisons of the impacts of different teaching approaches in psychiatric nursing on undergraduate nursing students

BACKGROUND

Psychiatric nursing education was significantly impacted during the COVID-19 pandemic, and innovative teaching can be challenging. This study aims to compare the effectiveness of four approaches to psychiatric nursing education in the context of the pandemic.

METHODS

A quasi-experimental design was adopted. Students were subjected to different teaching designs: face-to-face teaching (Class A in 2021), blended teaching with flipped classroom using roleplay (Class B in 2021), live broadcast teaching (Class A in 2022), and online blended teaching with flipped classroom using case studies (Class B in 2022). Multivariable logistic regression was used to analyse the outcomes in terms of academic performance and course workload.

RESULTS

The number of valid data points was 270. The results indicated that compared with Class A in 2021, the two classes in 2022 achieved significantly higher academic performance scores, and Class B in 2021 exhibited a significantly lower workload. Compared with Class A in 2022, Class B in 2021 exhibited a significantly lower workload. Compared with Class B in 2022, Class B in 2021 exhibited a significantly lower workload and achieved lower academic performance scores.

CONCLUSION

This study demonstrated that innovative teaching designs for psychiatric nursing offer advantages with regard to either facilitating academic performance or optimizing learners' task loads. Furthermore, blended learning is a promising teaching approach in the context of the COVID-19 pandemic. Future teaching initiatives could adopt student-centred constructive learning designs and ensure feasible teaching.

Culturally Safe Mentoring for American Indian Nursing Students

Being the least-represented ethnic/racial group in college settings, American Indian students may experience loneliness and self-doubt related to the challenges of adapting to an environment that embodies values, norms, and culture so different from those represented in their traditional culture. Ongoing health disparities and psychosocial inequities, and persisting impacts of historical colonization, have led to additional hardships for these students that further complicate their academic experiences. Fostering culturally safe learning environments where compassionate and caring faculty provide culturally aligned teaching is important in addressing these complex disparities. Derived from American Indian values and teachings, we present a culturally safe intergenerational mentoring approach that emphasizes the nursing mentors' responsibility to support the growth and success of American Indian nursing students. This approach, drawn from the wisdom of American Indian teachings, focuses on students' strengths and culturally based protective factors. Culturally informed faculty who are aware of the historical impacts of colonization and who have adequate mentoring capacity (time, interest, and commitment) contribute to safe and effective learning environments. Culturally safe mentoring is one approach to promoting American Indian students' potential for academic and professional success.

[Sophrology, an experience of corporality for student nurses]

The body approach is a real challenge in nursing training. It is part of the relationship between the caregiver and the cared-for. Through their bodies, students experience all their sensations and perceptions. Questioning nursing students through the phenomenological approach of sophrology means enabling them to achieve body-mind harmonization, a fundamental pillar of this mind-body technique. The regular practice of sophrology teaches them to act autonomously on themselves, developing their personal resources for a better body-mind and/or mind-body well-being.

Assessment of high fidelity simulation with actors in palliative care in nursing students: a mixed methods study

OBJECTIVE

The most effective training methods are experiential, including those focused on experiences and emotions. Clinical simulation, especially high-fidelity simulation, is one of the most effective methodologies for the acquisition of competencies in care like palliative care. The simulation with actors can train future healthcare science professionals: in technical, intellectual, or interpersonal skills. The objective is to evaluate high-fidelity simulation with actors as a tool in palliative care training for nursing students.

METHOD

Over three years, the study was conducted in a Faculty of Nursing of the south of Spain with nursing students. A mixed methods study with sequential explanatory design in three moments was conducted: (1) Quasi-experimental study in a single group (n = 12) before and after attending the palliative care course with Clinical Simulation with actors to assess the communication skills (CICAA scale), (2) Qualitative study with phenomenological perspective after Clinical Simulation (174 reflective students' narratives), (3) Cross-sectional observational study, one year later, to assess the transfer of knowledge and skills to the clinical practice (71 students).

RESULTS

Students who interacted with actors in Clinical Simulation improved their communication skills and the ability to establish an effective helping relationship with both end-of-life patients and their families. The students perceived the Clinical Simulation as an innovative learning methodology that is useful to encourage reflection and transfer of learning during their clinical internship.

CONCLUSIONS

Standardization of the use of active learning methodologies is recommended for a better acquisition of transversal skills such as communication skills in palliative care.

Emotional intelligence in preregistration nurse education

Emotional intelligence (EI) is considered essential to nursing practice, but it is unclear how best to support nursing students to develop EI skills. This article details a literature review that was undertaken to explore EI in preregistration nurse education and to identify effective methods for developing nursing students' EI skills. A total of 12 articles were included in the review, from which data were extracted, compared and categorised. Three main areas were identified regarding EI in preregistration nurse education: EI constructs, EI components and EI teaching methods. The review found that a range of EI constructs and components may be included in nurse education curricula, meaning that there is often inconsistency in the approaches used. Classroom teaching methods were primarily used, alongside online methods and experiential methods such as simulation-based learning. The findings of the review suggest there is a need for greater consistency in the EI constructs and components used in preregistration nurse education, as well as further research to determine which EI teaching methods are most effective.

Academic-Practice Partnership to Strengthen Nursing Care of Older Adults

A long-standing academic-practice partnership was leveraged to facilitate student learning opportunities pertaining to care provision for older adults living with multiple chronic conditions and complex medical problems. Students from a gerontological nursing course in an accelerated baccalaureate nursing program were partnered with gerontology-educated population health nurses in primary care settings. Students observed how population health nurses integrated the Institute for Healthcare Improvement Age-Friendly 4Ms framework into clinical practice as they performed behavioral, psychosocial, and biometric health risks assessments for older adults during their Medicare annual wellness visit. The population health nurses served as role models for professional delivery of age-friendly care including preventative health and wellness care. Student confidence and perception of their understanding of age-friendly and gerontological nursing care improved. Post clinical experience debrief sessions and clinical reflection assignments demonstrated students' admiration of the expansive role and person-centered approach that population health nurses undertake to ensure comprehensive assessment and wellness promotion. Students appreciated the fluidity of population health nurses' conversation regarding the things that matter most to older adults with complex medical conditions.

Postgraduate nursing students' experiences with simulation-based learning in palliative care education: A qualitative study

AIM

The aim of this study was to explore postgraduate palliative care nursing students' experiences with simulation-based learning focusing on communication skills, as a learning method in palliative care education.

