Theory and practice in the construction of professional identity in nursing students: a qualitative study

The undergraduate nursing students' experience and perceptions of aesthetics education: A qualitative study

BACKGROUND

Nursing's dual identity as an art and a science requires a balance within the curriculum. Aesthetics in nursing education, in the form of a course, a program, or an activity, is helpful to empower future nurses with aesthetic knowledge and competence in caring for patients in an artistic and humanistic way. However, the integration of aesthetics into nursing curricula remains underexplored.

AIM

To describe the undergraduate nursing students' experience and perspectives of aesthetics education, as a reference to the potential benefits and challenges of nursing aesthetics education.

DESIGN

Descriptive phenomenology qualitative approach.

METHODS

Purposive and snowball sampling were used to recruit participants from different provinces in China from July to August 2023. Data were collected through online individual interviews with 16 participants. Data were analyzed using the Colaizzi method.

RESULTS

Three themes and 12 subthemes were extracted. The themes were Growth through internalizing values and externalizing actions, unique connotations of nursing aesthetics, and expectations and suggestions for nursing aesthetic education.

CONCLUSIONS

The students had a deep understanding of aesthetics' role in nursing practice and profoundly improved their personalities, professional competence, and commitment through aesthetics education.

The Correctional Nursing Workforce Crisis: An Innovative Solution to Meet the Challenge

The aim of this article is to (1) review factors contributing to the nursing workforce crisis that also affect the specialty of correctional nursing and (2) describe an innovative programmatic approach to this crisis that includes translational strategies specific to recruitment and retention. A gap analysis led to a 4-phase framework identifying the career pathway for correctional nurses with a focus on recruitment and retention. The design of a correctional nurse recruitment and retention transition-to-practice program is the focus of the article and targets the preemployment phase of the framework. A correctional nurse expert panel reviewed and contributed to the structure and content of the program. Unique to this program is the content focus on professional identity in correctional nursing, which differs from professionalism.

Mediating role of professional identity between clinical learning environment and patient safety attitudes and professionalism in nursing interns

BACKGROUND

Nursing interns' patient safety attitudes and professionalism is important for safety and quality of care. Clinical internship is a core component of nurse education, and the clinical learning environment is considered a crucial factor in nursing interns' patient safety attitude and professionalism.

OBJECTIVES

To evaluate the patient safety attitude and professionalism of nursing interns, and explore latent influencing mechanism of clinical learning environment on it based on the Social Cognitive Theory (SCT) theory.

DESIGN

A cross-sectional study.

METHODS

A convenience sample of 402 nursing interns from 5 general hospitals in southwest China was surveyed between May-July 2023. Data on general information, clinical learning environment, safety attitudes and professionalism, and professional identity of nursing interns were collected. Regression analysis was used to analyze the factors influencing nursing interns' patient safety attitudes and professionalism in the clinical learning environment. The relationship between the clinical learning environment, professional identity, patient safety attitudes and professionalism were examined using Pearson correlation analysis and SPSS PROCESS macro (model 4).

RESULTS

Overall, the participants reported a higher than a moderate level of patient safety attitudes and professionalism (4.11 ± 0.57), while the domain of professionalism need to be improved. Teaching atmosphere of ward (β = 0.185, p = 0.006) and role of general manager in the department (β = 0.390, p = 0.001) were the two key factors for patient safety attitudes and professionalism of nursing interns. The effect of clinical learning environment on the safety attitudes and professionalism was partially mediated by professional identity (β = 0.066, P < 0.05).

CONCLUSIONS

Hospital administrators need to provide nursing interns a clinical learning environment with positive teaching atmosphere and a model role of general manager to increase their professional identity, and ultimately enhance their patient safety attitudes and intentions to safety-related behavior.

Exploring nursing students' reality shock and professional behavioral development in clinical practice: a hermeneutic phenomenological study

Background

The reality shock experienced by nursing students in clinical practice has attracted considerable attention. However, existing studies largely focus on quantitative analysis and overlook the depth of individual experiences.

Objective

This study adopts a qualitative research method and utilizes hermeneutic phenomenology to examine in depth the reality of the shock faced by nursing students during clinical practice, to demonstrate its impact on the development of professional behavior and to provide empirical evidence to improve nursing education.

Methods

A qualitative research method was adopted involving 30 nursing students completing a 32-week clinical internship at a tertiary hospital in Jinhua City. The subjects participated in focus group interviews conducted in three groups to collect information about their learning experiences during the internship. Wiklund's hermeneutic-phenomenological approach was used to analyze and interpret the data.

Findings

From the learning experiences of nursing students in clinical practice, three main themes of "promoting professional nursing behavior" were summarized: (1) Guidance from clinical instructors: The influence of preceptors' words and actions on students' professional behaviors; (2) Inspiration from clinical nurses: Observing experienced nurses enhances students' professional identity; (3) Learning from real-life cases: Clinical cases help students understand the core values of nursing.

Conclusion

Nursing students face emotional challenges and cognitive changes during clinical practice. Clinical instructors should instill positive energy in these students through professional behavior. They should encourage students to observe, analyze, and reflect on the exemplary words and actions of clinical nurses and to obtain authentic feedback through patient interactions to refine their professional behavior. This study can serve as a valuable reference for clinical teachers in supervising nursing students entering clinical practice for the first time and helping them develop their professional nursing behavior.

The impact of career calling on learning engagement: the role of professional identity and need for achievement in medical students

BACKGROUND

Career calling, professional identity and the need for achievement are believed to affect the students' learning engagement and effect. However, their regulatory relationship with medical students remains unclear.

METHODS

Our study surveyed 1250 medical students through a questionnaire, and the correlation of the study variables was analysed. Harman's Single-Factor test was performed on the data to rule out significant common method biases. The mediation effect was determined using the percentile Bootstrap method with deviation correction.

RESULTS

Career calling was positively correlated with professional identity (r = 0.51, p < 0.001) and positively correlated with the need for achievement (r = 0.49, p < 0.001). Learning engagement was positively correlated with professional identity (r = 0.56, p < 0.001) and positively correlated with the need for achievement (r = 0.55, p < 0.001). Professional identity was positively correlated with the need for achievement (r = 0.51, p < 0.001). In addition, professional identity plays a mediating role in the relationship between career calling and learning engagement (β = 0.36, p < 0.001). Additionally, the need for achievement influences how career calling affects learning engagement through professional identity (β = -0.06, p < 0.001).

CONCLUSIONS

Career calling, professional identity and the need for achievement were positively associated with learning engagement in medical students. Professional identity and the need for achievement act as intermediaries between career calling and learning engagement. This study found that strengthening the professional guidance of medical students and enhancing their sense of professional mission could promote their acceptance and identification of their major, enhance their professional identity, create a positive professional atmosphere, and improve learning engagement.

Development of nursing students' professional identity in different mentoring approaches during clinical training: A quasi-experimental study

BACKGROUND

The professional identity (PI) of nursing students' is essential for high quality performance and safe healthcare. Clinical training plays a key role in the development of professional identity during nursing studies.

AIM

The aim of this study was to investigate the impact of individual and group mentoring approaches on the development of PI during clinical training, as well as the influence of the order in which these approaches are applied, and the effect of time on the development of PI.

DESIGN

This study used a quasi-experimental design.

SETTINGS

The study was conducted at the Department of Health Studies in Croatia.

PARTICIPANTS

The 119 first, second, and third year ungraduate nursing students.

METHODS

Students were divided into two groups. Each group performed clinical training in group and individual mentoring approaches, but in different order. The Professional Identity Five Factor Scale (PIFFS) was used to measure PI levels at four different time points: immediately before and after the first and second rounds of clinical exercises.

RESULTS

Both groups of students, achieved approximately average results in all three dimensions of the PI. There was no statistically significant main effect of the group/individual mentoring approach on the dimensions of knowledge (P = 0.471), experience (P = 0.865) or perception of role model and professional future (P = 0.565). The levels of the dimensions knowledge (P = 0.001), experience (P = 0.001) or perception of the role model and professional future (P = 0.002) differed in four measurement points, which indicates a general increase in all three PI dimensions.

CONCLUSIONS

During the performance of the clinical training, the level of PI increased. The group mentoring approach has an immediate effect on increasing knowledge, but this effect diminishes over time. In terms of experience, both mentoring approaches have similar reinforcing effects. However, the individual approach seems to be more suitable for improving the perception of role models and the professional future.

How positive mental well-being influences professional identity and the mediating mechanisms in Chinese nursing students

AIM

To examine the association between positive mental well-being and professional identity in nursing students. The mediating effects of resilience and nurse-patient relationship were explored.

BACKGROUND

Professional identity of nursing students can influence their pursuit of a nursing career. Negative mental health problems, such as anxiety, depression, and high stress, are known risk factors for professional identity. Few studies have examined the association of professional identity with positive mental well-being and underlying mechanisms.

