A Survey on Turkish nursing students' perception of clinical learning environment and its association with academic motivation and clinical decision making

Exploring the experiences of female undergraduate nursing students in providing home healthcare to older adults

BACKGROUND

In light of the growing ageing population in Saudi Arabia and Saudi nurses' hesitation to work with the older population, it is important to understand the experiences of nursing students on their clinical placement in home healthcare.

METHODS

This study is a descriptive qualitative study based on five focus groups of 3-5 students each. Data were collected from female senior baccalaureate nursing students at a female governmental university in Saudi Arabia, and during their placement in home healthcare. Data were analysed using thematic analysis.

RESULTS

Five main themes emerged : struggling with their own family; struggling with cultural and social beliefs; struggling during clinical training; struggling with domestic caregivers; and reflections for the future were considered important impressions in clinical experience.

CONCLUSION

The culture of Saudi Arabian society is an important factor in shaping the training experience of female nursing students either positively or negatively, specifically in the context of home healthcare nursing for older patients. The results of this study show how important it is for students to be prepared for the clinical environment, the nature of the work, and the role of the home healthcare nurse in order to improve their clinical learning.

Motivations Driving Career Choices: Insights From a Study Among Nursing Students

Introduction

Globally, the nursing workforce is crucial to the functioning of healthcare systems. The alarming shortage of nursing staff necessitates careful consideration of the challenging aspects related to this issue to develop successful strategies for attracting and retaining nurses.

Objectives

This study aims to explore the motivational factors influencing the decision of students to choose a nursing career and the associated factors.

Methods

In this cross-sectional research, a questionnaire was administered to 308 students studying nursing at the Higher Institute of Nursing Professions and Health Techniques.

Results

The results of this study revealed several factors influencing the decision of nursing students to choose this profession. The desire to contribute to society and have a positive impact on individuals' lives was identified as the primary motivating factor. Economic considerations also played a significant role. Additionally, it was found that the educational level of parents is a factor influencing students' decisions.

Conclusion

This study highlights the importance of various factors in the decision-making process of nursing students. By considering these results, policymakers and healthcare professionals can create an environment conducive to attracting and retaining future nurses.

Ethics positions of nursing students in clinical decision-making

BACKGROUND

Ethics positions, consisting of the two fundamental dimensions of idealism and relativism, influence individuals' decision-making significantly. Particularly in an applied field such as nursing, the ethics positions of nurses can play a significant role in clinical decisions. Therefore, it is important to know the factors affecting the ethics positions of nurses in clinical decision-making.

AIM

The aim of the study is to examine the factors affecting the ethics positions of nursing students in clinical decision-making.

RESEARCH DESIGN

This is a two-phase sequential explanatory mixed methods study designed in accordance with the COREQ criteria. A participant Information Form and the Ethics Position Questionnaire were used to collect quantitative data. Qualitative data were obtained through focus group interviews.

ETHICAL CONSIDERATIONS

This study was conducted after receiving written permission from X University Ethics Board. Additionally, permission was obtained from the participating nursing faculty.

PARTICIPANTS

Among the fourth-year nursing students, 180 students participated in the quantitative phase and 30 students in the qualitative phase of the study.

RESULTS

The quantitative data analysis showed that the idealism sub-dimension mean scores of the participants were higher than the relativism sub-dimension mean scores. The analysis of the qualitative data resulted in four main themes that influence participants' ethics positions in clinical decision-making: (1) attitudes of role models in clinical practice (staff nurses/mentors/lecturers), (2) resources related to clinical practice (labs, hospitals/classrooms), (3) health system (hospital policies/school policies), and (4) personal differences (act with emotion/act with logic).

CONCLUSION

The results showed that the health system, role models in the clinic, personal differences, and skill-related resources affect the ethics positions of nursing students in clinical decision-making. In this regard, awareness can be raised by providing training to nursing students by academic instructors on ethics positions and the factors that are determined to affect ethics positions in clinical decision-making.

Effects of Expert Modeling Videos on the Development of Nursing Students' Clinical Competence

BACKGROUND

Nurse educators are called to develop innovative teaching strategies to build clinical competency. Expert modeling videos (EMVs) promote clinical competency by demonstrating exemplar nursing care.

METHODS

A quasiexperimental research study was conducted using a prebriefing intervention of a nursing process video for demonstration (experimental) and discussion (control) groups of nursing students. Simulation competency was measured using the Creighton Competency Evaluation Instrument (CCEI).

RESULTS

Students in the experimental group demonstrated a statistically significant improvement in simulation competency (p = .001) and performed significantly better in the CCEI domains of communication (p = .009) and patient safety (p = .002).

CONCLUSION

The use of EMVs in simulation prebriefing is an innovative teaching strategy to prepare undergraduate nursing students with the knowledge and skills required to enter the simulated environment. Through watching an exemplar demonstration of desired behaviors, students significantly improved their simulation performance and demonstrated clinically competent care of an acutely ill simulated patient. [J Nurs Educ. 2023;62(8):454-460.].