BACKGROUND

Communication is one of several important competencies in palliative care and found to be challenging. Developing appropriate communication skills in palliative care requires education and practice. To provide postgraduate palliative care nursing students with the required knowledge and experience, practical and active learning approaches, such as simulation-based learning, can be applied. Several studies have explored undergraduate nursing students' experiences with simulation-based learning in palliative care. However, to our knowledge no studies have explored postgraduate palliative care nursing students` experiences with simulation-based learning focusing on communication skills in palliative care education.

DESIGN

An exploratory descriptive design.

METHODS

A qualitative method was employed. Three focus group interviews were conducted in May 2022 using videoconferencing (Zoom) with 11 postgraduate palliative care nursing students, eight of whom wrote reflective notes. Data were analysed using systematic text condensation.

RESULTS

Three categories were identified in the data analysis: 1) from uncertain expectations to the real experience of simulation-based learning; 2) being a skilled professional in everyday life versus being observed in the scenarios; and 3) the balance between self-confidence and challenges in experiencing professional development and mastery.

CONCLUSIONS

Postgraduate palliative care nursing students seemed to experience anxiety towards simulation-based learning in palliative care education, as well as variable expectations for the approach. This could be due to their unfamiliarity with the learning method. The need for repetition was underlined and the students indicated that they would like to be able to participate in several simulation sessions to familiarise themselves with the approach. The contrast between being a skilled professional in everyday life and the pressure of being observed and judged in the scenarios was an important finding. Students outlined the desire to feel safe, but also highlighted the importance of being challenged to experience professional development and enhanced mastery. Generally, the findings indicate that academic and psychological safety should be a focus during simulation-based learning and instructors should understand that students may have varied learning strategies, divergent learning experiences and shifting beliefs in their own competencies.

Recognizing and Adapting to Cultural Differences: Influence of International Educational Programs on Future Nursing and Midwifery Practice

INTRODUCTION

International educational programs build cultural humility and safety skills in nursing and midwifery students; however, long-term outcomes of these programs are unclear. The purpose of this study was to explore the impact of international educational programs on nurses' and midwives' future professional practice.

METHOD

Using grounded theory informed by Charmaz, 13 general nurses, two mental health nurses, three midwives, and four dual-qualified nurse/midwives across eight different countries were interviewed. Three categories evolved from the analysis. This article reports on the category Recognizing and adapting to cultural differences.

FINDINGS

Participants developed cultural safety and awareness from participation in programs extending into future practice. Experiencing and adapting to cultural similarities and differences, they developed culturally congruent practices many years after program completion.

DISCUSSION

International programs contributed to participants' professional practice. Positive and ongoing influences are important for employers to promote patient safety and culturally congruent quality care. Findings are also relevant for education providers to inform quality cultural learning.

Impact of resilience-based intervention on emotional regulation, grit and life satisfaction among female Egyptian and Saudi nursing students: A randomized controlled trial

AIM

Evaluate and compare the impact of a resilience-based intervention on emotional regulation, grit and life satisfaction among female Egyptian and Saudi nursing students.

BACKGROUND

Nursing students should experience a comprehensive learning environment since they are mind-body-spirit creatures. Therefore, nursing education should emphasize growing students' physical, social, emotional and spiritual well-being in addition to their knowledge, skills and attitudes.

DESIGN

This study followed a parallel arm randomized controlled trial design. Study participants were randomly assigned to the intervention or control groups in a (1:1) ratio. It was conducted between January 2023 and the end of April 2023.

METHOD

Students were randomly allocated to the eight-week resilience intervention (n= 60) or a control (n= 60) group (half of the students in each group were from each country). The intervention group received a pamphlet and attended eight weekly 15-person sessions on resilience, grit (perseverance), emotional regulation and self-care. The Emotion Regulation Questionnaire, the Short Grit Scale and the Satisfaction with Life Scales were administered pre- and immediately post-intervention.

RESULTS

Between pre- and post-intervention, there were significant improvements in grit (from 41.374.27 to 51.235.22 among Egyptian students with an effect size of 0.663 and from 42.974.30 to 54.103.87 among Saudi students with an effect size of 0.800), as well as mean emotional regulation (from 36.635.11 to 55.707.51 among Egyptian students with an effect size of 0.818 and from 44.606.87 to 61. With a substantial effect size of 0.850 (p0.001), Egyptian nursing students experienced a more significant rise in mean life satisfaction than Saudi nursing students (18.336.54 to 29.305.14).

CONCLUSION

Resilience-based interventions enhanced emotional regulation, grit and life satisfaction in Egyptian and Saudi female nursing students. Grit, resilience and emotional regulation should be incorporated into nurse training to equip female students with the necessary values and protective factors to succeed in their studies. Given the unique challenges and stressors that female nursing students may face, nursing programs and institutions must provide resources and support services to help students manage stress and build resilience.

The relationship between a growth mindset and the learning engagement of nursing students: A structural equation modeling approach

AIMS

To explore the relationship among a growth mindset, well-being and learning engagement of nursing students and the mediating effect of well-being.

BACKGROUND

Reduced well-being and learning burnout are common among nursing students. From the perspective of positive psychology, a positive education can help students obtain well-being, improve their academic performance and be actively involved in learning. The core of positive education is a growth mindset. However, few studies have explored the causal relationship among a growth mindset, learning engagement and well-being.

DESIGN

Correlational design based on cross-sectional data from a multicenter survey study.

METHODS

A web-based survey was completed by 1065 nursing students from 5 schools in China between August 2022 and December 2022. The Growth Mindset Scale, the PERMA profiler and the Learning Engagement Scale were used to investigate the effect of a growth mindset on learning engagement and the mediating effect of well-being.

RESULTS

Both a growth mindset (r = 0.272, p < 0.01) and well-being (r = 0.693, p < 0.01) were positively correlated with learning engagement, and a growth mindset (r = 0.363, p < 0.01) was positively correlated with well-being. Well-being completely mediated the relationship between a growth mindset and learning engagement.

CONCLUSIONS

The growth mindset and well-being of nursing students are related to learning engagement. Therefore, schools can change students' thinking mode by carrying out positive education to enable students to acquire the ability to maintain their well-being and to improve their well-being and learning engagement.

Views, emotional Reaction, and Bereavement Healing Rituals of Saudi Male Nursing Students: A Qualitative Approach

AIM

The study described the perception and attitude of Saudi male nursing students towards death and dying.

METHODS

This qualitative study recruited Twelve male Saudi nursing students from Nursing Department at University, Riyadh, Saudi Arabia. Data collection was conducted using unstructured one-on-one online interviews from January to February 2021 using thematic approach to analyse the data.