METHODS

This was a cross-sectional study of Chinese nursing students on clinical placement. The Warwick-Edinburgh Mental Well-being Scale, Professional Identity Scale, Connor-Davidson Resilience Scale, Nurse-Patient Relationship Scale, and Patient Health Questionnaire were used, and demographic and study-related characteristics were measured. Multivariable linear regression and mediation analyses analyzed the associations. We followed the STROBE reporting guidelines.

RESULTS

Of 208 participants, the total scores of positive mental well-being and professional identity were at a moderate level. Positive mental well-being was associated with professional identity after adjusting for confounders including the main reason for choosing nursing and negative mental health. Resilience was a full mediator of the association between positive mental well-being and professional identity, whereas nurse-patient relationship was a partial mediator.

DISCUSSION AND CONCLUSION

Positive mental well-being was associated with professional identity in Chinese nursing students on clinical placement, mediated through resilience and nurse-patient relationship. Positive mental well-being can be a facilitator for the professional identity of nursing students, and resilience and nurse-patient relationship could be potential mechanisms for nurse professional development.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Nurse researchers, educators, and policymakers are informed to increase the awareness of positive mental well-being and develop interventions targeting resilience and nurse-patient relationship for building a stable and satisfied nursing team.

Cognitive Flexibility and Professional Identity in Nursing Students: The Modeling Role

BACKGROUND

Students' professional identity is essential to build nursing competence. Cognitive flexibility plays a crucial role in developing professional identity, as well as clinical supervisors and academic teachers through role modeling. This study analyzed the role of internship and theoretical modeling in the link between cognitive flexibility and professional identity.

METHOD

Participants were first-, second-, and third-year nursing students (n = 284) at a university in northern Italy. Participants completed an online survey, and multigroup analysis was performed.

RESULTS

Internship modeling was positively associated with professional identity but not for second-year students. Theoretical modeling was not significantly associated with professional identity and cognitive flexibility. Theoretical modeling did not mediate the relationship between cognitive flexibility and professional identity. Clinical internship modeling mediated the relationship between cognitive flexibility and professional identity but not for second-year students.

CONCLUSION

Internship modeling helps students give sense and coherence to learning, which contributes to their professional identity. [J Nurs Educ. 2024;63(11):764-772.].

Effectiveness of the small private online course-based flipped teaching program for enhancing nursing students' self-directed learning ability in the Surgical Nursing course: A practical study

Small private online course-based flipped teaching is an innovative hybrid instructional approach that merges online and offline activities, fostering autonomous learning among students prior to class and facilitating the assimilation of knowledge within the confines of the classroom. To determine the effectiveness of the small private online course-based flipped teaching model on undergraduate nursing students' self-directed learning abilities, we performed a practice version of the small private online course-based flipped teaching program as a quasi-experiment, specifically designed for the Surgical Nursing course and assessed its effectiveness in students' self-directed learning abilities. To this end, a total of 264 students from the 2019 nursing major cohort were selected. Three classes comprising 131 students were randomly selected as the experimental group, and three other classes, comprising 133 students, were set as the control group. The results revealed no significant differences in the scores of self-directed learning abilities between the experimental and control groups before the experiment. After the experiment, the average scores on each dimension of the self-directed learning abilities improved significantly, and the final score of the experimental group was higher than that of the control group. The small private online course-based flipped teaching model can promote undergraduate nursing students' self-directed learning abilities, owing to its practicality and feasibility for the selected course.

Internship and postgraduate entrance examination: A qualitative study on the psychological experience of undergraduate nursing students under dual pressure in China

Background

With the development of nursing positions and nursing disciplines in China's tertiary hospitals, the number of people applying for the master's degree in nursing is also increasing year by year. Postgraduate examinations are held during internship, so nursing students face the dual pressure of testing and internship, which brings varying degrees of negative experiences and emotional fluctuations.

Objective

To explore the psychological experiences and influencing factors of undergraduate nursing students under the dual pressures of clinical nursing internships and postgraduate examination preparations.

Design

Descriptive qualitative study.

Method

Purposeful sampling was used to recruit 18 participants from eight tertiary hospitals in China between October and December 2023. Semi-structured in-depth interviews were conducted, with interview recordings transcribed verbatim. Thematic analysis was then applied to the data.

Results

Four themes were identified: negative experiences under dual pressures, coping mechanisms for negative experiences, motivational effects under dual pressures, and evaluations of significant individuals. Nursing students improved their overall abilities through internships and exam preparations, gaining a clear understanding of themselves and certain hospital roles. However, at this stage, students also experienced adverse psychological experiences for various reasons. Thus, they employed several methods to alleviate their psychological stress, aiming for a better state to face internships and exam preparations.

Conclusion

Schools and hospitals should pay more attention to the needs of nursing students under dual pressures, monitoring their emotional states, and providing psychological support to enhance their stress-coping abilities. It is important to ensure the overall well-being of students while strengthening the motivational effects of internships and learning experiences.

Changes in the Professional Identity and Self-Efficacy of Nursing Students Engaged in the Objective Structured Clinical Examination Using Simulation Learning

BACKGROUND

The Objective Structured Clinical Examination (OSCE) is widely adopted in nursing education to enhance clinical skills and professionalism. With OSCE, the learning process is important, and students who underwent OSCE felt more confident and better prepared for their next clinical training.

OBJECTIVES

This study aims to clarify how the self-efficacy and professional identity of nursing students change after learning through simulation education and OSCE. Clarification of these issues will allow an OSCE design utilizing simulation-based education as will be discussed.

METHODS

This study used a pre-post study design, and the participants were 74 nursing university students at one university in Japan who agreed to participate in the study. The total scores and subscale scores for professional identity and self-efficacy were compared before and after the OSCE using the Wilcoxon signed-rank test. Spearman's rank correlation coefficient was calculated to examine the relationship between professional identity and self-efficacy.

RESULTS

There were significant increases in self-efficacy scores (p<0.05) after OSCE, but there were no significant changes in the total scores of professional identities before and after the OSCE. Professional identity scores, such as choosing nursing again and desire to improve nursing skills, increased.

CONCLUSIONS

Simulation-based OSCE effectively enhances nursing students' self-efficacy and certain aspects of professional identity, indicating its potential for nursing education.

Registered nurses' perceptions of nursing student preceptorship: Content analysis of open-ended survey questions

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.

The impact of a nutrition course on self-epistemic authority, professional meaning as mediating factors on professional identity among nursing students

BACKGROUND

The professional competence of nursing personnel is integral to the efficacy of nursing procedures. Educational endeavors, especially those encompassing professional training programs, are critical in fostering a professional identity among nurses. The role of nurses within a multi-disciplinary nutrition team has the potential to enhance professional identity and improve the quality of care provided.

OBJECTIVE

This study aimed to explore the potential impact of knowledge acquisition and practical nutrition education on the development of professional identity among nursing school students. Furthermore, we hypothesize that professional autonomy and self-epistemic authority mediated the relationship between a sense of meaning, professional mission, and professional identity.

DESIGN

A cross-sectional survey compared nursing students who had completed a practical nutrition course with those who had not. The study measured professional identity, professional autonomy, self-epistemic authority, and sense of meaning. Data collection was conducted using validated questionnaires, with questions tailored to suit the study demographic. Mediation analysis was conducted on the combined sample of both groups.

PARTICIPANTS

The study included 98 nursing students, divided into a study group (57 students who completed a nutrition course) and a control group (41 students who did not complete the course).

RESULTS

Significant differences were found between the groups in measures of professional identity (t = 3.42, p < .001), professional autonomy (t = 2.93, p < .005), and self-epistemic authority (t = 2.78, p < .007). There was no significant difference in the sense of meaning (t = 1.45, p = .150). Mediation analysis on the combined sample revealed that self-epistemic authority mediated the relationship between professional meaning and professional identity, while professional autonomy did not.

CONCLUSION

The findings suggest that practical nutrition education enhances nursing students' professional identity, autonomy, and self-epistemic authority. Future studies should include larger and more diverse samples to further explore these relationships.

The effects of profession-related films on the professional pride of nursing students: A randomised controlled trial

AIM

This study aimed to determine the effects of profession-related films on the professional pride of nursing students.

DESIGNS

The study was conducted with a randomised controlled experimental design.

METHODS

The sample of the study consisted of 102 students enrolled in the first year of the School of Nursing, Zonguldak Bulent Ecevit University in Türkiye in the 2022-2023 academic year. These students were randomly assigned to the experimental (n = 57) and control (n = 45) groups. The experimental group watched two documentaries and a film on YouTube with a one-week break. Self-administered online questionnaires were distributed via WhatsApp groups for pretests and posttests. Data were collected with a "Sociodemographic Data Form" and the "Nursing Professional Pride Scale (NPPS)" included in the questionnaire forms prepared on the Google Forms platform. Data were analysed using Spearman's rho, the Mann-Whitney U Test, and the Wilcoxon Signed-Rank Test.

