Clinical placement experiences by undergraduate nursing students in selected teaching hospitals in Ghana

Male nursing students' experiences of their clinical internships: A qualitative study

Background

Nursing has traditionally been a predominantly female profession; however, there has been a gradual increase in the proportion of male nursing students in recent years. Male nursing students may encounter distinct challenges within clinical settings, potentially impacting their physical and mental well-being.

Aim

This study aims to explore the clinical internship experiences of male nursing students and provide them with adequate support for their successful adaptation to clinical roles.

Methods

This study used a descriptive design and qualitative approach. The participants were enrolled using a convenience sampling method. Data were collected using individual face-to-face semi-structured interviews.

Results

Male nursing students' experiences of their clinical internships were described through the following themes: (1) dynamics of working as a nurse, (2) not just a male nursing student, (3) gender-based stereotypes, (4) balance between forte and failing, (5) difficulties and challenges when working in hospitals, and (6) lessons learned and knowledge needs.

Conclusions

Our research findings have significantly enhanced our comprehension of male nursing students' experiences and offered valuable recommendations for both nursing education and clinical practice. Simultaneously, these results provide essential information support for nursing educators and hospital administrators.

Delegating care as a double-edged sword for quality of nursing care: a qualitative study

BACKGROUND

Considering the significance of care delegation in enhancing the quality of nursing care and ensuring patient safety, it is imperative to explore nurses' experiences in this domain. As such, this study aimed to explore the experiences of Iranian nurses regarding the delegation of care.

METHODS

This qualitative study was conducted between 2022 and 2023, employing the content analysis method with a conventional approach. The study utilized purposeful sampling method to select qualified participants. Data collection was carried out through in-depth and semi-structured interviews utilizing open-ended questions. The data analysis process followed the steps proposed by Graneheim and Lundman (2004) and involved the use of MAXQDA version 12 software. To ensure the trustworthiness of the data, the study employed the four rigor indices outlined by Lincoln and Guba (1985).

RESULTS

In the present study, a total of 15 interviews were conducted with 12 participants, the majority of whom were women. The age range of the participants fell between 25 and 40 years. Through qualitative data analysis, eight subcategories and three main categories of "insourcing of care", "outsourcing of care" and "delegating of care to non-professionals" were identified. Additionally, the overarching theme that emerged from the analysis was "delegation of care, a double-edged sword".

CONCLUSIONS

The results of the study revealed that the delegation of care occurred through three distinct avenues: to colleagues within the same unit, to colleagues in other units, and to non-professionals. Delegating care was found to have potential benefits, such as reducing the nursing workload and fostering teamwork. However, it was also observed that in certain instances, delegation was not only unhelpful but also led to missed nursing care. Therefore, it is crucial to adhere to standardized principles when delegating care to ensure the maintenance of high-quality nursing care.

The development of a framework for clinical education programme of undergraduate nursing students in Ghana

INTRODUCTION

Clinical education is an important aspect of the training of nursing students but it is faced with challenges in Ghana. The development of a framework will respond to the need for improvement in the quality of clinical nursing education. This study describes part of a larger study which culminated in the development of a framework for a clinical education programme for undergraduate nursing students in Ghana. The aim of the current study was to integrate findings from a scoping review and situational analysis to develop a framework for clinical education in nursing.

METHODS

A sequential multimethod design approach was used to conduct the study. A scoping review on the practices that facilitate clinical nursing education and situational analysis were first conducted. The lessons learnt from the scoping review and the situational analysis provided the data matrix that was triangulated to develop the framework. The framework was developed using the model for clinical education developed by South African Nursing Education Stakeholders in consultation with experts in nursing education. An implementation plan was developed from the framework and evaluated using a Delphi technique.

FINDINGS

The resulting framework indicates the need for effective communication and collaboration between nursing education institution and the service setting to ensure that there is a well-structured clinical placement, formal supervision system and effective clinical assessment of students. The framework also proposes that to ensure quality clinical nursing education there is the need for Nursing Education Institutions to implement innovative and cost-effective clinical teaching methods.

CONCLUSION

The framework spells out the functions of the various stakeholders in nursing education and how these can be integrated and implemented to enhance quality clinical nursing education. Effectiveness of the thematic areas of the framework will increase the quality of clinical nursing education.