RESULTS

The result of the study presented three themes. The first theme describes the Muslim Saudi male nursing student's religious beliefs and practices in terms of three concepts. The second theme is the emotional reaction of the participants. The third theme is bereavement healing rituals.

CONCLUSION

The knowledge on how nursing students with an Islamic belief view the concept of death and dying provides valuable and critical information on developing educational intervention as well as course and training contents that needs to be included in developing the competencies of these students.

Using palliative and end-of-life simulation to enhance pre-licensure nursing students' emotional intelligence, palliative care knowledge and reflective abilities: A single group, pretest-posttest study

BACKGROUND

Nursing students have reported that they lack skills and knowledge in palliative and end-of-life care, and as a result, they faced numerous challenges caring for patients and families receiving palliative and end-of-life care during clinical attachments.

OBJECTIVES

To develop a palliative and end-of-life care simulation program and evaluate its effects on nursing students' emotional intelligence, palliative care knowledge and reflective abilities.

DESIGN

A single group, pretest-posttest quasi-experimental study.

SETTINGS

A simulation center in a Singapore university.

PARTICIPANTS

A convenience sample of 135 third-year undergraduate nursing students.

METHODS

Students attended a two-day simulation program consisting of four scenarios in total. Outcomes were measured before and after the study. Palliative care knowledge was measured using the Palliative Care Knowledge Test, emotional intelligence using the Trait Meta-Mood Scale-24, and reflective abilities using the Groningen Reflective Ability Scale. Outcome and demographic data were analyzed using descriptive and inferential statistics.

RESULTS

Total Palliative Care Knowledge Test scores (p = 0.003) and total Trait Meta-Mood Scale-24 scores (p < 0.001) improved significantly, but there was no significant change in Groningen Reflective Ability Scale scores (p = 0.650). Demographic characteristics did not significantly influence most outcome variables. Students' highest education level and experience with caring for a person receiving palliative or end-of-life care significantly affected the posttest scores of the Palliative Care Knowledge Test. Students with prior experience in caring for a person receiving palliative or end-of-life care scored significantly better in the Palliative Care Knowledge Test post-simulation compared to those who did not (p = 0.011).

CONCLUSIONS

The palliative and end-of-life simulation program significantly improved nursing students' emotional intelligence and palliative care knowledge. Further research is needed on developing a reliable tool to measure nursing students' palliative care knowledge. Future simulations should include structured and deliberate reflection features aside from debriefings to enhance reflective abilities, which is an important nursing competency. More research is needed on the effect of palliative and end-of-life care simulations on emotional intelligence and reflective abilities, and the influence of demographic variables on nursing students' outcomes.

Ethics education: Nurse educators' main concern and their teaching strategies

BACKGROUND

To practice nursing ethics, students must first understand the ethical concepts and principles of their profession, but despite this knowledge, students face challenges in implementing ethical principles in clinical settings. The educational performance of nurse educators is critical in resolving these challenges. This study focused on the lived experiences of nurse educators.

OBJECTIVE

To address the main concern of educators when teaching ethics to undergraduate nursing students and how they deal with it.

RESEARCH DESIGN

We conducted this qualitative content analysis in Iran in 2020. We used individual semi-structured interviews to collect, record, and transcribe data, as well as Graneheim and Lundman method to analyze them.

PARTICIPANTS

and research context: We used purposive sampling to select 11 nurse educators who either were currently in the position of ethics educators or had taught ethics from Iranian universities of medical sciences.

ETHICAL CONSIDERATIONS

The present study received the code of ethics No. IR.MODARES.REC.1399.036. Participants were aware of the study's purpose and signed a consent form to participate in the study. We considered data confidentiality and the voluntary principle in data collection.

FINDINGS

Nurse educators' main concern was how to sensitize students to ethical principles in clinical settings, so they tried to involve students in the teaching process, to repeat and practice ethical principles and concepts, simplify and simulate ethical principles and concepts, and provide opportunities for students to gain clinical experiences.

DISCUSSION

To sensitize students to ethical nursing care, nurse educators try to institutionalize ethical principles using different teaching methods, including students' involvement in teaching, experiential learning through simulated situations, practice, repetition, and provision of opportunities for practice and experience.

CONCLUSION

Improving students' cognitive ability and objectifying moral concepts and principles for students will institutionalize moral values in them that are fundamental for their moral sensitization.

Measuring Nursing Student Development Through Computer-Based Simulation Activities

BACKGROUND

New nurse attrition jeopardizes patient safety, devastates career plans, and negatively impacts costs to hospitals and patients. Employers and educators recognize the widening transition-to-practice gap in meeting expectations for practice-ready, resilient nurses.

PURPOSE

The purpose of this study was to test the use of computer-based simulation activities (CBSAs) to measure processes in Aller's Development of Decision-Making and Self-Efficacy Model (ADD-SEM).

METHODS

BSN students (N = 50) in a multisite, cross-sectional study used CBSAs to provide data on decision making (Virtual Patient Lasater's Clinical Judgment Rubric), psychological capital (Nursing Anxiety and Self-Confidence in Decision-Making Scale©), and reflection.

RESULTS

Repeated-measures analysis of variance and reflexive thematic analysis revealed that decision-making (DM) scores were highest in noticing and lowest in interpreting with significant differences in cohorts (DM) (juniors: P < .001; seniors: P = .013) and self-confidence/anxiety ( P < .001).

CONCLUSION

The CBSAs are an effective means of measuring student development of DM and psychological capital needed to retain resilient nurses.

Pre-assessment judgement framework for judging nursing students' performance in clinical placements: A qualitative case study

AIM

This study aims to better understand and articulate the pre-assessment judgement processes commonly used by experienced clinical facilitators when assessing nursing students undertaking clinical placement.

BACKGROUND

In the Australian context, clinical facilitators are registered nurses who primarily educate, monitor, support and assess groups of nursing students on clinical placements without carrying a patient load. The duties and scope of clinical facilitators may differ across international and institutional contexts. However, the core concepts of this paper will be relevant despite these differences as the importance of facilitators' confidence in making pre-assessment judgements of individual nursing student performance while on placement is universally acknowledged. Nursing students are often assessed on their provision of safe practice, patient task-orientated outcomes and professional behaviour. Clearly articulating performance judgements prior to formal assessment is vital to ensure progressive learning of students. Literature reports that many clinical facilitators lack confidence in the art of making performance judgements and call for targeted professional training and support in the clinical assessment of nursing students. To better understand and address this problem, clinical facilitators need a shared understanding of how individual nursing students' pre-assessment performance judgements are reached during placement experiences.