RESULTS

The mean age of the participants was 18.80 ± 0.99 years, 80% of the participants were female, the place where 79.4% had lived for the longest duration in their lives was the city, 85.3% had information about the profession of nursing before they started university (36.8% from the internet, 34.6% from people around them). The experimental group had significantly higher NPPS scores than the control group after the intervention (p = 0.017). There was also a significant increase in the dimensions of professional feeling (p = 0.012) and desire to continue the profession in the experimental group (p = 0.002).

PATIENT OR PUBLIC CONTRIBUTION

Patients and public were not involved in this research.

Cultivating Comfort: Examining Participant Satisfaction with Hypnotic Communication Training in Pain Management

Context

One in four Canadians experiences chronic pain, yet insufficient services and restrictions surrounding prevailing treatments result in inadequate management and significant negative consequences for these individuals. Previous work indicates that hypnotic communication represents a promising complementary treatment; however, training protocols for healthcare professionals are underdeveloped and understudied.

Aim

To evaluate the level of satisfaction for a training program on hypnotic communication in pain management clinics.

Design

Qualitative study.

Methods

Six health professionals who first completed the hypnotic communication training participated in 30 minutes virtual semi-structured interviews. These testimonials allowed them to elaborate on their user experience and potential areas for improvement. Thematic analysis using qualitative data management software NVIVO was conducted on the interview data.

Results

Two themes emerged from the interviews. 1) Satisfaction: Participants expressed satisfaction on various structural aspects of the training, including the provided materials, atmosphere, training structure, presentation modalities, practical workshops, acquired knowledge, trainer quality, and training duration. 2) Areas for Improvement: Five main improvement suggestions were identified (providing more material; more practical workshops, more concrete and adapted; testimonials from former patients; follow-up training meeting; and continuing education).

Implications for the Profession and/or Patient Care and Conclusion

The results improved the training program to help minimized inherent biases related to this technique, cut associated costs, and identify reasons that would explain its underutilization among medical professionals in Quebec. Our work highlights that healthcare professionals in chronic pain management clinics (eg, respiratory therapists, nurses) can incorporate this simple hypnotic communication technique into their usual care and contribute to the well-being of patients.

Impact

This study aimed to address the lack of training protocols for healthcare professionals, that are underdeveloped and understudied. The main findings on participant' satisfaction and the areas of improvement for the training will help the refinement of the training to better suit healthcare professional's needs in hospitals and chronic pain facilities.

Professional identity and preparedness for hospital practice among undergraduate nursing students: A cross-sectional study

BACKGROUND

Professional identity is a crucial characteristic that undergraduate nursing students must possess to ensure effective and safe clinical practice. It has been identified as a factor influencing nursing student retention and their intention to remain in the nursing profession. However, the influential factors that impact the development of professional identity among nursing students currently are not well known.

OBJECTIVES

To identify factors determining professional identity among undergraduate nursing students and to confirm the relationship between nursing students' professional identity and their preparedness for hospital practice.

DESIGN

A cross-sectional study.

SETTINGS

The largest public nursing college in Oman.

PARTICIPANTS

180 full-time undergraduate nursing students in their third and fourth years who had completed at least one clinical course.

METHODS

Students completed validated, self-administered paper questionnaires through convenience sampling, including professional identity and preparedness for hospital practice scales.

RESULTS

The mean total score for professional identity was 63.3 (SD = 10.5), indicating a moderate level of professional identity. The findings showed a low level of preparedness for hospital practice among nursing students, with, a mean total score of 165.8 out of 246 (SD = 30.4). We found a significant positive association between professional identity and preparedness for hospital practice (r = 0.43, p < 0.001), the number of clinical courses taken (r = 0.15, p = 0.041), enrolment in fourth-year clinical courses (H (4) = 19.9, p = 0.001), grade (H (3) = 7.8, p = 0.049) and the selection of nursing profession as the first choice (H (3) = 28.0, p = 0.05).

CONCLUSIONS

The study has implications for identifying students with lower readiness for hospital practice and providing them with the necessary training. Nursing educators should prioritize reinforcing professional identity among students who have chosen nursing as a secondary option or have a lower grade. This can be achieved by promoting a positive nursing image and fostering a supportive clinical learning environment.

Transition shock among nursing interns and its relationship with patient safety attitudes, professional identity and climate of caring: a cross-sectional study

BACKGROUND

Nursing interns often experience lots of challenges during their clinical nursing internships, which can adversely affect career decisions and result in a squandering of nursing education resources. Patient safety attitudes, professional identity and climate of caring may affect nursing interns' clinical experience. However, more evidence is requested to validate these relationships for nursing educators to develop effective education programs and facilitate interns' successful transition.

METHODS

This was a cross-sectional study, which used a convenience sampling method to recruit 387 nursing interns during December 2022 to April 2023 in university affiliated hospital in Hunan province, China. Data were collected using standardized scales. Spearman correlation and multiple regression analysis were employed to examine the relationship between transition shock, patient safety attitudes, professional identity, and climate of caring.

RESULTS

Nursing interns experienced transition shock at a moderate level and the highest levels of transition shock in response to overwhelming practicum workloads, with the second being related to the conflict between theory and practice. Transition shock was negatively correlated with patient safety attitudes, professional identity and climate of caring among nursing interns.

CONCLUSIONS

Nursing managers and educators need to value the transition shock experienced by nursing interns. Our study suggests that developing a strong sense of professional identity and a positive attitude toward patient safety can be effective in reducing the level of transition shock among nursing interns. In addition, a caring climate within the nursing unit can significantly enhance the overall experience of nursing interns. This can be achieved by enhancing the support of clinical mentors, providing patient safety-focused education, and facilitating team communication among nurses.

Nursing students' processes of taking role models and being role models: A descriptive phenomenological study

BACKGROUND

Role models are frequently viewed as a means of motivating people to adopt new behaviors and inspiring them to establish ambitious targets. Role models play a significant role in the characters of individuals and can be effective in shaping their career choices, education, and identities. Within the nursing profession, role models are integral to nursing students' journey towards understanding the nursing role and professional responsibility. For this reason, it is very important for nursing students to identify role models that support the development of students growth and development.

OBJECTIVES

This study aimed to investigate the qualities of nurses who serve as role models for senior undergraduate nursing students in shaping their professional attitudes and behaviors, identify the motivations behind selecting these individuals as role models.

DESIGN

A descriptive phenomenological research method was used.

SETTINGS

The research was conducted at a state university nursing school.

PARTICIPANTS

The study was conducted with the participation of 16 senior nursing students.

METHODS

Data collected from one-on-one interviews. A thematic analysis was used to analyze the data.

RESULTS

Student nurses mostly took clinical nurses and lecturers as professional role models. They were most impressed by their role models' knowledge, strong communication skills, and respect for human beings. To imitate their role models, students were willing to work in the clinic to improve their communication and psychomotor abilities and engaged in research and inquiry in areas where they felt insufficient. However, they also reported that most clinical nurses were not positive role models. They avoided taking nurses as role models because they had low communication skills, did not guide the student, and did not value human beings.

CONCLUSIONS

The study's findings indicated that student nurses were primarily influenced by clinical nurses and viewed them as both positive and negative role models, and they aspired to emulate the qualities of the nurses they considered positive role models while actively avoiding behaviors and traits associated with those seen as negative role models. Clinical nurses, who are in contact with prospective nurses the most, have an important role in guiding them.

Knowledge about the best practice guidelines in the nursing degree: A non-randomized post-test design

AIM

To compare knowledge of Nursing Degree students about Best Practice Guidelines when there are included as teaching content in a subject vs knowledge through having the usual internship experience without teaching specific guidelines contents.

DESIGN

Non-randomized post-test-only design with a comparison group.

METHODS

143 students of the nursing degree at the Autonomous University of Barcelona were recruited. The intervention group received a classroom training in three Best Practice Guidelines with Problem-Based Learning methodology. The comparison group only attended internship, without specific guidelines contents. Knowledge was evaluated with an ad hoc post intervention questionnaire. The information was collected between 2016 and 2018.

RESULTS

The average score of knowledge was low, 5.1 out of 10, and differs between guides. The best results were obtained by the students with internships and that had consulted the guides on some occasions. Synchronized effort and leadership in Academia and Healthcare are needed to favour evidence-based practice. The combination of the consultation of the Best Practice Guidelines in theoretical learning combined with the practice, increases the knowledge of the Best Practice Guidelines and will favour the implementation of evidence-based practice. Some students were involved in questionnaire design.