Association between postpartum depression and breastfeeding self-efficacy in mothers: a systematic review and meta-analysis

BACKGROUND

Depression is one of the most common mental disorders in the postpartum period. Depression can decrease self-efficacy in breastfeeding by reducing the mother's self-confidence. Considering the conflicting results regarding the relationship between postpartum depression and breastfeeding self-efficacy, this systematic review was conducted to investigate the relationship between breastfeeding self-efficacy and postpartum depression.

METHOD

In this systematic review, published articles in PubMed, Scopus, Web of Sciences, Cochrane Library, and Google Scholar databases were searched using English keywords "Self-efficacy, breastfeeding, breastfeeding Self-efficacy, depression, postpartum depression" without publication date limit. Data analysis was done with employing STATA14 software. Heterogeneity was assessed using I2 index which was 0%. Therefore, the fixed effects method was used to combine the data and perform meta-analysis.

RESULT

The results of the meta-analysis showed that based on the fixed effect method, depression was associated with decreased breastfeeding self-efficacy on the first day (SMD = 0.62, 95%CI: -0.830, -0.41, p = 0.0001) and on the third day (SMD = 0.84, 95% CI: -0.55,1.14, p = 0.0001). The Begg and Manzumdar test revealed no publication bias, with p = 0.317.

CONCLUSION

Postpartum depression may be associated with a decrease in the mother's breastfeeding self-efficacy and placing mother in a condition to pay low attention to her maternal role. Therefore, healthcare providers should provide adequate support according to the needs of mothers and develop diagnostic and treatment protocols to improve the level of maternal health.

The effect of "typical case discussion and scenario simulation" on the critical thinking of midwifery students: Evidence from China

BACKGROUND

Assessment ability lies at the core of midwives' capacity to judge and treat clinical problems effectively. Influenced by the traditional teaching method of "teacher-led and content-based", that teachers involve imparting a large amount of knowledge to students and students lack active thinking and active practice, the clinical assessment ability of midwifery students in China is mostly at a medium or low level. Improving clinical assessment ability of midwifery students, especially critical thinking, is highly important in practical midwifery education. Therefore, we implemented a new teaching program, "typical case discussion and scenario simulation", in the Midwifery Health Assessment course. Guided by typical cases, students were organized to actively participate in typical case discussions and to promote active thinking and were encouraged to practice actively through scenario simulation. In this study, we aimed to evaluate the effect of this strategy on the critical thinking ability of midwifery students.

METHOD

A total of 104 midwifery students in grades 16-19 at the West China School of Nursing, Sichuan University, were included as participants through convenience sampling. All the students completed the Midwifery Health Assessment course in the third year of university. Students in grades 16 and 17 were assigned to the control group, which received routine teaching in the Midwifery Health Assessment, while students in grades 18 and 19 were assigned to the experimental group, for which the "typical case discussion and scenario simulation" teaching mode was employed. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) and Midwifery Health Assessment Course Satisfaction Questionnaire were administered after the intervention.

RESULTS

After the intervention, the critical thinking ability of the experimental group was greater than that of the control group (284.81 ± 27.98 and 300.94 ± 31.67, p = 0.008). Furthermore, the experimental group exhibited higher scores on the four dimensions of Open-Mindedness (40.56 ± 5.60 and 43.59 ± 4.90, p = 0.005), Analyticity (42.83 ± 5.17 and 45.42 ± 5.72, p = 0.020), Systematicity (38.79 ± 4.70 and 41.88 ± 6.11, p = 0.006), and Critical Thinking Self-Confidence (41.35 ± 5.92 and 43.83 ± 5.89, p = 0.039) than did the control group. The course satisfaction exhibited by the experimental group was greater than that exhibited by the control group (84.81 ± 8.49 and 90.19 ± 8.41, p = 0.002).

CONCLUSION

The "typical case discussion and scenario simulation" class mode can improve the critical thinking ability of midwifery students and enhance their curriculum satisfaction. This approach carries a certain degree of promotional significance in medical education.

The effect of the clinical supervision model on nursing internship students' nursing process-based performance: an experimental study

BACKGROUND

The nursing process is a systematic method for identifying the patient's problems and planning to resolve them. It is also a crucial pillar of high-quality nursing care. Nursing internship students may lack the necessary skills to implement the nursing process due to the increased independence, the absence of constant professorial supervision, and limited experience. The clinical supervision model is a method of clinical education that bridges the gap between theory and practice.