DESIGN

A qualitative case study was used, with data collected via semi-structured interviews. Fifteen Australian clinical facilitators participated, each with over six months of experience.

METHODS

Interview transcripts were analysed through an interpretive-constructivist paradigm. Thematic analysis revealed themes that were then deductively described through the application of the Cognitive Continuum Theory.

RESULTS

Six modes of pre-assessment judgement emerged from the data synthesis process: 1) Recognising patterns, 2) Acknowledging uncertainty, 3) Understanding key players, 4) Verifying or refuting the information, 5) Benchmarking performance and 6) Contextualising information. Each mode is validated through the deductive application of the Cognitive Continuum theory.

CONCLUSIONS

Understanding how experienced clinical facilitators make pre-assessment performance judgements has the potential to increase confidence in performance judgement decisions. In turn, confidence in judgements will increase clinical facilitator's capacity to give nursing students feedback that can be explained and justified. The pre-assessment judgement framework also provides a preliminary model for teaching the art of reaching accurate performance judgements to clinical educators in disciplines beyond nursing.

Addressing the Mental Health of Nursing Students During the Pandemic: The Evaluation of a Needs Assessment by a College of Nursing Mental Health Task Force

BACKGROUND

A Mental Health Task Force (MHTF) was developed in a large public college of nursing in the Southeastern United States to address the urgent mental health needs expressed by growing numbers of nursing students related to the coronavirus disease 2019 (COVID-19).

AIMS

The purpose of this study was to report on a needs assessment conducted by the MHTF.

METHODS

The needs assessment study design was a 16-item cross-sectional online survey and four "Town Hall" focus groups with nursing students, faculty, and staff (n = 1-8 participants per group). Survey data were analyzed using descriptive statistics and free-text questions from the survey and focus groups were analyzed using a qualitative descriptive approach.

RESULTS

Undergraduate and graduate students (n = 115) ranging in age from 17 to 50 years completed the survey; 95% female, 94% full-time, 56% employed, 77% White, and 81% in the Bachelor of Science in Nursing program. Eleven students participated in the focus groups. The analysis of the free-text survey questions identified the students' perceived needs. Mental health care was the most frequently requested, followed by faculty check-ins, stress management, and peer support.

CONCLUSIONS

The administration of the survey provided an opportunity for students to communicate concerns and make requests. To address the ongoing effects of the COVID-19 pandemic on nursing students, multi-modal needs assessments should be conducted periodically to identify priority mental health needs.

Exploring the Impact of the COVID-19 Pandemic on Academic Burnout Among Nursing College Students in China: A Web-Based Survey

BACKGROUND The COVID-19 pandemic has brought changes and challenges to nursing students. However, little is known about the prevalence of academic burnout among nursing students in this challenging circumstance. This study aimed to assess nursing student academic burnout and its influencing factors. MATERIAL AND METHODS We conducted a sample survey of a 4-year undergraduate nursing university in Wuhu, Anhui Province, China. The social-demographic information questionnaire, Academic Burnout Scale, Connor-Davidson Resilience Scale, Impact of Event Scale-6, Patient Health Questionnaire-2, and Professional Identity Scale were used. Stepwise multiple linear regression was used to clarify the relationship among sociodemographic characteristics, resilience, and academic burnout. RESULTS Of all the study participants, 51.30% had a certain degree of academic burnout. Academic year, satisfaction with specialty, satisfaction with online learning, professional identity, and psychological resilience were negatively correlated with academic burnout among nursing students. Depression was positively correlated with academic burnout. CONCLUSIONS Nursing students had a high degree of academic burnout. Academic year, satisfaction with specialty, satisfaction with online learning, professional identity, and psychological resilience were protective factors that reduced nursing students' academic burnout.

Health coaching for undergraduate nursing students: a pilot study for an action research

BACKGROUND AND AIM

The Nursing undergraduate degree educational program represents an intensive and complex course, and includes a number of professionalizing practical internships, and for these reasons it requires an action to support and improve. Coaching is based on the premise that people have personal strengths and abilities which, through a interview, can be directed to solving their problems. Several studies demonstrate the efficacy of Health Coaching in different University, but never have been measured benefits regard skills improving. The objective of the study is to assess the impact of a health coaching program on the nursing students.

METHOD

A pre-post quasi-experimental study was conducted, involving the activation of a Health Coaching Program for 25 nursing students selected through convenience sampling, based on their fulfillment of the inclusion criteria. The Health Coaching Program was administered by the Health Coaching Academy.

RESULT

This study also evaluated parameters such as: level of concentration in study, motivation, problem solving and reorganization skills, study organization skills, psycho-physical-emotional state comprehension, decision-making skills and self-esteem, noting a statistically significant increase post-HC program. A statistically significant improvement was also found in the students' perception of their own stress management skills after the course.

CONCLUSION

This study strengthens the hypothesis that HC programs contribute to improving performance of nursing students. Those conclusions need to be corroborated by future studies on the topic to further support the hypothesis that programs of HC within the learning nursing contexts can lead to a tangible benefit for students of the health professions.

Experience of verbal violence among Chinese nursing students in clinical practice: a qualitative study

BACKGROUND

Workplace violence is prevalent in the nursing profession, and as a relatively junior link of the professional hierarchy, nursing students are not immune to it. Among these, verbal violence may have more serious consequences for the victims than physical violence, but the literature on verbal violence among nursing students in Chinese clinical settings is limited.

AIMS

To explore the verbal violence experience among Chinese nursing students in clinical practice, and the strategies used by nursing students to cope with violence.

DESIGN

A descriptive qualitative study.

METHODS

From January 2022 to June 2022, semi-structured interviews were conducted with 21 nursing students in clinical practice by purposive snowball sampling. Nvivo12 software and inductive content analysis were used for data analysis. This paper followed the COREQ (Consolidated criteria for Reporting Qualitative Research) guidance.

RESULTS

Through data analysis, three themes were defined:(1) Multiform verbal violence; (2) Hurting and impacting and (3) Struggling or Coping. The findings indicated that nursing students were subjected to multiple forms of verbal violence in clinical practice, not only from patients and caregivers, but also from peers such as clinical tutors and doctors, which not only harmed students' personal health and well-being, but may also contribute to the nursing industry's future loss of human resources. Seeking emotional support from others and forcing themselves to grow up were the most commonly used coping strategies.