'They're not doing too much are they?' How the socialization of registered nurses perpetuates status differences with certified nursing assistants: A qualitative study

BACKGROUND

Limited knowledge exists about how the socialization of vocationally trained registered nurses both at school and during internships in the community of practice influences their perception of, and working relationship with certified nursing assistants.

OBJECTIVES

This paper studies, first, how registered nurse students internalize the perceptions and discourses about certified nursing assistants conveyed by teachers, mentors and other students during their socialization at school and in the community of practice. Second, it examines how this socialization forms student's perception of, and actual working relationship with certified nursing assistants.

DESIGN

Qualitative descriptive and exploratory study using an interpretative framework.

METHODS

Individual in-depth interviews were conducted with 15 registered nurse students that were in their third or fourth year of training.

RESULTS

The findings reveal that at school the division of tasks and working relationship between registered nurse students and certified nursing assistants was very rarely discussed explicitly. However, teachers and students implicitly and explicitly conveyed that certified nursing assistants have lower status, describing the latter's role as inferior and as assisting to the role of registered nurses. During internships in the community of practice, some students initially adjust this perception when directly working with certified nursing assistants, who generally are their mentor in the first years of training, consider certified nursing assistants as equal and highlight the interdependence of the two occupational groups. Yet, further in their training, registered nurse students start to relate more to graduated registered nurses and reproduce the dominant perception and discourse that certified nursing assistants are inferior and supposed to support registered nurses, thereby perpetuating pervasive status differences and inequality.

CONCLUSION

Findings will assist nurse educators both in training centers and in the community of practice to understand how education can be used to end pervasive status differences and foster mutual respect and equity between different designations in nursing.

Latent profiles of nursing students' professional identity and their relationship with stress and coping styles during clinical practicum

AIM

This study aimed to identify the latent profiles of professional identity among nursing students and explore the factors associated with different profiles.

BACKGROUND

Nursing students' professional identity is easily influenced by various factors. However, current studies mainly focused on the overall level of professional identity and its related factors, ignoring the population heterogeneity of nursing students' professional identity.

DESIGN

A cross-sectional study.

METHODS

A convenient sampling was used to collect data from 384 nursing students who were undergoing their clinical practicum in the affiliated hospitals of a medical university in China between January and April 2021. Data were collected using the demographic questionnaire, the nursing student internship stress scale, the simplified coping style questionnaire, and the professional identity scale for nursing students. A latent profile analysis was used to identify the latent profiles of professional identity. Kruskal-Wallis H test, analysis of variance and ordinal logistic regression were used to determine factors that were associated with different profiles of professional identity.

RESULT

Nursing students' professional identity could be classified into four profiles: low professional identity, relatively low professional identity, relatively high professional identity and high professional identity. These four profiles showed unique relationships with choosing nursing voluntarily, willing to be a clinical nursing staff, stress in conflict between study and work, and positive coping styles.

CONCLUSION

The majority of the nursing students were classified into profile 1 (low professional identity) and 2 ( relatively low professional identity). Nursing students' lower professional identity need to be further enhanced by improving social recognition of nurses to increase the willingness of high school graduates to choose nursing voluntarily, allocating nursing workforce rationally to increase the willingness of nursing student to be a clinical nursing staff, reducing nursing students' stress in conflict between study and work and encouraging them to adopt positive coping styles.

Research on the learning experience of virtual simulation class experimental teaching and learning based on the perspective of nursing students

BACKGROUND

The enrichment of information technology has impacted traditional teaching modes. The emergence of virtual simulation class experimental teaching software has effectively improved the quality of nursing experiment teaching. The learning experience of virtual simulation class experiment teaching and learning based on the perspective of nursing students is explored to provide a basis for improving related learning effects in the future.

METHODS

Fourteen undergraduate nursing students were selected using the purposive sampling method for semi-structured interviews. The Colaizzi seven-step analysis method was used to collate and analyse the interview data.

RESULTS

Two themes and six sub-themes were considered during the data analysis. The two themes were positive experiences and negative experiences. In the positive learning experience, undergraduate nursing students showed a deep memory of authentic and diverse scenes, which presented knowledge in a clearly logical, visualised and stereoscopic manner. Negative experiences are manifested as significantly different learning efficiencies in different grades and subjects, and timing the delivery of teaching feedback is difficult.

CONCLUSION

Virtual simulation experimental teaching can promote the subjective initiative of nursing students' learning and promote better coordination and unity in their image and theoretical thinking. Some advantages can be augmented by following the national educational policy, strengthening the information construction, combining the construction of virtual simulation experiments with the discipline's characteristics and optimising the resources. This paper provides a reference for the future exploration of nursing education and further improving the construction of virtual simulation experimental teaching tools and resources.

The nursing process: A supportive model for nursing students' learning during clinical education - A qualitative study

AIM

The aim of this study was to increase understanding of nursing students' learning during clinical education in relation to the nursing process.

BACKGROUND

Nursing students' learning during clinical education is of great importance in creating meaning for theory and development of core competencies. As a theoretical model, the nursing process is challenging to apply in practice for both students and registered nurses, although use of the model has benefits for patient care.

DESIGN

This is a descriptive qualitative study with an abductive approach.

METHODS

Twelve semi-structured interviews with nursing students in education from six universities in Sweden were conducted in 2021-2022. Data were examined using qualitative content analysis.

RESULTS

The results revealed that the nursing process supported learning when theory and practice 'spoke the same language'. This allows for the opportunity to perform in a consistent way with the theory, while obtaining awareness of an invisible process. Furthermore, the nursing process supported learning by incorporating a thought structure for the student´s professional role through developing independence to conduct a holistic assessment and increasing an understanding of the nurse´s area of responsibility.

CONCLUSION

The results revealed that when theory and practice were aligned, the nursing process became a meaningful structure to develop a sustainable, safe way of thinking for one's future professional role. It is important to use supportive pedagogical models for students and supervisors that facilitate the integration of concepts of the nursing process in practice.

Nursing students' attitudes towards sexuality before training in sexual and reproductive health

AIM

To know the attitudes towards sexuality of nursing students and those sociodemographic and cultural factors that can influence it.

DESIGN

An observational study was carried out on Nursing degree students. One hundred and eighteen nursing degree students who were going to take the sexual and reproductive health nursing course.

METHODS

A self-administered online questionnaire. This questionnaire had several parts specifically designed to collect sociodemographic variables. In order to determine the attitudes towards sexuality, the questionnaire based on the ATSS (Attitudes Towards Sexuality Scale). The Double Standard Scale (DSS) was also used. This scale evaluates double standards within the area of sexuality. The Rape Supportive Attitude Scale (RSAS), was included to determine beliefs about rape, rapists and their victims.

RESULTS

The ATSS shows a statistically significant association with religious beliefs (p = 0.005), with mean scores of 113.84 (SD = 9.81) for non-believers (no religion), 108.36 (SD = 15.68) for non-practicing believers and 102.32 (SD = 17.87) for believers (those who practice their faith). The mean score in the DSS shows a statistically significant association with alcohol consumption (p = 0.001). The mean score on the RSAS is statistically significantly associated with the place of residence (p = 0.050), the means were 44.32 (SD = 9.26) for those who lived in the city, 34.94 (SD = 19.21) if the place of residence was between 10,000 and 5000 inhabitants and 32.54 (SD = 15.01) if the family home was in a town with less than 5000 inhabitants.

CONCLUSION

Religious beliefs reduce liberalism and positive attitudes towards sexuality, whereas sporadic alcohol consumption increases them.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The contribution of interprofessional education in developing competent undergraduate nursing students: integrative literature review

BACKGROUND

Effective interprofessional team collaboration is one of the necessary domains for successful interprofessional collaborative practices in healthcare (IPCP), which is crucial for the delivery of safe and quality healthcare services. Therefore, understanding the contribution of interprofessional education in nursing students is vital to improving collaboration practices in nursing students, in preparation for the dynamics that await after registration in practice amongst the interprofessional team. Thus, the aim of the study was to summarise the contribution of interprofessional education in nursing education in developing competent undergraduate nursing students.

DESIGN

The integrative literature review design as described by Whittemore and Knafl was adopted for the review. The review consists of five steps, namely, problem identification, literature search, data analysis, data interpretation, and the last step was data presentation. Three databases were searched for the articles, namely CINHAL, Scopus, and Science Direct. Articles were retrieved using Search terms such as "Competence," "Contribution,", "Development," "Interprofessional education" and "Undergraduate nursing students" retrieved Articles published between 2018 and 2022 were selected.

RESULTS

Three themes emerged from the review, namely the promotion of patient safety in nursing practice, the socialisation of nursing students in interprofessional collaboration, and the promotion of the development of professional identity.