Nursing Students' Fear of Negative Evaluation and Perceptions of Clinical Decision-Making

BACKGROUND

Nursing is a profession based on theoretical knowledge and practice, and the clinical decision-making process is important. Many factors affect the fear of negative evaluation, and fear of a negative evaluation is a potential variable that can affect clinical decision-making.

METHOD

This descriptive cross-sectional study included undergraduate nursing students (n = 283).

RESULTS

Nursing students' fear of a negative evaluation and clinical decision-making scale scores were 31.92 ± 08.51 and 149.18 ± 13.67, respectively. No significant relationship was identified between the scores (p > .05).

CONCLUSION

The fear of a negative evaluation was not associated with nursing students' perceptions of clinical decision-making. To reduce nursing students' fear of a negative evaluation and improve their clinical decision-making ability, appropriate training programs should be developed and implemented by nursing educators and administrators. [J Nurs Educ. 2023;62(6):325-331.].

A Multisite Assessment of Saudi Bachelor Nursing Students' Perceptions of Clinical Competence and Learning Environments: A Multivariate Conceptual Model Testing

Background: It is thought that students’ perceptions of educational and clinical learning environments improve the effectiveness of curricula and professional standards. It is essential to examine the educational and clinical learning environments in which nursing students learn, as well as how nursing students evaluate particular factors of these environments. Objectives: The objectives of this study were to (1) identify nursing students’ perceptions on professional competence and learning environments in the classroom and clinical settings and (2) test a hypothetical model of variables that influence and predict students’ perceptions of learning environments and professional competencies. Methods: The study employed a descriptive cross-sectional methodological design. Five hundred and eighteen undergraduate nursing students were recruited from three Saudi Arabian universities using a convenient sampling technique. Using valid and reliable self-reported questionnaires, including the Dundee Ready Educational Environment Measure (DREEM), the modified Clinical Learning Environment Inventory (CLEI), and the Nurse Professional Competence Scale-Short (NPCS-SF), data were collected. Results: Perceptions of professional competence and learning environments were positive among nursing students. With satisfactory fit indices, the final model found that students’ perceptions of clinical competence were significantly predicted by their perceptions of the clinical environment (B = 0.43, p < 0.001), students’ perceptions of university environments (B = 0.29, p < 0.001), ward type (B = 0.12, p < 0.001), and students’ year of study (B = 0.11, p < 0.001). The students’ perceptions of clinical environments were significantly predicted by their perceptions of the university environment (B = 0.31, p < 0.001), gender (B = 0.13, p < 0.001), students’ year of study (B = 0.12, p < 0.001), and ward type (B = 0.11, p < 0.001). Moreover, the students’ perceptions of the university environment were significantly predicted by gender (B = 0.11, p < 0.001) and length of training (B = 0.12, p < 0.001). Conclusions: A range of factors might influence students’ perceptions of their professional competence and learning environments. Improving the learning environments and clinical experiences of students could enhance their clinical competence. This study’s findings provide evidence for how to enhance the learning environments in the classroom and clinical settings in order to improve students’ clinical competence, which will ultimately result in better patient outcomes. It is a top priority for nursing educators all around the world to improve classroom and clinical learning settings that foster students’ learning and professional competencies.

Levels of motivation and basic psychological need satisfaction in nursing students: In perspective of self-determination theory

BACKGROUND

Motivation is the first and most important constituent element of learning behavior. One of the most important theories in this field is self-determination theory (SDT) which is a general theory of motivation. According to this theory, the satisfaction of basic psychological needs of autonomy, competence, and relatedness are effective in the internalization of incentive. Hence this theory can be a good foundation for reforming medical education programs.

OBJECTIVE

The aim of this study was determining the basic psychological need and the effect of it on level of motivation and self-determined motivation of nursing student in the field.

METHODS

This is a cross-sectional, descriptive-analytical study done through a census on 243 nursing students of Guilan University of Medical Sciences. Data gathering tool was demographic information, motivation level, and basic psychological needs questionnaire. Data were analyzed using independent t-test, Spearman and Pearson correlation, Man-Whitney, backward regression considering P < 0.05.

RESULTS

The findings showed that the majority of students (51.9 %) were female and, the mean age was 21 years. Statistical tests indicated a significant relationship between levels of motivation, basic psychological needs, and demographic variables. However, the regression coefficients indicated that the need for competence and relatedness could be a suitable predictor for internal motivation.

CONCLUSION

Basic psychological needs satisfaction, especially needs of competence and relatedness in the clinical field by instructors can lead to internalization of their incentive and positive outcomes.

Student nurse experiences in public healthcare clinical practice during the COVID-19 pandemic: A qualitative study

BACKGROUND

The social crises induced by the coronavirus disease (COVID-19) pandemic have had adverse effects on the global healthcare system. Public healthcare centers have restructured their services to address clinical needs at the forefront of the pandemic. This led to nursing students immersing themselves in clinical experience while practicing at public healthcare centers during the COVID-19 pandemic.