CONCLUSION

Nursing educators and nursing managers need to pay attention to verbal violence in the clinical environment, and actively develop the ability of nursing students to deal with uncivilized behavior. Establishing relevant courses and training such as communication, resilience, and violence prevention, establishing a stricter clinical mentor appointment system, and teaching assessment system may be strategies to help nursing students better perform clinical practice.

Self-compassion among Undergraduate Nursing Students at a State University in Indonesia during the COVID-19 Pandemic

OBJECTIVE

To determine the level of self-compassion and investigate the relationships between sociodemographic variables and self-compassion among undergraduate nursing students at a state university in Indonesia during the COVID-19 Pandemic.

METHODS

This study used a cross-sectional design. Samples were selected using a proportionate stratified random sampling technique (n=260). Data were collected using an Indonesian version of the Self-compassion Scale, which consists of 6 subscales: self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification. Data were analyzed using univariate and bivariate analysis.

RESULTS

60% of students had moderate self-compassion. Students scored the highest in self-kindness (3,93±1,02) and over-identification (3,58±0,94), indicating that they often tried to love themselves when they felt emotional pain and often get carried away when something upsetting happened. Subsequently, a significant correlation was found between age and self-compassion (p<0.05).

CONCLUSION

Self-compassion among nursing students should be improved through interventions such as compassion literacy, mindfulness training, and compassion-based experiential techniques.

Learning strategies of undergraduate nursing students during the COVID-19 pandemic

OBJECTIVES

to analyze the learning strategies used by nursing students from a public university, in remote teaching, during the COVID-19 pandemic.

METHODS

a cross-sectional study developed with nursing students who attended remote teaching classes. The sample was obtained by convenience and data were collected online, with 112 participants. Student and Mann-Whitney tests were performed for data analysis.

RESULTS

the most frequently used learning strategies were self-regulatory and cognitive. There was moderate use of interpersonal help-seeking and emotional control strategies. Male students, with a private study environment and good internet connection, used emotional control strategies more frequently.

CONCLUSIONS

self-regulatory and cognitive learning strategies, appropriate for higher education, were frequently used by nursing students, which is an important tool for adapting these students to the university context.

Protecting the mental health of the future workforce: exploring the prevalence of cognitive distortions among nursing students

BACKGROUND

Evidence suggests that stress and anxiety are commonly experienced by nursing students. Cognitive distortions, or negative thinking styles, are linked to stress and anxiety and have been shown to have a detrimental effect on mental health. Therefore, identification of cognitive distortions among nursing students may serve to prevent the development of mental health issues among this population.

AIM

To explore the prevalence of cognitive distortions among a sample of nursing students, identify which types were more common and determine how these types varied by sociodemographic characteristics.

METHOD

A cross-sectional online questionnaire survey was conducted with undergraduate nursing students at a university in Palestine. All students enrolled during the 2020-21 academic year ( n =305) were invited to participate, of whom 176 responded.

RESULTS

Of the 176 students who responded, 9 (5%) had severe levels of cognitive distortion, 58 (33%) had moderate levels, 83 (47%) had mild levels and 26 (15%) had healthy levels. Of the nine types cognitive distortions described in the questionnaire, respondents engaged most in emotional reasoning, followed by perfectionist thinking and 'What if?'

QUESTIONS

The cognitive distortions that respondents were least likely to engage in were polarised thinking and overgeneralising. Single, first-year and younger respondents had a significantly higher level of cognitive distortions.

CONCLUSION

The results emphasise the importance of identifying and managing cognitive distortions in nursing students, not only in the mental health clinics at the university where the study took place, but also in preventive well-being services. Universities should prioritise nursing students' mental health.

Interdisciplinary simulation for nursing and medical students about final conversations: Catalyzing relationships at the end of life (CAREol)

OBJECTIVES

Final conversations (FCs) go beyond how patients want to be cared for at the end of life (EOL) and focus on messages of love, identity specific, and unique to an individual and relationship that requires self-examination, everyday talk that normalizes a difficult situation, religious/spiritual messages, and if needed, difficult relationship talk to heal broken relationships. The purpose of the Catalyzing Relationships at the End of Life (CAREol) program was to provide interdisciplinary education to nursing and medical students and clinical faculty about facilitating FCs among patients and families.

METHOD

This two-part, quasi-experimental program consisted of a cognitive (online) and experiential (live simulation) curriculum experience. Program curriculum, including video vignettes, readings, and live simulation (utilizing actors), was developed by the study team. Reflective journaling and researcher designed pre- and post-tests were used to assess comfort, confidence, importance, and distress regarding FCs and collaboration with other disciplines.

RESULTS

The pre-/post-test questions demonstrate statistical significance based on a paired t-test with effect sizes supporting the practical importance of the findings for effect size. Preliminary content and thematic analysis of qualitative responses describe categories of the mock team meeting experience and interaction with the actors to change patient and family outcomes.

SIGNIFICANCE OF RESULTS

Early intervention with the CAREol program provides a framework to help students and clinical faculty facilitate FCs that may result in peace and comfort for patients and families during a difficult time.

"It Is OK Not to Be OK": Nursing Students' Backgrounds and Perceptions of Mental Health Stigma and Implications for Mental Health Nursing Education

There has been a notable increase in reported mental illnesses in recent years. Although mental illness is being discussed more openly, stigma toward mental illness still exists. Stigma can result in inadequate care for people with mental illnesses. Students come into nursing from a variety of backgrounds and these backgrounds influence their nursing clinical judgments, especially related to caring for people with mental illnesses. A qualitative descriptive analysis was conducted using 60 undergraduate nursing student reflections on their backgrounds and perceptions of mental health stigma. Students wrote about their Previously Held Beliefs and the Influence of Culture, Overcoming Stigma through their Experiences with Friends and Family, Influence of Popular Culture, and Personal Experiences, and their New Understanding of mental illness and what that means for their future nursing practice. These findings have important implications for nursing education including providing more opportunities for nursing students to care for people with mental illnesses, reframing how mental health content is delivered in undergraduate nursing programs, and providing additional support for students with personal mental illnesses.

Combating Social Isolation in Older Adults: An Intergenerational Nursing Communication Project

The importance of social connection to health and well-being has long been recognized. Social isolation is prevalent and impactful in the lives of older adults across care settings. A semester-long communication-focused clinical project was developed and piloted with sophomore Bachelor of Nursing Science students during Fall 2020 and replicated in Fall 2021 and 2022. Students were paired with older adult volunteers/mentors from a senior living organization and contacted mentors every 2 weeks over the 15-week semester. Older adult volunteers served as mentors, sharing their wisdom and life experiences. Students practiced their communication skills and learned about their mentor's life. Pre- and post-activity surveys of student attitudes toward older adults/aging suggested a dramatic and positive shift in perspective, and mentors rated the experience highly favorably. Intergenerational communication and relationship building has the potential to combat social isolation, promote healing and growth, and enable mutually beneficial engagement. [Journal of Psychosocial Nursing and Mental Health Services, 61(10), 7-11.].