CONCLUSION

This study is the first step in determining the contributions of early interprofessional education to nursing education. It could set the stage for further studies that examine strategies the undergraduate nursing curriculum can adopt and develop sound interprofessional competencies that promote patient safety and quality healthcare by nursing students.

IMPACT

The developers of the nursing curriculum and nursing educators can use the results in developing a curriculum that includes interprofessional education with the aim of improving the quality of teaching and learning that advances competent and safe nursing students.

Attitudes and self-efficacy towards infection prevention and control and antibiotic stewardship among nurses: A mixed-methods study

AIMS

To gain a comprehensive understanding of nurses' infection control practices, antibiotics stewardship attitudes and self-efficacy when caring for patients with multidrug-resistant bacterial infections in a hospital setting.

BACKGROUND

Multidrug-resistant bacteria cause a substantial health burden by complicating infections and prolonging hospital stays. Attitudes and self-efficacy can inform professional behaviour. Nurses' attitudes and self-efficacy concerning multidrug-resistant bacteria, infection prevention and control and antibiotic stewardship are vital in keeping patients safe.

DESIGN

A descriptive and convergent mixed-methods design involving quantitative and qualitative approaches was used.

METHODS

Two hundred and seventeen nurses working in clinical practice at seven different hospital wards (i.e., general medicine, surgical, haematological and oncology) at a Norwegian university hospital were invited to participate. Data were collected in February and March 2020 via two questionnaires: the Multidrug-Resistant Bacteria Attitude Questionnaire and the General Perceived Self-Efficacy Scale (n = 131) and four focus group interviews (n = 22). The data were analysed using descriptive statistics and systematic text condensation.

RESULTS

Most nurses showed moderate knowledge, adequate behavioural intentions towards infection prevention and antibiotic stewardship, and high self-efficacy. However, they reported negative emotions towards their knowledge level and negative emotions towards nursing care. The nurses appeared uncertain about their professional influence and role in antibiotic stewardship practices. Organisational and relational challenges and ambivalent perceptions of nurses' role were potential explanations.

CONCLUSION

Nurses report moderate attitudes and high self-efficacy when caring for patients with multidrug-resistant bacterial infections. This study suggests that nurses experience organisational and relational factors in their work environment that challenge their attitudes towards infection prevention and control and antibiotic stewardship practices. Measures that strengthen their knowledge and emotional response underpin correct infection prevention and control behaviour. A role clarification is needed for antibiotic stewardship. No Patient or Public Contribution.

RELEVANCE TO CLINICAL PRACTICE

Measures to increase attitudes towards infection prevention and control, antibiotic stewardship and multidrug resistance is recommended. Measures should be taken to overcome organisational challenges. A clarification of the nurses' role in antibiotic stewardship is needed.

'I've got no idea': an ethnography of Critical Care Nurses' nuanced and ambiguous professional identities in regional Australia

Historical sociological perspectives posit professional identity to emerge from socialisation and attainment of 'traits' considered unique to and distinguishing of a profession. Such essentialist understandings, however, cannot account for group heterogeneity, nurses' lived experiences, nor the fluidity of professional and personal identity. This article conceptualises professional identity as being both individual and collective, influenced by context, involving subjective meaning-making, and membership to a specific professional group. Drawing on ethnographic data gathered through participant observation and semi-structured interviews with Critical Care Nurses in an Intensive Care Unit in regional Australia, we identify four themes that reveal different aspects of professional identity: conceptualising professional identity; professional identity as a title and legislative requirement; professional identity as qualifications and training; and professional identity as a social performance. The findings demonstrate that Critical Care Nurses hold multifaceted perceptions of professional identity. While they collectively distinguish their nursing training, knowledge, and practice from other nurses, they struggle to articulate what professional identity is, while creating boundaries between different forms of nursing education and qualifications to construct their professional identity. These uncertain and diverse meanings of professional identity contribute to nurse identity ambiguity, while also reflecting the necessity of flexible individual and collective nursing identities.

Positive and negative aspects of psychological stress in clinical education in nursing: A scoping review

BACKGROUND

Even though clinical practice is crucial for nursing students' personal and professional development, it is recurrently associated with stress. However, stressful situations may not only elicit negative responses, but positive responses as well, and such aspects should be further investigated.

AIM

To explore the literature addressing the positive and negative aspects of stress experienced by nursing students during clinical practicum.

DESIGN

This scoping review followed the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines.

DATA SOURCES

CINAHL, MEDLINE/PubMed, PsycINFO, Web of Science, IBECS, LILACS, BDENF and two theses and dissertations repositories.

REVIEW METHODS

Searches were conducted from June to August 2022. Studies addressing the positive and negative aspects of stress experienced by nursing students during clinical practice were included regardless of the method adopted.

RESULTS

This review included 32 studies published between 1999 and 2022 in 25 countries across four continents: Africa, America, Asia, and Europe. Stress can positively influence academic performance, especially in mobilizing a search for learning and professional development and in integrating theoretical knowledge and improving clinical skills and competencies. Negatively, stress can cause biopsychosocial symptoms that compromise a student's academic performance and can cause doubts and uncertainties about the construction of their professional identity.

CONCLUSIONS

Although the negative aspects stand out over the positive ones, it is evident that both are present in the clinical practice environment. When considering stress of nursing students, educators should conduct the teaching-learning process in order to reduce the negative impact and promote the positive side of stressful situations.

The mediating effect of clinical teaching behavior on transition shock and career identity among new nurses: A cross-sectional study

BACKGROUND

New nurse attrition is a worldwide problem. Because of the gap between theory and practice in their work, new nurses may experience transition shock, which can have a negative impact on their career identity. Clinical teaching behavior is an important component in reducing the impact of new nurse transition, stabilizing the hospital nursing workforce, and cultivating high-quality nursing talents.

OBJECTIVES

Based on the New Nurse Transition Model, to explore the mediating role of clinical teaching behavior in the relationship between transition shock and career identity in the new nurse population of Gansu Province.

DESIGN

A cross-sectional study.

SETTING

Seventeen hospitals in Gansu province of China.

PARTICIPANTS

A total of 1684 new nurses (1590 female and 94 male) were recruited from seventeen hospitals in Gansu province.

METHODS

Three questionnaires include: The Clinical Teaching Behavior Inventory (CTBI-23), the Transition shock of Newly Graduated Nurses Scale (TSNGNS), and the Nurse's Career Identity Scale (NCIS). Structural equation modeling was used to deal with the relationships among clinical teaching behavior, transition shock, and career identity.

RESULTS

Transition shock was found to be negatively related to both career identity and clinical teaching behavior, with clinical teaching behavior mediates the relationship between transition shock and career identity.

CONCLUSIONS

The clinical teaching behavior of the teaching staff plays a role in mediating the relationship between new nurses' sense of career identity and transition shock. Accordingly, the teaching behavior of clinical teaching should be improved and the quality of clinical teaching behavior should be improved to increase the career identity of new nurses and reduce the turnover rate of new nurses.

Formation of Interpersonal Competencies Through Interprofessional Simulation: Nursing and Medicine

AIM

The aim of this study was to analyze the process of interpersonal competencies formation in nursing and medical students who participated in a standardized interprofessional clinical simulation.

BACKGROUND

Interprofessional education in health sciences has had an important impact on the development of relational qualities centered on the patient.

METHOD

The study followed a qualitative interpretive approach with students. Students who participated in clinical simulation activities were asked about their experiences and their learning process with respect to interpersonal competencies. A thematic analysis of the data was performed.

RESULTS

Three themes emerged: 1) approaching the practice with uncertainty and fear of new relationships, 2) reflecting on decisions while recognizing distinctive roles, and 3) recognizing the human sense of practice while developing skills for caring and curing.

CONCLUSION

Students underwent this process and learned about empathy, communication, critical reflexive thinking, and teamwork.

Exploring Occupational Therapists' Professional Identity: A Q-Method Study

(1) Background: This study examines the nature of the rarely studied factors of the professional identity from an occupational therapist's perspective. (2) Methods: Q-methodology was applied to identify the different perspectives. Participants were selected through a non-probability sampling procedure in the whole Spanish territory. Different assessment tools were considered, in order to develop an ad hoc tool which had 40 statements classified into four categories. A factor analysis was performed by applying Ken-Q analysis v.1.0. (3) Results: Thirty-seven occupational therapists participated in the study. Their diverse approaches revealed different perspectives that influence the professional identity of occupational therapists: professional identity, due to referents, a grey field on professional identity, reaffirming a common professional identity, the role of education and mentors on professional identity and the outcome of ongoing training, in order to develop the abovementioned identity. (4) Conclusions: Once the different aspects of the professional identity have been understood, future educational initiatives can be designed to adapt curricula to the professional scene.