OBJECTIVES

The aim of this study was to explore and understand the experiences of nursing students practicing in public healthcare centers in response to the COVID-19 pandemic.

DESIGN

A qualitative study.

SETTING

A public healthcare center in Korea.

PARTICIPANTS

Twenty third-year nursing students from a university in Korea.

METHODS

A qualitative study design was used where students provided reflections on their experience in clinical practice at public healthcare centers. Data were collected between November 5 and December 17, 2021. Data were analyzed using the phenomenological approach proposed by Colaizzi.

RESULTS

Three categories emerged. Students immersed themselves in a practicum experience in public healthcare in response to COVID-19. Students recognized the challenges associated with providing healthcare services during the pandemic. The students expanded their field of interest to community nursing.

CONCLUSION

In the context of COVID-19, supplementing academic education and training for nursing students with experience in clinical practice at public healthcare centers enhanced the capabilities of future nurses. It increased confidence in their work and responsibilities.

Nurse students' perception of the academic learning environment in Tunisian institutes of nursing sciences: A multisite cross-sectional study

BACKGROUND

A learning environment is an important determinant of students' learning behaviours, professional competencies, and academic performances. It is also an essential indicator of the quality of teaching programmes. To date, there is not a Tunisian study, that analysed nurse students' perceptions of the educational environment.

AIMS

This study aimed to assess the perception of Tunisian higher nursing institutes students regarding the quality of the learning environment, and identify the factors associated with it.

DESIGN

Multi-site cross-sectional survey.

SETTING

Five universities of nursing sciences in Tunisia.

PARTICIPANTS

Undergraduate nursing students (n = 736).

METHODS

A cross-sectional descriptive study was conducted during the academic year 2019-2020. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was used to describe the students' perceptions of the learning environment. The participants were recruited using a convenience sampling method. Statistical analyses were performed using SPSS version 20. One-way analysis of variance and t-test were used to compare the DREEM scores and socio-demographic/academic characteristics. A p-value of less than 0.05 was considered significant.

RESULTS

The mean overall DREEM score was 110.92 ± 20.55, indicating a positive perception of the learning environment. The year of study was significantly associated with total DREEM scores, with first-year students scoring higher than third- and second-year students (p = 0.035). The perception of the learning environment varied significantly among the five institutes (p < 10^-3). Demotivated atmosphere, lack of a support system, poor timetable organisation, and teacher-centred learning were revealed as problematic areas that needed improvement (individual score < 2). Our adapted version of the DREEM obtained acceptable internal consistency (Cronbach's alpha coefficient of 0.881).

CONCLUSIONS

The study reported positive perceptions of the students regarding their academic learning environment. However, the DREEM scores reflected a traditional learning environment. It is essential to re-engineer the curriculum and shift the teaching paradigm towards 'student-centred curriculum' to enhance both the effectiveness and the efficiency of the learning environment.

Nursing students' classroom climate perceptions: A longitudinal study

BACKGROUND

As a versatile and dynamic process, classroom climate directly affects the learning levels of students and their quality of life while in school.

OBJECTIVES

The study was conducted to explore and compare nursing students' perceptions of classroom climate throughout four years of university education and to evaluate the influencing factors.

DESIGN AND SETTINGS

The longitudinal study was conducted between 2017 and 2020 in the nursing department of a university in Turkey.

PARTICIPANTS

The study was carried out with 134 nursing students who enrolled in their first year and agreed to participate in the study.

METHODS

The data were collected at the end of the fall semester of each of the four years using the Student Information Form and the Classroom Climate Inventory.

RESULTS

The mean score of students' perceptions of classroom climate was 2.88 ± 0.83 for all academic years. The classroom climate inventory mean scores of fourth-year students were statistically significantly higher than their scores in the first and third years (p = 0.000). The students' classroom climate levels were statistically significantly affected by the positive classroom communication among students in all academic years in a positive direction. Statistically significant effective factors in students' classroom climate perceptions by year were as follows: the sense of belongingness to the class in the second and third years (although significantly lower in the first year), socio-cultural activities organized at school the second and fourth years (p < 0.05), instructors' attitudes supporting classroom communication in the first year, and opportunities supporting communication in the school environment in the fourth year (p < 0.05).

CONCLUSIONS

Students' perception of the classroom climate was moderate overall and affected by positive classroom communication among students in all academic years. School administrators and educators can develop strategies and organize activities to increase positive communication in the classroom.

Academic motivation and self-directed learning readiness of nursing students during the COVID-19 pandemic in three countries: A cross-sectional study

BACKGROUND

It is crucial to evaluate student academic motivation and self-directed learning (SDL) readiness while teaching online or flexibly. During the coronavirus disease 2019 epidemic, there were few investigations on the link between academic motivation and SDL readiness.