Problematic internet use and psychological distress among student nurses: The mediating role of coping skills

Problematic internet use has become a growing concern among student nurses, posing potential risks to their well-being and academic performance. Yet, the extent to which coping skills can help alleviate the adverse effects of problematic internet use on the psychological well-being of student nurses remains largely understudied. This study examined the mediating role of coping skills in the relationship between problematic internet use and psychological distress among student nurses. This cross-sectional study was conducted to collect data from 279 student nurses enrolled in a public-funded nursing school. Mediation analyses were conducted using the PROCESS Macro with Model 4. Findings showed that student nurses reported moderate levels of problematic internet use with a mean score of 2.233 (SD = 0.765). Several factors strongly predicted problematic internet, including being on the 3rd year of education (β = -0.261, p < 0.001), having an average academic performance (β = 0.184, p = 0.006), and using the internet for <3 h per day (β = -0.304, p < 0.001). Problematic internet use was significantly associated with increased psychological distress (β = 0.1791, p < 0.01). Coping skills were found to mediate the relationship between problematic internet use and psychological distress (β = 0.0160, SE = 0.0095). Overall, this study sheds light on the determinants of problematic internet use among student nurses and its negative impact on psychological well-being. By addressing problematic internet use and promoting healthy coping mechanisms, nursing education can better prepare student nurses to maintain their well-being and academic performance in the digital age.

"Untold and unexpected clinical practice stress," nursing students' experience of disgust: A phenomenological approach

BACKGROUND

In the clinical learning environment, nursing students often face situations that cause physical disgust. Previous studies have shown that more than half of the students experienced disgust, and that high disgust sensitivity in students was related to negative results in terms of academic and caring behavior.

OBJECTIVES

This study aims to understand the experience of disgust felt by nursing students in a clinical learning environment.

DESIGN

A qualitative study using phenomenological method.

METHODS

In-depth, one-on-one interviews were conducted with 18 nursing students at a university in South Korea. The data obtained through the interviews were used to explore the essential structure and meaning of disgust using phenomenological analysis.

RESULTS

This study derived four categories, nine theme clusters, and twenty-one themes. The four categories were "fear that stimulates the senses," "untold and unexpected clinical practice stress," "ambivalence towards myself and patients," and "struggling to become a nursing professional."

CONCLUSIONS

Nurse educators must be aware that nursing students may feel disgust in clinical settings and are therefore under stress. They must also assist students so that their concerns caused by emotions that they cannot easily reveal do not affect their nursing careers.

Learning Nursing Skills of Practice Virtually: The Rough Ground of Engagement

BACKGROUND

In spring 2020, nursing education programs abruptly transitioned the teaching and learning of nursing practice skills to virtual environments as the result of the coronavirus disease 2019 (COVID-19) pandemic.

METHOD

This study sought to describe ethnographically how faculty and students formed and integrated clinical judgment and other nursing practice skills within this quickly formed virtual subculture. Thirty-seven associate-degree nursing students participated in small group interviews, and four faculty participated in one-to-one interviews.

RESULTS

Two overarching themes were identified: (1) the pervading mood of learning through the pandemic; and (2) the primacy of the nursing traditions of direct care experience. Themes were nested further within the five essentials for human learning: curiosity, authenticity, emotion, sociality, and failure.

CONCLUSION

Virtual simulation cases with focused prebriefing and debriefing sessions provided experiences that were targeted, shared, guaranteed, and safe. Adequately supported virtual simulation platforms can enhance the learning of nursing skills. [J Nurs Educ. 2023;62(10):541-547.].

The Effects of Low-Fidelity Simulation on Students' Perceived Abilities to Build Therapeutic Relationships

BACKGROUND

The combination of nursing student anxiety toward patients with mental health conditions, along with their unpreparedness for exercising active listening, empathy, and self-awareness in clinical situations, creates a barrier to achieving therapeutic nurse- patient relationships.

METHOD

A quantitative quasiexperimental study with a one-group pretest-posttest design was used to determine whether a low-fidelity communication simulation laboratory would decrease nursing students' perceived anxiety levels toward mental health patients and increase students' perceived empathy, self-awareness, and active listening levels.

RESULTS

After completing the communication simulation laboratory, students' anxiety decreased significantly (p < .001) and active listening increased significantly (p < .001); empathy and self-awareness levels were relatively unchanged.

CONCLUSION

Using a communication simulation laboratory effectively decreased nursing students' perceived anxiety levels toward patients and improved their perceived active listening skills. The findings of the study support the use of low-fidelity simulations to prepare students for psychiatric nursing clinical practice. [J Nurs Educ. 2023;62(10):575-579.].

Fostering Nursing Students' Growth in Patient Teaching and Empathy Toward Homeless People

ABSTRACT

Helping nursing students explore personal perceptions toward the poor can support students' ability to care for impoverished people in their later nursing practice. A community-based mental health clinical site at a transitional housing complex for the homeless provided a meaningful experience for accelerated baccalaureate nursing students. Students offered basic health screening to the low-income residents and participated in a virtual health education question-and-answer meeting with former transitional housing residents. Through reflective journaling, students described how they gained empathy and new understanding of the needs of people living in poverty or unhoused, and developed confidence in patient teaching.

Emotional and Psychological Effects of the COVID-19 Pandemic on Nursing Students

ABSTRACT

The COVID-19 pandemic impacted the mental health and educational experiences of nursing students in undergraduate and graduate programs. A larger mixed-methods study aimed to understand how COVID-19 impacted personal lives and learning experiences of students across all programs levels. This article reports on qualitative data obtained from focus groups organized by student program level. Six themes emerged, including fear and uncertainty, trust in God, educational and career concerns, concerns about family, mental health issues, and isolation/lack of human touch. Key areas covered are the emotional and psychological effects of COVID-19 and its factors and the role of faith during COVID-19 among nursing students.

The impact of COVID-19 on stress and resilience in undergraduate nursing students: A scoping review

BACKGROUND

Being a nursing student can be a stressful experience, faced with considerable academic and clinical demands. It has been suggested that the Coronavirus Disease 2019 (COVID-19) may have further exacerbated the pressure nursing students face. It has been posited that resilience, a complex psychological concept, may help nursing students overcome stressful situations.