The impact of university-based education on nursing professional identity: a qualitative examination of students' experiences

OBJECTIVES

To examine graduate students' perceptions of their nursing professional identity within the university-based educational system.

METHODS

A qualitative phenomenological approach was adopted involving the completion of in-depth interviews and focus groups among master's degree students in Morocco.

RESULTS

The shift to university-based nursing education system was associated with the development of a positive self-image, sense of empowerment, and attachment to professional values in addition to role extension and involvement in research.

CONCLUSIONS

The perceived external barriers such as negative social image, role ambiguity, and unsupportive work environments, limit the reach of the positive influence of the educational shift and may lead to doubts in integrating the clinical workspace.

Clinical supervisors' perceptions and use of the fundamentals of care framework in supervision of nursing students

AIM

To explore clinical supervisors' perceptions and use of the Fundamentals of Care framework in supervising nursing students in clinical placement in hospital settings.

DESIGN

A qualitative study using focus group interviews. Reported in accordance with Consolidated Criteria for Reporting Qualitative Research.

METHODS

Twelve clinical nurse supervisors working in medical, surgical or psychiatric wards in hospitals in Denmark participated in four focus groups conducted from September to November 2020. Data were analysed using thematic analysis.

RESULTS

Clinical supervisor's perceptions and use of the framework are described in three themes: structuring students' clinical learning, supporting tool for learning what nursing care is and developing own supervision practice.

CONCLUSION

Supervisors perceive the Fundamentals of Care framework positively and use it as a supporting tool to structure and facilitate students' reflection on what nursing is and requires. They perceive that having a shared framework across school and clinical setting contributes to a safe and positive learning environment. Furthermore, using the framework develops their own practice as clinical supervisors.

Perceived professional identity and related factors in Iranian nursing students: a cross-sectional study

BACKGROUND

Professional identity, an important process in the development and expansion of the nursing profession, is built over time and includes gaining insight into professional performances and fostering ideals and values for the profession. Several factors influence the formation of professional identity. This study investigates the level of professional identity in nursing students and its predictors using a localized tool.

METHODS

This cross-sectional study recruited 195 nursing students at Semnan University of Medical Sciences, Semnan, Iran, who were selected by census sampling in 2020. Data were collected using a researcher-made professional identity questionnaire and were then analyzed in SPSS-18 using descriptive and inferential (logistic regression) statistics.

RESULTS

The mean total score of the students' perceived professional identity was 316.72, indicating a strong professional identity. The students' professional identity had a significant relationship with variables including GPA above 16 (OR = 2.65, P = 0.002), choosing the field out of interest (OR = 2.15, P = 0.015), and having work experience while studying (OR = 3.10, P = 0.006).

CONCLUSION

The findings showed that selecting the field of nursing out of interest, having a GPA above 16 and work experience while studying are associated with a higher perception of professional identity among nursing students. The professional identity of nursing students can be enhanced through reinforcing the mentioned factors and further attention to their role in the promotion and consolidation of professional identity. The researchers recommend that educational directors, nursing professors, and clinical nursing educators make greater efforts to develop and promote the professional identity of nursing students.

Digital Technologies and the Role of Health Care Professionals: Scoping Review Exploring Nurses' Skills in the Digital Era and in the Light of the COVID-19 Pandemic

BACKGROUND

The nursing role significantly changed following reforms in the nurse training process. Nowadays, nurses are increasingly trained to promote and improve the quality of clinical practice and to provide support in the assistance of patients and communities. Opportunities and threats are emerging as a consequence of the introduction of new disruptive technologies in public health, which requires the health care staff to develop new digital skills.

OBJECTIVE

The aim of this paper is to review and define the role of nurses and the skills they are asked to master in terms of new methodological approaches and digital knowledge in a continuously evolving health care scenario that relies increasingly more on technology and digital solutions.

METHODS

This scoping review was conducted using a thematic summary of previous studies. Authors collected publications through a cross-database search (PubMed, Web of Science, Google Scholar) related to new telemedicine approaches impacting the nurses' role, considering the time span of 2011-2021 and therefore including experiences and publications related to the first phase of the COVID-19 pandemic.

RESULTS

The assessment was completed between April and July 2021. After a cross-database search, authors reviewed a selection of 60 studies. The results obtained were organized into 5 emerging macro areas: (1) leadership (nurses are expected to show leadership capabilities when introducing new technologies in health care practices, considering their pivotal role in coordinating various professional figures and the patient), (2) soft skills (new communication skills, adaptiveness, and problem solving are needed to adapt the interaction to the level of digital skills and digital knowledge of the patient), (3) training (specific subjects need to be added to nursing training to boost the adoption of new communication and technological skills, enabling health care professionals to largely and effectively use new digital tools), (4) remote management of COVID-19 or chronic patients during the pandemic (a role that has proved to be fundamental is the community and family nurse and health care systems are adopting novel assistance models to support patients at home and to enable decentralization of services from hospitals to the territory), and (5) management of interpersonal relationships with patients through telemedicine (a person-centered approach with an open and sensitive attitude seems to be even more important in the framework of telemedicine where a face-to-face session is not possible and therefore nonverbal indicators are more problematic to be noticed).

CONCLUSIONS

Further advancing nurses' readiness in adopting telemedicine requires an integrated approach, including combination of technical knowledge, management abilities, soft skills, and communication skills. This scoping review provides a wide-ranging and general-albeit valuable-starting point to identify these core competences and better understand their implications in terms of present and future health care professionals' roles.

Nursing students’ perceptions and experiences of e-internships during the COVID-19 pandemic: A phenomenological study

Background

Clinical internship is an indispensable stage for nursing students to graduate successfully and become qualified nurses. However, COVID-19, a novel coronavirus disease with strong human-to-human transmission, hit China in late 2019 and forced the Chinese government to suspend classes and clinical internships. To cope with this situation, e-internship, which facilitate varied interactions without the need for direct contact, is used as an alternative strategy to help nursing students continue their internships.

Objectives

To describe the perceptions and experiences of undergraduate nursing students in e-internships during the COVID-19 pandemic.

Methods

A descriptive phenomenological design was adopted. Seventeen undergraduate nursing students in a major teaching hospital in Changsha, China, were recruited into the study. Data were collected through semi-structured, in-depth, face-to-face interviews. The interviews were transcribed verbatim and analyzed using Colaizzi’s approach.

Results

Four themes were captured from the data analysis: perceived images of clinical nurses in e-internships, psychological experience, perceived benefits of e-internships, and perceived limitations of e-internships.

Conclusions

Our findings suggest that e-internship is a suitable method for training and cultivating undergraduate nursing students during a crisis. To enhance the efficiency of e-internships, guidelines and standards should be formulated, and effective measures should be taken to build better e-internship platforms. In the future, we suggest combine on-site internships with e-internships, thereby fully using their advantages, and improve the efficiency of internships as much as possible.

Bachelor of Science in Nursing students' perceptions of being a nurse: A scoping review

BACKGROUND

High attrition rates in new graduate nurses maybe attributed to unrealistic perceptions of being a nurse. It is therefore important to identify nursing students' perceptions and the factors that influence them.

AIM

The present study was conducted to identify and describe the literature relating to nursing students' perceptions of being a nurse. Research questions guiding the review were: (1) What are nursing students' perceptions of nursing? (2) What factors influence nursing students' perceptions of nursing?

METHOD

A scoping literature review was conducted between the years 2008 and March 2022 to capture nursing student perceptions from multiple countries, and year levels of study to note the changes in perceptions overtime. The data sources consisted of five electronic data bases; CINAHL, Medline, PsychINFO, Scopus, and Web of Science and search engine Google Scholar revealed 39 relevant sources. A scoping review methodology informed by the Joanna Briggs Institute and a published Scoping Review Checklist guided this review. An inductive thematic analysis identified five key themes.

RESULTS

Key themes: Attributes and characteristics of nurses; Nursing as a profession; Skills required for nursing; Gender perceptions; and Influence of time and previous health work experience. Findings provide insight for future research to ensure the adequacy of curricula experiences in preparing new graduates for having realistic perceptions for practice.

CONCLUSION

For nursing students to be prepared for the role of a nurse they must have realistic perceptions of what it means to be a nurse. Whilst it is evident that perceptions can be influenced by a variety of sources, this review highlights a lack of research pertaining to perceptions related to the physical, emotional, and social effects on an individual from being a nurse.

Fourth year intellectual disability student nurses' journey and future work intention: a qualitative study

BACKGROUND

The aim of this qualitative study is to explore the views and experiences of final year BSc intellectual disability nursing students' journey, future work plans and examine factors influencing their migration intentions following graduation.