AIM

This study investigated the connection between academic motivation and SDL readiness and the three academic motivation domains' predictive features.

METHODS

This cross-sectional study used convenience sampling to recruit 1187 nursing students from four nursing colleges in three countries. We utilized the Academic Motivation Scale College Version and Self-directed Learning Readiness Scale for Nurse Education to collect data. Descriptive and inferential statistics were employed to analyze the data.

RESULTS

Extrinsic motivation received the highest mean. Most nursing students exhibited SDL readiness, whereas "desire for learning" was rated the highest dimension of SDL readiness. We found significant differences in nursing students' intrinsic and extrinsic motivation and amotivation between the three countries. Finally, country, gender, and intrinsic motivation were significant predictors of the nursing students' SDL readiness.

CONCLUSION

Among Filipino, Saudi, and Thai nursing students, their SDL readiness is influenced by the intrinsic motivation domain. Therefore, nursing students with higher levels of intrinsic motivation are proactive learners for SDL.

Exploring student perceptions of the learning environment in four health professions education programs

The desire to support student learning and professional development, in combination with accreditation requirements, necessitates the need to evaluate the learning environment of educational programs. The Health Education Learning Environment Survey (HELES) is a recently-developed global measure of the learning environment for health professions programs. This paper provides evidence of the applicability of the HELES for evaluating the learning environment across four health professions programs: medicine, nursing, occupational therapy and pharmaceutical sciences. Two consecutive years of HELES data were collected from each program at a single university (year 1 = 552 students; year 2 = 745 students) using an anonymous online survey. Reliability analyses across programs and administration years supported the reliability of the tool. Two-way factorial ANOVAs with program and administration year as the independent variables indicated statistically- and practically-significant differences across programs for four of the seven scales. Overall, these results support the use of the HELES to evaluate student perceptions of the learning environment multiple of health professions programs.

Clinical decision-making of bachelor and clinical internship (professional) nursing students in Indonesia

Background: Clinical decision-making is an essential element of every professional nursing career. A nurse’s aptitude for clinical decision-making influences the quality of the healthcare they provide. This research aims to describe the clinical decision-making among nursing students at Universitas Indonesia.

Design and Methods: This research employed a cross-sectional design by sampling 216 students across several types and level of students’ programs in the University. The samples were selected using a stratified random sampling technique and met the inclusion criteria. The instrument of this research was the 2014 Nursing Decision Making Instrument. The survey instrument was translated from English into Indonesian, and its validity and reliability were tested (α Cronbach value = 0.816).

Results: The results of the univariate analysis revealed that students’ clinical decision-making abilities vary; 59.2% in the analysis category, 40.3% in the quasi-rational category, and 0.5% in the intuitive category.

Conclusion: This research concludes that the clinical decisionmaking ability of bachelor and professional nursing students’ program is in the analysis category that indicate that students’ clinical decision-making abilities involve their explicit-theoretical knowledge and are supported by evidence-based practices. Therefore, their clinical decision-making can be logically defended, though it requires a longer duration of time to strengthen those abilities. The students’ clinical decision-making must continuously be improved to enable them to create precise decisions based on various situations and clinical conditions.

The psychometric properties of the Persian version of the MUSIC Model of Academic Motivation Inventory among nursing students

Aim

To determine the psychometric properties of the Persian version of the MUSIC Inventory in nursing students.

Design

Cross‐sectional psychometric study.

Methods

Transcultural adaptation of the MUSIC Model of Academic Motivation Inventory was carried out using translation to Persian and back‐translation. Then, the qualitative and quantitative face and content validity of the inventory were evaluated. Construct validity was assessed by exploratory factor analysis. To perform construct validity and reliability, a convenience sample of 360 undergraduate nursing students was recruited. Cronbach's alpha was used to assess internal consistency reliability.

Results

Cronbach's alpha for all items of the MUSIC inventory was .94, and each factor was between .72–.93. Exploratory factor analysis supported the 5‐factor structure of the MUSIC inventory. These 5 factors explain 66.59% of the overall extracted variance. Three items of the MUSIC inventory, which were related to the empowerment component, were deleted.

Conclusion

Based on the findings of this study, the Persian version of the MUSIC Model of Academic Motivation Inventory is a valid and reliable tool for Persian language nursing students.

Nurse anesthetists' reflections and strategies when supervising master's students

OBJECTIVE

The objective was to describe registered nurse anesthetists' reflections and strategies in relation to supervision of specialist nursing students in anesthetic care.

BACKGROUND

In anesthesiology care, registered nurse anesthetists work with advanced care in a high-technology environment. The complexity of working with production requirements, time pressure and patient safety creates great challenges. Registered nurse anesthetists have a unique position and are responsible for the patient's life during surgery. At the same time, they must supervise students without risking patient safety. Little research to date has focused on the clinical supervisory role in this context.