AIMS

The aim of this scoping review was to examine the relationship between resilience and stress in nursing students during the COVID-19 pandemic.

METHODS

Relevant publications were identified by a comprehensive search of the literature from January 2019 to September 2022 to capture relevant publications during the COVID-19 global pandemic period from the following databases: CINAHL, Medline Complete, APA PsycInfo, Ovid EmCare and Web of Science. Fifteen studies met our inclusion criteria and were included in the review using Arskey & O'Malley's (2005) methodological framework for scoping reviews.

RESULTS

Our findings suggest that nursing students from all around the world have experienced high levels of stress during the COVID-19 pandemic. Almost unanimously, resilience was identified as a key protective factor against stress and the development of psychological morbidity. Those nursing students with higher levels of resilience were deemed more likely to stay on track with their studies, despite COVID-related challenges.

CONCLUSION

In conclusion, this scoping review adds to the well-established argument to incorporate resilience-building activities in undergraduate nursing curricula. Developing levels of resilience has the potential to empower nursing students for academic and clinical success, whilst facing the challenges of an ever-changing world.

The effectiveness of learning strategies for the development of Emotional Intelligence in undergraduate nursing students: A systematic review protocol

AIM

This protocol proposes a systematic review to identify and disclose learning strategies and evaluation tools to improve Emotion Intelligence (EI) in undergraduate nursing students.

BACKGROUND

EI improves the ability to manage emotions and their consequences. Management of emotions is fundamental in nursing both at inter- and intra-professional levels, and with the patients and their family carers.

DESIGN

Systematic review protocol of effectiveness based on the Joanna Briggs Institute (JBI) guidelines.

REVIEW METHODS

All articles based on educational programmes and/or activities to develop EI in nursing curricula will be included in the review. It will analyse the principle EI attributes and outcomes such as burnout, intention to leave and problem-solving skills. Based on the review question, seven databases will be searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, EMBASE, PsycINFO and ERIC. Also, grey literature (Google Scholar and Open Gray) will be searched. Since no similar systematic reviews are present in the literature, no time limits will be set. To establish the quality of studies JBI tools will be used. When appropriate, we will meta-analyse prevalence and incidence estimates or we will meta-synthesize themes and findings.

EXPECTED RESULTS

This systematic review is expected to provide an overview of educational and training methods, pedagogical strategies and evaluation tools to address EI in nursing and provide high-quality care to patients and their families. Results of the review will support nursing educators and leaders in implementing teaching and learning strategies to improve the Emotional Intelligence of undergraduate nursing students.

CONCLUSIONS

Mastering emotions is fundamental for nurses. Implementing education courses based on EI according to the best training methods and pedagogical strategies could become key for nursing curricula. Moreover, after the review, it will be possible to identify the best training methods and pedagogical strategies for implementing continuing professional development (CPD) courses in EI in the courses of following graduation.

Nursing students' academic conditions, psychological distress, and intention to leave school: A cross-sectional study

BACKGROUND

Psychological distress and intention to leave school are highly prevalent among nursing students. Academic conditions, including psychosocial stressors and school-work-life conflicts, could contribute to psychological distress and intention to leave school.

OBJECTIVE

To explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

DESIGN

Cross-sectional correlational design.

SETTINGS

Data collection was performed in February and October 2021 in two nursing schools in Canada: Cegep (publicly funded college, technical degree) and university (bachelor's degree).

PARTICIPANTS

230 nursing students (Cegep 131, university 99).

METHODS

A self-administered online questionnaire assessed academic conditions (psychosocial stressors (Demand-Control-Support, Effort-Reward Imbalance and Overcommitment scales) and school-work-life conflicts (single item)), psychological distress (Kessler-6 scale), intention to leave school, and several covariates. Poisson robust multivariate regression models were built to explore the associations between academic conditions and 1) psychological distress and 2) intention to leave school.

RESULTS

A large proportion of participants experienced high efforts, school-work-life conflicts, overcommitment, and psychological distress (49.5-84.7 %). One out of five participants had had intention to leave school "many times" (Cegep 20.61 %; university 22.22 %). In adjusted analysis, overcommitment and school-work-life conflicts were associated with a higher prevalence of psychological distress (Prevalence ratio = 2.10; 95 % Confidence Intervals = 1.15-3.84 and Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.24-4.32, respectively). Adverse associations were observed between effort-reward imbalance (Prevalence ratio = 2.32; 95 % Confidence Intervals = 1.09-4.94) as well as school-work-life conflicts (Prevalence ratio = 2.40; 95 % Confidence Intervals = 1.05-5.45) and intention to leave school.

CONCLUSIONS

Academic conditions might be risk factors for psychological distress and intention to leave school among nursing students. Interventions targeting modifiable academic conditions might improve nursing students' mental health and retention.

Effects of blended learning on undergraduate nursing students' knowledge, skills, critical thinking ability and mental health: A systematic review and meta-analysis

AIM

This study aimed to evaluate the effects of blended learning on nursing students. The primary outcomes include knowledge and skills, and the secondary outcomes include critical thinking ability, mental health, blended learning design, and nursing students' attitudes toward blended learning.

BACKGROUND

Blended learning combines the advantages of online learning and traditional face-to-face learning, and makes up for the disadvantages of simple online learning or traditional learning. The effects of blended learning on the knowledge, skills, critical thinking ability, and mental health of nursing students were unknown.

DESIGN

Systematic review and meta-analysis.

METHODS

The present systematic review and meta-analysis was applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Publications were searched in PubMed, Web of Science, EMBASE, ERIC, CINAHL and the Cochrane's Library before February 2023. Two researchers independently retrieved articles and evaluated quality. The meta-analysis was performed using Stata 12.0 software according to PRISMA guidelines. The risk of bias in the selected studies was evaluated using the Revised Cochrane risk-of-bias tool for randomized trials. Heterogeneity was assessed by I2 and P statistics. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used as effective indicators.

RESULTS

A total of 26 studies involving 2823 nursing students were included in the present study. The results showed that blended learning courses were designed based on learning theory. Blended learning was more effective on the knowledge (SMD = 0.73, 95%CI [0.37, 1.09]) and skills (SMD = 0.86, 95% CI [0.35, 1.37]) compared with non-blended learning for nursing students. Critical thinking ability improved significantly through BL (SMD = 2.23, 95% CI [0.85, 3.61]). In addition, blended learning had a positive impact on nursing students' mental health. Nursing students were very satisfied with blended learning.