METHODS

A qualitative component of a mixed methods study where a focus group interview was conducted with final year BSc intellectual disability nursing students (n = 10) from one University in Ireland in June 2019. A topic guide was utilised, and participant's were interviewed about their programme, future work plans and migration intentions. An inductive approach was utilised, and data were analysed using a pre-existing framework for initial coding and thematic development. Duffy's conceptual model of identity transformation provided a structure to analyse the data and map themes onto the conceptual framework.

RESULTS

The findings were mapped onto the five stages of Duffy's (2013) conceptual model of identity transformation: Pre-Entry; Reaffirming; Surmounting; Stabilising and Actualising. Findings indicate that further work is required to promote intellectual disability nursing and address professional esteem issues, support for education and professional development, such as providing career guidance opportunities prior to course completion, development of clinical skills within their education programme and support for the professional development of new graduates. Participant's identified uncertainty about career opportunities and saw scope for future professional development opportunities particularly in community-based work.

CONCLUSION

This study has identified that final year intellectual disability nursing students are uncertain about career options and opportunities for intellectual disability nurses in other country's. There is an urgent need for the intellectual disability nursing profession to articulate their practice and advocate for their role and contribution to the care of people with intellectual disability. This study identified a clear need for direction and information regarding intellectual disability nursing roles and career opportunities.

Factors influencing the professional identity of nursing interns: a cross-sectional study

BACKGROUND

Improving the professional identity of nursing intern is significant for enhancing the number of new registered nurses and easing the shortage of nursing personnel. The clinical internship is a key period for the formulation of professional identity. However, we know little about the factors influencing the nursing interns' professional identity during clinical internship. Therefore, this study explore the influencing factors of nursing interns' professional identity during clinical internship. This study will provide evidence and suggestions for generating effective strategies contributing to professional identity improvement of nursing interns.

METHODS

This was a cross-sectional study. The convenience sampling was used to recruit 398 nursing interns from a teaching hospital in Hunan, China. The demographic characteristics information was collected by a self-developed questionnaire. The nursing interns' professional identity and potential influencing factors (e.g., work atmosphere, teacher capacity) were measured by questionnaires with good psychometric properties. The appropriate indicators were used for descriptive statistics, and t test, analysis of variance, Pearson's correlation analysis and multiple linear regression were used to analyse the influencing factors.

RESULTS

In this study, the influencing factors of nursing interns' professional identity are education level, first choice of major, residential status, work atmosphere, and teacher capacity. The results showed that: (1) the nursing interns with a higher education level reported a lower level of professional identity; (2) the nursing interns whose first choice of major was not nursing discipline reported a lower level of professional identity; (3) the nursing interns live in rural areas (compared to urban areas) reported a higher level of professional identity; (4) the nursing interns in better work atmosphere reported a higher level of professional identity; (5) the nursing interns under the guidance of the teachers equipped with better teaching capacity reported a higher level of professional identity.

CONCLUSION

The education level, first choice of major and residential status are influence factors of nursing interns' professional identity. The nursing educators need to pay attention to nursing interns whose first choice is not nursing, and in a bachelor program, who may have a lower level of professional identity. It is crucial to enhance the nursing interns' professional identity by improve the work atmosphere and clinical teachers' capacity, to promote nursing interns to choose nursing as a profession and reduce the shortage of nursing workforce.

Professional Identity Scale for Male Nursing Students Using the Rasch Model and Latent Regression on Gender and Background Variables

This study developed a professional identity (PI) scale and compared the scores of male and female nursing students. Few studies have focused on male nursing students to understand their PI vis-à-vis related background variables relative to female ones. We recruited 384 male nursing students in Taiwan to construct the PI scale based on the Rasch model with 12 items and 3 factors, namely cognitive, emotional, and behavioural identity. The PI scale showed a good model fit in confirmatory factor analysis, with factor loadings ranging from 0.56 to 0.73. Cronbach’s alpha coefficients ranged from 0.72 to 0.79 for the three subscales and 0.88 for the entire scale. The results of the multiple latent regression analyses showed that male nursing students had higher PI in the total scale and its three factors than did female ones. Having mothers with medical or nursing-related jobs may help promote the cognitive PI of male nursing students. Experiences of caring for family members can help promote PI among female nursing students but not among male ones. Future research should focus on decreasing loss in behavioural PI for both genders after graduation and on reinforcing the association between behavioural PI and interest in nursing among male nursing students.

Implementation of a Registered Nurse Primary Care Clinical Mentoring Academy

Registered nurses (RNs) are pivotal team members for improving the quality of care in communities; however, they are underutilized in primary care. Two schools of nursing in Alabama partnered to develop and implement a project to build a resilient primary care RN workforce. A major component of this project is the Primary Care Clinical Mentoring Academy (PCCMA), which was designed to prepare RN clinical mentors to implement positive student learning experiences in the primary care setting. The PCCMA follows a comprehensive curriculum implementing both didactic instruction and interactive activities related to primary care competencies; interprofessional education and collaborative practice; and primary care RN mentor roles and responsibilities. Participants reported that the PCCMA was effective and useful, and they perceived that it would improve their overall job performance as a clinical mentor. The PCCMA is an effective way to produce confident and capable RN mentors in primary care. [J Contin Educ Nurs. 2022;53(7):312-320.].

Evaluation of post-simulation sonographer students' professional behaviour in the workplace

INTRODUCTION

In Australia, sonographer's professional identity is traditionally 'caught' from clinical role models. A four-year undergraduate-postgraduate course introduced professional identity education, with simulated practice, to prepare novice sonographer students prior to clinical practice. Preclinical students learnt sonographer professional behaviour, and humanistic attributes, during simulation designed with volunteer peers as standardised patients, educator role-models, immediate feedback, self-reflection, and longitudinal multi-observer assessment. This paper reports on the transfer of learnt professional behaviour and humanistic attributes to clinical practice.

METHODS

Professional behaviour evaluations completed by 94 clinical assessors described 174 students' professional behaviour and attributes one month into their initial clinical practice (2015-6). Student performance of each behaviour, and behavioural category, was quantitatively analysed by modelling binomial proportions with logistic regression.

RESULTS

Students demonstrated substantial learning transfer to clinical practice, achieving an overall mean score of 'consistent' sonographer professional behaviour and humanistic attributes (mean score of equal to or >3/4), one month into clinical practice. Professional behaviours varied in transferability, with 'response to patient's questions' showing least efficacy (P < 0.05). Increased deliberate practice with educator role-models improved transfer efficacy significantly (P < 0.001).

CONCLUSION

Preclinical application of theory to simulated practice, using standardised patients, educator role-models, immediate feedback, and multi-observer assessment, facilitated substantial transfer of sonographer professional behaviour and attributes to clinical practice. The efficacy of transfer varied but improved with increased deliberate practice and feedback.

IMPLICATIONS FOR PRACTICE

The incorporation of preclinical professional behaviour education with simulated practice into the core curriculum of sonographer courses is recommended for the formation of sonographer professional identity, improved clinical outcomes and increased patient safety during the early stages of ultrasound education.

Understanding nursing students' perceptions of the general practice environment and their priorities for employment settings

AIM

To explore final year nursing students' perceptions of the general practice environment and their priorities when choosing a workplace.

DESIGN

Online survey, reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

METHODS

The validated Profession Scale from the Scale on Community Care Perceptions (SCOPE) tool was used to identify characteristics within the general practice environment and the importance of these in choosing a workplace. To explore the factor structure, exploratory factor analysis was undertaken which was used to revise the survey language and flow before widespread dissemination.

RESULTS

Three hundred and fifty-five responses were received. Factor analysis revealed three factors: Provision of care, Employment conditions and Nature of work. Respondents exposed to general practice in the Bachelor of Nursing program or who had a general practice clinical placement had significantly different perceptions across all factors. Although wages, advancement opportunities, work pressures and the physical nature of work were perceived as important in choosing a workplace, they were seen as only moderately present in general practice.

Effectiveness of a professional identity promotion strategy for nursing students during the COVID-19 pandemic: A quasi-experimental study

Aim

To evaluate the effectiveness of a professional identity promotion strategy (PIPS) on nursing students' professional identity and resilience.

Methods

This study was a quasi‐experimental study with a random cluster sample of 103 sophomore undergraduate nursing students. One hundred students answered the questionnaires at both baseline and follow‐up (51 of 53 in the intervention group and 49 of 50 in the control group). Intervention and control groups underwent 5 months PIPS and standard professional education from May 2 to September 27, respectively. Participants completed the professional identity questionnaire for nursing students (PIQNS) and Connor–Davidson resilience scale (CD‐RISC). Data were collected at baseline (T0), after the intervention (T1) and 3 months after the intervention (T2), and analyzed using the Chi‐squared test, Fisher's exact test, and repeated‐measures analysis of variance.