DESIGN

A qualitative design was used.

METHODS

The data were collected in 2018 from qualitative interviews with a purposive sample of twelve student registered nurse anesthetists from a large hospital in Sweden. The data were analyzed using content analysis.

RESULTS

The results demonstrated that the dual role of registered nurse anesthetist and supervisor was experienced as satisfying, important and promoting development, although it also involved several challenges. Creating opportunities for supervision and learning in perioperative care improved supervisors' prerequisites for supporting students and helping them develop. Being a supervisor was also rewarding, and given the interplay with students, supervision was viewed as a process of mutual growth.

CONCLUSION

By focusing on students and their learning, we can help produce well-qualified registered nurse anesthetists who have positive experiences of the workplace and who want to stay in their profession.

Nursing and Midwifery Students' Satisfaction with Their Clinical Rotation Experience: The Role of the Clinical Learning Environment

BACKGROUND

The clinical learning environment and clinical rotation experience of students are integral to nursing curriculum and are a crucial component of nursing education which helps transform theoretical knowledge to clinical practical skills.

OBJECTIVE

This study was aimed at assessing the role of the clinical learning environment on undergraduate nursing and midwifery students' satisfaction with their clinical rotation experience.

METHOD

The study employed a quantitative cross-sectional survey design. Data was collected from a sample of 240 undergraduate nursing and midwifery students of the University for Development Studies, Tamale, Ghana, using a structured questionnaire. Ethical approval was obtained from the University of Cape Coast Ethics Review Board. Descriptive analysis was displayed as frequencies and percentages. Inferentially, Fisher's exact test, linear regression, and Spearman's correlation tests were used to test for and quantify associations between independent and dependent variables at p ≤ 0.05.

RESULTS

The level of students' satisfaction with both clinical rotation experience and the clinical learning environment was high (65.6% and 63.5%, respectively). A statistically significant association of the students' satisfaction with their clinical rotation experience was found. There was a statistically significant relationship between the clinical learning environment (χ 2 (9, N = 224) = 80.665, p < 0.001), pedagogical atmosphere in the clinical area (r s  = 0.379, p < 0.001), the leadership style of the ward manager (r s  = 0.340, p < 0.001), the premises of nursing in the ward environment (r s  = 0.501, p < 0.001), and the students' satisfaction with their clinical rotation experience.

CONCLUSION

These findings provide nurse educators and clinicians with meaningful understanding about areas to prioritise when planning clinical learning opportunities in such a way that skills learning and practice of nursing skills are successful and satisfactory for undergraduate student nurses and midwives.

A quasi-experimental study of specialized training on the clinical decision-making skills and social problem-solving abilities of nursing students

Background: In Asian countries, clinical practice places little emphasis on developing the clinical decision-making skills and social problem-solving abilities of nursing students.Objective: This study explored whether a 3-months-in-1-unit training program improved nursing students' clinical decision-making skills and social problem-solving abilities compared to the 1-month-in-1-unit rotation program.Methods: A quasi-experimental study was conducted. A 3-months-in-1-unit training program was conducted in the intervention group (n = 77), rountine1-month-in-1-unit rotation was conducted in the control group (n = 73). Clinical decision-making skills and problem-solving abilities were measured using the Chinese version of the Clinical Decision-Making Nursing Scale and the Social Problem-Solving Inventory-Revised.Results: Nursing students in the intervention group scored higher clinical decision-making skills (t = 7.677, p < 0.05), positive problem orientation (t = 18.359, p < 0.05), negative problem orientation (t = -3.711, p < 0.05), and rational problem-solving (t = 2.312, p < 0.05) than the control group.Conclusions: The 3-months-in-1-unit specialized training program had a significant positive impact on students' clinical decision-making skills and social problem-solving abilities.

The predict of metacognitive awareness of nursing students on self-confidence and anxiety in clinical decision-making

PURPOSE

This study was conducted to investigate the affect that metacognitive awareness in nursing students has on self-confidence and anxiety with respect to clinical decision-making.

DESIGN AND METHODS

The sample for this descriptive, correlational, and cross-sectional study consisted of 186 nursing students who voluntarily participated. Data were collected using the Metacognitive Awareness Inventory and Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale. Correlation and regression analyses were then performed on the data.

FINDINGS

Nursing students' metacognitive awareness level explained the three subdimensions of self-confidence in clinical decision-making by 26.7% (r²  = 0.267, p < 0.01), 24.6% (r²  = 0.246, p < 0.01), and 26.8% (r²  = 0.268, p < 0.01), respectively. Nursing students' metacognitive awareness level explained the three subdimensions of anxiety in clinical decision-making by 3.7% (r²  = 0.037, p < 0.01), 3.2% (r²  = 0.03, p < 0.05), and 2.4% (r²  = 0.024, p < 0.05), respectively.

IMPLICATIONS FOR NURSING PRACTICE

Clinical decision-making skills can be supported by increasing students' metacognitive awareness.