CONCLUSIONS

The results of this study indicated that blended learning had a positive impact on nursing students. In the future, the optimal ratio of online to offline learning in blended learning should also be explored.

Improving the knowledge of and compliance with infection control for emerging respiratory infectious diseases among nursing students using importance-performance analysis: A descriptive survey study

BACKGROUND

Due to a lack of prior training on emerging respiratory infectious diseases (ERIDs), systematic nursing guidelines, supplies, and manpower, nurses experienced extreme physical and psychological stress while providing care to patients with infectious diseases during the pandemic.

OBJECTIVES

This study aimed to investigate the knowledge of and compliance with infection control for ERIDs among nursing students, as well as identify the priorities in infection control knowledge and compliance using importance-performance analysis (IPA), to prepare supporting data for developing infection control training programs for ERIDs.

DESIGN

This descriptive survey used IPA to examine nursing students' knowledge of infection control priorities and ERID compliance.

SETTING

The participants were recruited from a convenience sample of first- to fourth-year nursing majors from one region of South Korea.

PARTICIPANTS

Data were collected from 481 nursing students through a questionnaire survey conducted between May 3 and June 30, 2022.

METHODS

Data were examined using descriptive statistics, an independent t-test, a one-way analysis of variance, and IPA.

RESULTS

The IPA results showed that among 12 items related to nursing students' knowledge of infection control for ERIDs, item #1 (definition of ERID) belonged to quadrant C (low priority), whereas all other items (items #2-12) belonged to quadrant A (concentrate here). Among 12 items related to compliance with infection control for ERIDs, items #2 (hand hygiene) and #3 (mask wearing) belonged to quadrant B (keep up the good work), whereas the remaining 10 items belonged to quadrant A (concentrate here).

CONCLUSION

In order to improve nursing students' knowledge of and compliance with infection control for ERIDs, infection control training with more specific material should replace the present curriculum in South Korea.

Nursing students' perceived stress, social support, self-efficacy, resilience, mindfulness and psychological well-being: A structural equation model

Nursing students' stress, protective factors (e.g. resilience, social support, mindfulness and self-efficacy) and psychological well-being (PWB) have been well reported in the literature. However, the interactions of these variables were scarcely examined in the latter part of the COVID-19 pandemic and in the context of a developing country. This cross-sectional correlational study complying with STROBE guidelines tested a hypothetical model of the interrelationships of nursing students' stress, protective factors and PWB using structural equation modelling (SEM). Nursing students (n = 776) from five nursing schools in the Philippines were conveniently recruited from September 2022 to January 2023. Six validated self-report scales (Perceived Stress Scale, Multi-dimensional Scale of Perceived Social Support, Generalized Self-Efficacy Scale, Connor-Davidson Resilience Scale, Mindful Attention Awareness Scale, and Psychological Wellbeing Scale) were used to collect data. SEM, mediation analyses and path analyses were used for data analysis. The emerging model demonstrated acceptable model fit parameters. Stress negatively impacted protective factors, while all the protective factors positively influenced PWB. Social support mediated the influence of stress on resilience, mindfulness and PWB. Resilience is a significant mediator of stress, self-efficacy, social support and PWB. Mindfulness mediated the influence of stress, social support and self-efficacy on PWB. Finally, self-efficacy had a mediating role between resilience and mindfulness. Nursing institutions and nurse educators can use the proposed model as their basis for empirical and theoretical evidence in creating programmes that will strengthen nursing students' protective factors, thus reducing stress while improving PWB and learning outcomes.

From students to nurses under pressure: Nursing students' entry into employment during the first COVID-19 wave

AIMS AND OBJECTIVE

To describe the experiences of nursing students and their mental health as they entered employment during the first wave of the COVID-19 pandemic (May-June 2020).

BACKGROUND

As other healthcare professionals, nursing students who worked during the first COVID-19 wave suffered from dysfunctional mental health symptoms.

DESIGN

Sequential, mixed-method, multicentre study.

METHODS

The study population comprised 92 students in the third and fourth year of the Nursing degree at three Spanish universities, who entered employment during the pandemic. Data were collected between May and June 2020. In the quantitative phase, data were collected using an online questionnaire containing both validated anxiety and stress scales. In the qualitative phase, semi-structured interviews were conducted with 18 participants. A descriptive analysis of the quantitative data and a reflexive thematic analysis of the qualitative data were carried out, and analyses were combined. COREQ checklist was used for reporting.

RESULTS

The combined quantitative and qualitative results were organised into five thematic areas: (1) Interruption of clinical placements, (2) Entering employment on a healthcare assistant contract, (3) Preventing contagion, (4) Adapting to the situation and managing emotions, and (5) Lessons learned.

CONCLUSION

The students had a positive overall experience of entering employment, as they were able to develop their nursing skills. However, they had an emotional impact in form of stress caused by excessive responsibility, academic uncertainty, lack of personal protective equipment and training in its use, and the possibility of spreading disease to their family members.

RELEVANCE TO CLINICAL PRACTICE

In the current context, changes must be made in study programmes to instruct nursing students to be able to cope with extreme clinical situations, such as pandemics. The programmes should include a more extensive coverage of epidemics and pandemics and management of emotional aspects such as resilience.

What are nurse practice assessors' priorities when assessing student mental health nurses? A qualitative content analysis

BACKGROUND

UK healthcare policy has observed over a decade of changes that has focussed on healthcare staffs' professional values as a marker for safe, high-quality care In 2018 the regulatory body for nursing and midwifery introduced several new proficiencies, with an emphasis on physical health assessment. However, a global debate has since surfaced regarding the generification of nurse education, which has been thought to have eroded field specific skills in mental health nursing.

AIM

To explore the priorities of practice assessors, articulated within the open comments written within online practice assessment documents.

METHODS

A qualitative study was conducted, with data collected from comments made within online practice assessment documents relating to the ongoing assessment of student mental health nurses at one UK University. 26 individual sets of assessor comments were collected. An inductive content analysis was used to explore the nature of qualitative feedback provided to student mental health nurses, generated by mental health practice assessors. The COREQ checklist was used for the reporting of the study.

RESULTS

Findings demonstrated that practice assessors were prioritising two core areas or broad-based skills categories: 'transactional' and 'transformational' competencies. Transactional competencies related to the practical application of specific tasks. Transformational competencies were commented on more frequently and placed emphasis on the students' personal attributes and characteristics, and how these contribute to 'good' mental health nursing practice.

CONCLUSION

Mental health nurses prioritise assessing student nurses in relation to their personal attributes, work ethic, and values that are congruent with humanist perceptions of mental health nursing.