Results

There were no significant differences between the two groups (p > .05) regarding demographic questions, professional identity, or resilience at baseline (p > .05). Significant differences were found in professional identity between groups (p < .001), measurement times (p = .026), and in the interaction between groups and measurement times (p = .018) from T0 to T2. Significant differences were found in resilience between groups (p < .001), measurement times (p = .007), and in the interaction between groups and measurement times (p = .035) from T0 to T2.

Conclusions

The PIPS program improved nursing students' professional identity and resilience. Further long‐term effectiveness of the program needs to be tested with implementation through various forms of mobile technology.

Final clinical practicum shapes the transition experience and occupational commitment of newly graduated nurses in Europe-A longitudinal study

AIMS

The aim of the study was to examine the association between the characteristics of a nursing student's final clinical practicum and the success of transition of newly graduated nurses (NGNs) in six European countries.

DESIGN

A longitudinal design with two data collections points (pre- and post-graduate).

METHODS

The data were collected with an online survey between May 2018 and April 2020 from graduating nursing students (n = 1796) in Finland, Germany, Iceland, Ireland, Lithuania and Spain. Altogether, 642 NGNs responded to the second questionnaire 1 year after graduation. Logistic and linear regression analyses were used to examine the associations between five clinical practicum characteristics and three indicators for the success of transition (ease of transition, turnover intentions and occupational commitment). Models were adjusted for demographic and background/workplace factors and professional competence.

RESULTS

Several associations were observed between the different clinical practicum characteristics and the indicators for a successful transition. Good pedagogical atmosphere and good supervisory relationship were associated with higher likelihood of an easy transition. Good leadership style of the ward manager, good premises of nursing care on the ward and a good supervisory relationship were associated with higher occupational commitment. No consistent association with turnover intention was found.

CONCLUSION

Having a good final clinical practicum before graduation can contribute to an easier transition experience for newly NGNs and strengthen their commitment to the nursing profession.

IMPACT

This study adds to the limited existing knowledge about the importance of final clinical practicums in shaping the transition process and occupational commitment of NGNs. Investing in creating a good final practicum experience could help healthcare organizations engage new nursing professionals and thus alleviate the existing shortage of nurses.

The role of self-efficacy in mediating between professional identity and self-reported competence among nursing students in the internship period: A quantitative study

AIM

This study explored the relationship between self-efficacy, professional identity and competence among nursing students and analyzed the mediating role of self-efficacy in the relationship between professional identity and competence.

BACKGROUND

Increasing attention has been paid to the cultivation of competence among nursing students; however, few studies to date have analyzed its related factors and examined their relationship.

DESIGN

A quantitative study with a descriptive design was performed in this study, adopting an online survey with convenience and snowball sampling. A cross-sectional sample of 887 nursing students in the internship period of their education program in mainland China was recruited from November to December 2020.

METHODS

The Nursing Students Competence Instrument, Professional Identity Questionnaire for Nurse Students and General Self-efficacy Scale were distributed online. Descriptive statistics, Pearson's correlation, structural equation modeling (SEM) and the bootstrap method were employed in data analysis.

RESULTS

Competence was significantly and positively correlated with professional identity (r = 0.598; P < 0.01) and self-efficacy (r = 0.692; P < 0.01). SEM analysis revealed that professional identity (β = 0.31; P < 0.01) or self-efficacy (β = 0.31; P < 0.01) could have a positive impact on competence. Meanwhile, self-efficacy played a mediating role in the relationship between professional identity and competence, with an indirect effect of professional identity creation through self-efficacy accounting for 52% of the total effect.

CONCLUSIONS

Self-efficacy mediates the relationship between professional identity and competence to some extent. School educators and clinical tutors should pay greater attention to students' professional identity and self-efficacy to improve students' competence.

COVID-19 Pandemic Impact on Nursing Student Education: Telenursing with Virtual Clinical Experiences

Introduction

The COVID-19 pandemic affected nursing students dramatically when the clinical sites and the onsite classrooms closed to physical participation. This necessitated a move to virtual classrooms and virtual clinical experiences. Some nursing schools adopted telenursing to comply with their Board of Registered Nursing direct patient care requirements. Students value the hands-on nursing in a direct care facility and clinical instructors must replicate this in a virtual setting. This article discusses telenursing and Teach-Back processes with student active engagement that facilitates learning and meets the direct care requirement. The purpose is to share best practice ideas for clinical instructors to educate when clinical settings are unavailable.

Methods

This innovation includes examples from five clinical instructors when in-person clinicals were not available due to the COVID-19 pandemic. They used virtual teaching and telenursing for nursing students which complied with clinical requirements of preconference, clinical experience, and post-conference. Telenursing combines case studies or shared documents, student collaboration, and includes a patient or patient actor via telehealth. Clinical instructors present a patient history or case study and allow students time for preparation. Socratic questioning helps students focus on determining the correct questions to ask. Telenursing call to the patient and teach-back questioning validated patient learning. Following the call, the instructor leads a post-conference debrief and students independently document the call.

Conclusion

Five clinical instructors follow the process of pre-brief, case presentation, and debrief while students develop critical thinking, strong communication skills, documentation requirements, and utilize the nursing process of assessment, diagnosis, outcome, plan, interventions, and evaluation. Students will have future opportunities to develop hands-on skills as they return to the clinical setting.

Student nurse socialization: A model of professional discourse adoption

AIM/OBJECTIVE

Through an exploration of student nurses and lecturers' professionalism discourses, this study illuminates influences on professional socialization and offers an appreciation of the processes of language (discourse) adoption involved.

BACKGROUND

Professionalism is a complex concept to define. Nursing research has predominantly explored professionalism in clinical practice; however, the time spent university is key to professional socialization and identity development. Previous research focused on socialization in the clinical area only. This study examined how student nurses and their lecturers construct their talk regarding professionalism while at university.

DESIGN

A social constructionism approach was adopted, where it is assumed that we jointly construct our world on shared assumptions and that language is central to this process.

METHODS

Employing a Discourse and Social Psychology (DASP) approach to discourse analysis, seven nursing students (Adult, Child, and Mental Health fields) and eight lecturers participated in a total of 16 interviews.

RESULTS

The findings indicated participants drew on several interpretative repertoires. These changed over the 3 year degree. Analysis led to development of a Model of Professional Discourse Adoption, illustrating a three phased process, resonating with theories of professional socialization in nursing.

CONCLUSIONS

The study offers insights into how education strategies may support learning and teaching, and professionalism communication.

Professional identity, wellness, and future hope among nurse interns in Egypt

Objective

Since nursing is a performance-based profession, clinical learning environments play an important role in the acquisition of professional abilities and train nursing students to enter the nursing profession and become a registered nurse. The study aimed to investigate the relations among professional identity, wellness, and future hope in nurse interns.

Methods

A cross-sectional, analytic, descriptive, correlational study design was used to test these relations in the study where 210 nurse interns’ students were selected using a convenience sampling from Zagazig University hospitals and Suez Canal University hospitals in Egypt. The questionnaires consisted of 4 parts, namely demographic characteristics, Professional Identity Scale for Nursing Students (PISNS), Holistic Health and Wellness Survey, and Hope scale.

Results

Less than half of the study sample had chosen nursing specialty by own will (43.8%), while slightly more than half of them had a “very good” graduation level, and had no nursing role model. The lowest mean professional identity score was for independence in career choice while the highest was for social modeling. The reported physical wellness mean-score was the least, while social wellness was the highest. Professional identity, wellness, and future hope scores differed significantly based on nurse interns’ personal characteristics. There were statistically significant, positive, weak-to-moderate correlations among the scores of professional identity, wellness, and future hope; however, the “choice of nursing study by own will” was a statistically significant independent positive predictor of the scores of professional identity, wellness, and future hope.

Conclusions

Nurse interns’ professional identity, wellness, and future hope were positively inter-correlated. However, nurse interns’ wellness was the lowest, and it should be fostered as it was the main predictor for future hope. The internship programs should be modulated to improve nurse interns’ professional identity, particularly regarding independence, and should foster their well-being in the clinical environment.

Student experiences of a return to practice programme: a qualitative study

BACKGROUND

Nurses, midwives and other health professionals who return to practice come from a range of backgrounds and return for a variety of reasons. Much of the research on return to practice concerns programme provision rather than returnee experience.

AIM

This qualitative study focused on the experiences of nursing, midwifery and allied health students undertaking a return to practice programme at a higher education institute. It interpreted the perceptions of the student experience of returning to clinical practice following a lapse in professional registration.

METHODS

Data collection methods were qualitative and involved focus groups. Findings were analysed using thematic analysis.

FINDINGS

Several themes and subthemes emerged from the data, including 'the importance of returnee identity' and 'challenges and barriers'. Findings demonstrated different approaches to and influences on returnees' learning journeys.

CONCLUSION

Previous knowledge, skills and experience were often hidden from view and hard to explain although crucial to returnee success.