Nursing Students' Experiences Related to Operating Room Practice: A Qualitative Study

PURPOSE

The purpose of this study was to examine the experiences of nursing students concerning operating room (OR) practice.

DESIGN

A qualitative design was used in this study.

METHODS

Data were collected from second-year nursing students using the semistructured interview form including open-ended questions about their OR experiences. Perspectives of phenomenological approach including existentials of lived body, lived relations, lived space, and lived time were used in data analysis.

FINDINGS

The study data regarding experiences of nursing students concerning OR practice were organized under three themes, namely, "OR environment," "emotions," and "career plans after graduation." Nine subthemes emerged: educational experience, teamwork, and communication, excitement, enjoyment, anxiety, fear, different emotions, working as a surgical nurse, and working in departments other than OR.

CONCLUSIONS

In clinical environments, student nurses should be supported by staff and instructors to facilitate learning and create meaningful learning experiences.

What Academic Factors Influence Satisfaction With Clinical Practice in Nursing Students? Regressions vs. fsQCA

Clinical practices are considered one of the cornerstones in nurses' education. This study provides a framework to determine how factors in the academic environment, influence nursing student's satisfaction with their practices. A cross-sectional analytical study was conducted in a convenience sample of 574 nursing students at a private university in Valencia, during the 2016/2017 academic year, 79% (456) were women. Two statistical methodologies were used for data analysis: hierarchical regression models (HRM) and fuzzy sets qualitative comparative analysis (fsQCA). The HRM indicate that the students' mean score influences all dimensions of satisfaction. Furthermore, in the fsQCA, the type of service and center, as well as the type of management, the preference in the choice of the practice center and the number of students per period per clinical educator influence satisfaction with clinical practices. These results could be used to understand how academic factors influence nursing students' satisfaction with their clinical practices and to create intervention programmes that improve it. This will help prepare students to be the future nursing workforce.

A predictive model of student nursing competency in clinical practicum: A structural equation modelling approach

BACKGROUND

Clinical teaching is the most important element in the development of students' nursing competencies. However, students' learning modalities in clinical settings are unclear.

OBJECTIVE

To analyse path relationships affecting students' learning outcomes in clinical practicum using LISREL software.

DESIGN

A cross-sectional survey was administered.

SETTINGS AND PARTICIPANTS

Participants were 392 senior students who had completed their final internship recruited from two nursing programmes in central Taiwan.

METHODS

Administration and completion of the following structured questionnaires: the Competency Inventory of Nursing Students, the Teaching Competence of Nurse Preceptor questionnaire, the Student Evaluation of the Clinical Education Environment, Level of Reflective Thinking, and the Metacognitive Inventory for Nursing Students.

RESULTS

The results suggested that teaching competence may indirectly affect nursing competence through metacognition and reflection. The clinical learning environment may directly affect nursing competence or indirectly affect nursing competence through metacognition. Both metacognition and reflection have direct effects on nursing competence, and reflection exerts indirect effects on nursing competence through metacognition. The path relationships differed according to the employment plan group.

CONCLUSIONS

Reflection and metacognition are essential skills for the development of nursing competence in clinical settings. Clinical instructors must facilitate student learning by fostering a positive learning environment and teach students the reflective and self-regulation skills necessary to achieve favourable learning outcomes in clinical settings.

A Comparison of Patient Safety Competencies between Clinical and Classroom Settings among Nursing Students

Background: As nurses play an important role in the implementation of patient safety in hospitals, competencies of patient safety should be developed and enhanced among nursing students. Self-assessment is a method that can be used to assess patient safety and its dimensions to help the students prepare themselves before entering the work life.Purpose: This study aimed to investigate differences in patient safety competencies between classroom and clinical settings among nursing students using a self-assessment method.Methods: A descriptive study using the Health Professional Education in Patient Safety Survey (H-PEPSS) questionnaire was conducted among 181 nursing students in a public university in Indonesia. Paired t-test, ANOVA, and independent t-test were performed to determine the comparison in the values of patient safety dimensions across classroom, clinical learning, and year of nursing course.Results: Nursing students showed a higher mean value in the classroom setting than the clinical setting. Out of the seven dimensions of patient safety competencies, “clinical safety” (M=4.36) and “communicate effectively” (M=4.29) obtained the highest score in classroom setting, while “adverse events” showed the lowest (M=4.03). In the clinical setting, “clinical safety” (M=4.19) and “communicate effectively” (M=4.12) obtained the highest score, while “working in teams” (M=3.82) was the lowest. The third-year students showed a better score than the fourth year in most dimensions.Conclusion: In this study, the patient safety competencies among nursing students were higher in the classroom setting than in the clinical setting. It is recommended to investigate the factors that can increase the achievement of patient safety competence among nursing student in the clinical setting.

Students' perceptions of teaching factors that demotivate their learning in lectures and laboratory-based skills practice

Objectives

The objective of this paper is to report students' perceptions of factors that demotivated their learning in lectures and laboratory-based skills practice settings.

Methods

A total of 23 students were recruited from the Bachelor of Nursing courses at three Japanese universities, using purposive sampling. A semi-structured interview was conducted with each participant between November 2017 and January 2018 to elicit their perceptions about which aspects of the teaching context demotivated their engagement in learning. The results were analyzed using thematic analysis.

Results

Three themes were generated: a restrictive environment, discouraging attitudes and discouraging teaching approaches.

Conclusions

To prevent students from experiencing demotivation, teachers in the nursing faculty need to manage learning resources more effectively, create a quiet and focused atmosphere to allow students to concentrate, and be enthusiastic about teaching. They also need to add value to their classes, help students to follow lectures, and ensure that the workload they give their students is appropriate.

Evaluating the learning environment of nursing students: A multisite cross-sectional study

BACKGROUND

Identifying students' experiences of the university and clinical learning environments informs quality improvement of courses.

OBJECTIVES

To investigate undergraduate nursing students' perceptions of their education environment and the facilitators and barriers to learning, during university and clinical experiences.

DESIGN

Multi-site cross-sectional survey.

SETTING

Four universities in Vietnam.

PARTICIPANTS

Undergraduate nursing students (n = 891).

METHODS

Between May and August 2016, Vietnamese versions of the Dundee Ready Education Environment Measure (Nursing) and the modified Clinical Learning Environment Inventory measured students' perceptions of university and clinical environments respectively. Two additional open-ended questions elicited perceptions of facilitators and/or barriers to clinical learning.

RESULTS

The university environment was rated as needing improvement and significant differences between universities and year of study detected. University environment mean scores were significantly higher in second year students compared with those in the third or fourth years of study. Active teaching and interpersonal relationships at university were rated positively. Overall, clinical environment scores were mid-range and second year students' mean scores were significantly higher than third or fourth years. Clinical placements greater than four weeks duration had significantly higher mean score than two week placements.

CONCLUSIONS

Evaluation of university and clinical experiences assists with identifying potential areas of interruption to nursing students' transfer of learning. In both learning environments, Vietnamese students' experiences were similar to those experienced in Western countries in that interpersonal relationships with teachers and ward staff were key factors perceived to influence learning. A notable difference in this study was the hospital environment in Vietnam had features unique to this country that interrupted students' transfer of learning. Globally it is a priority for nurse educators to facilitate both on and off campus environments that promote students' learning. Assessing these environments is a useful strategy for quality improvement of courses.

Academic Motivation in Nursing Students: A Hybrid Concept Analysis

Background:

Taking into account the breadth of the concept of motivation and its importance for nursing students, it is imperative to clarify the concept of academic motivation. This study is an attempt to analyze the concept of academic motivation in nursing students.

Materials and Methods:

The study was carried out in 2018 as a combined literature review and qualitative research. Hybrid concept analysis model was employed to clarify the concept at three phases. At theoretical phase, articles indexed in credential databases were searched using keywords “academic motivation” and “nursing.” Totally, 30 articles were analyzed. At fieldwork phase, 12 nursing students were interviewed. At conclusive phase, the findings of the two earlier phases were analyzed. After determining the attributes, antecedents, and consequences, a final definition of academic motivation in nursing student was introduced.

Results:

Academic motivation has six main attributes including “being an internal process,” “purpose oriented,” “variable,” “unique,” “driving force of educational performance,” and “facilitator of learning and educational achievement.” In addition, antecedents and consequences of academic motivation in the nursing students were revealed and a general definition of the concept was codified.

Conclusions:

Academic motivation of nursing students is a broad and multi-dimensional concept that is affected by various personal, family, social, educational, and professional factors. Moreover, it is a factor in achieving academic success, better quality of learning, creativity, academic satisfaction, reduction of anxiety, continuing education, and training competent nurses.

Comparison of students’ motivation at different phases of medical school

SUMMARY INTRODUCTION: Knowledge about student motivation allows educators to broaden their understanding and to establish strategies that make it possible to enhance motivation. OBJECTIVES To investigate the levels of student motivation at different phases of medical education, comparing incoming students' motivation with that of those at the end of their studies, as well as during the different preclinical, clinical, and clerkship cycles. METHOD: Cross-sectional study including students from a Brazilian public university. The questionnaire included sociodemographic data and the Academic Motivation Scale (AMS). Student motivation was compared at different phases of the medical course. RESULTS: 710 students were included. Students in the preclinical phase (1st-2nd years) had higher levels of integrated regulation AMS (e.g.,"Education is a privilege."), introjected regulation AMS (e.g."I come because it is what is expected of me."), and intrinsic motivation AMS (e.g."School is a pleasure"). Students in the clinical phase (3rd-4th years) had higher levels of amotivation (e.g., "I'm wasting my time at school.") and external regulation AMS (e.g., "I'm coming to school to earn a degree"). AMS levels of external regulation, introjected relation, and integrated regulation were different for Clerkship students (5th-6th years) compared to preclinical students, but not for clinical students. Comparing only the first and last years, incoming students had higher levels of integrated regulation AMS and lower levels of amotivation AMS and external regulation AMS. CONCLUSION: Important motivational changes were found during different phases of medical school, with higher levels of motivation during the course's initial semesters. These findings can aid in developing educational strategies to stimulate self-determined education.

The transfer of theoretical knowledge to clinical practice by nursing students and the difficulties they experience: A qualitative study

BACKGROUND

Nursing education contains both theoretical and practical training processes. Clinical training is the basis of nursing education. The quality of clinical training is closely related to the quality of the clinical learning environment.

OBJECTIVES

This study aimed to determine the transfer of theoretical knowledge into clinical practice by nursing students and the difficulties they experience during this process.

METHODS

A qualitative research design was used in the study. The study was conducted in 2015 with 30 nursing students in a university located in the east of Turkey, constituting three focus groups. The questions directed to the students during the focus group interviews were as follows: What do you think about your clinical training? How do you evaluate yourself in the process of putting your theoretical knowledge into clinical practice? What kind of difficulties are you experiencing in clinical practices?

RESULTS

The data were interpreted using the method of content analysis. Most of the students reported that theoretical information they received was excessive, their ability to put most of this information into practice was weak, and they lacked courage to touch patients for fear of implementing procedures incorrectly. As a result of the analysis of the data, five main themes were determined: clinical training, guidance and communication, hospital environment and expectations.

CONCLUSIONS

The results of this study showed that nursing students found their clinical knowledge and skills insufficient and usually failed to transfer their theoretical knowledge into clinical practices. The study observed that nursing students experienced various issues in clinical practices. In order to fix these issues and achieve an effective clinical training environment, collaboration should be achieved among nursing instructors, nurses, nursing school and hospital managements. Additionally, the number of nursing educators should be increased and training programs should be provided regarding effective clinical training methods.

A study of the relationship between the study process, motivation resources, and motivation problems of nursing students in different educational systems

BACKGROUND

The study process is related to students' learning approaches and styles. Motivation resources and problems determine students' internal, external, and negative motivation. Analyzing the study process and motivation of students yields important indications about the nature of educational systems in higher education.

OBJECTIVES

This study aims to analyze the relationship between the study process, and motivation resources and problems with regard to nursing students in different educational systems in Turkey and to reveal their effects according to a set of variables.

DESIGN

This is a descriptive, cross-sectional and correlational study.

SETTINGS

Traditional, integrated and problem-based learning (PBL) educational programs for nurses involving students from three nursing schools in Turkey.

PARTICIPANTS

Nursing students (n=330).

METHODS

The data were collected using the Study Process Questionnaire (R-SPQ-2F) and the Motivation Resources and Problems (MRP) Scale.

RESULTS

A statistically significant difference was found between the scores on the study process scale, and motivation resources and problems scale among the educational systems. This study determined that the mean scores of students in the PBL system on learning approaches, intrinsic motivation and negative motivation were higher. A positive significant correlation was found between the scales.

CONCLUSIONS

The study process, and motivation resources and problems were found to be affected by the educational system. This study determined that the PBL educational system more effectively increases students' intrinsic motivation and helps them to acquire learning skills.

Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students

BACKGROUND

High-fidelity simulation (HFS) offers a strategy to facilitate cognitive, affective, and psychomotor outcomes and motivate the new generation of students.

OBJECTIVES

The purpose of this study was to examine the impact of using high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students.

DESIGN

A post-test, quasi-experimental design was used.

SETTINGS

Two private universities in Lebanon were targeted to implement the intervention.

PARTICIPANTS

A convenience sample of 56 nursing students from two private universities in Lebanon were recruited.

METHODS

Data were collected using the Lasater Clinical Judgment Rubric and the Motivated Strategies for Learning questionnaires.

RESULTS

Nursing students exhibited significant improvement in clinical judgment and motivation due to exposure to HFS. There was a significant difference post HFS between the intervention group and the control group in clinical judgment intervention (t=5.23, p<0.001) and motivation for academic achievement (t=-6.71, p<0.001). The intervention group had a higher mean score of clinical judgment (29.5, SD=5.4) than the control group (22.1, SD=5.7) and, similarly, students had higher mean scores of motivation (198.6, SD=10.5) in the intervention group than in the control group (161.6, SD=20). The analysis related to differences between the intervention and control groups in motivation and clinical judgment; controlling for previous experience in health care services, the analysis showed no significant difference (Wilk's lambda =0.77, F=1.09, p=0.374).

CONCLUSION

There is a need for nursing educators to implement HFS in nursing curricula, where its integration can bridge the gap between theoretical knowledge and nursing practice and enhance critical thinking and motivation among nursing students.