OBJECTIVE

This study was conducted to investigate the impact of the clinical supervision model on the performance of nursing internship students in each of the five stages of the nursing process, as well as overall.

METHOD

This experimental study was conducted in 2022. The 70 eligible internship students were conveniently selected and randomly assigned to either an intervention or a control group. In the present study, the clinical supervision model was implemented for the intervention group, while the control group received routine supervision. This was carried out over six sessions in three months. The data collection was conducted using a researcher-developed checklist of nursing process-based performance in both groups. Moreover, the Manchester questionnaire was used to evaluate the model in the intervention group. The variables considered as confounding factors included age, gender, marital status, number of monthly shifts, and grades of the nursing process credit completed in the third semester. SPSS version 16 software, descriptive statistics (frequency distribution, percentage, mean, and standard deviation), and analytical statistics (independent t-test, chi square, repeated measures Anova and LSD) were used to analyze the data.

RESULTS

Intergroup analysis revealed that there was no significant difference between the scores of nursing process steps and the total score before the intervention in the control and intervention groups, as well as in baseline characteristics (P > 0.05). According to the intragroup analysis, the intervention group showed a significant increase in both the total scores and scores of nursing process steps over time (P < 0.001), whereas the control group exhibited contradictory results (P > 0.05). Finally, the "P-Value Intervention" demonstrated the effectiveness of this training model in improving the performance of the intervention group based on the nursing process compared to the control group. The mean score of the Manchester questionnaire in the intervention group was 136.74, indicating the high impact of implementing the clinical supervision model in the intervention group.

CONCLUSION

The results indicated that the implementation of the clinical supervision model led to improved utilization of the nursing process by nursing internship students at all stages. Therefore, it is recommended that nurse educators utilize the clinical supervision model by providing feedback on errors in action during supervision sessions to enhance the quality of nursing care provided by nursing internship students and improve patient safety in clinical environment.

About half of Ethiopian midwifery professionals reported being dissatisfied with their jobs: A systematic review and meta-analysis

Background

Increasing well qualified health professionals is a part of sustainable development goal to specially to decrease maternal mortality below 70 per 100,000 deaths. Contrarily, The Nursing and midwifery councils (NMC) expect that 36% of healthcare workers, especially midwives, are leaving their jobs due to high turnover rates and job unhappiness worldwide.

Methods

Studies were rigorously searched utilizing international databases from PubMed, Google Scholar, Cochrane Library, and Embase. Using the New Castle Ottawa scale for a cross-sectional study design, the quality of the articles that were searched was evaluated. The systemic review was conducted using the random effect approach, and statistical analysis was done using STATA version 17 software for the window. The Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guideline was followed for reporting results.

Results

A total of nine observational cross-sectional studies were included in this review. The pooled level of job satisfaction among midwives in Ethiopia was 52.2% (95% CI =41.7, 62.9). The pooled odds ratio showed that a significant positive association was found between midwives' job satisfaction and studied variables. Male midwife (OR = 0.45; 95% CI: 0.04, 0.87), fair supervision (OR = 2.03; 95%CI: 1.58-1), workload (OR = 1.72; 95%CI: 1.102-2.43) and motivation (OR = 1.64; 95%CI: 1.02-2.25) were strongly associated with job satisfaction.

Conclusion

Evidence suggested that motivating employees, providing fair supervision, fair workloads, and fostering positive relationships with managers are all crucial tactics for retaining and enhancing the satisfaction of health professionals at health care facilities in Ethiopian.

Predictors of Job Satisfaction and Association with Psychological Distress Among Academic Medicine Faculty in Kazakhstan

BACKGROUND

The growing concern for the faculty's well-being is allied with the emotionally demanding nature of teaching, which has an adverse effect on physical and mental health. There is abundant evidence that academic medicine faculty are subjected to high rates of dissatisfaction, distress, burnout, and turnover among medical educators. This study is dedicated to the exploration of the association between job satisfaction and psychological distress among academic medicine faculty in Kazakhstan.

METHODS

The observational cross-sectional study was conducted among medical educators in Kazakhstan between 1 October and 25 December. The survey was completed by 715 representatives of academic medicine staff. The sample size was calculated by Epi Info Sample Size Calculator, version 7.0. Multinomial logistic regression analysis using the forced entry procedure was applied to identify the factors associated with job satisfaction.

RESULTS

The prevalence of job satisfaction, depression, anxiety, and stress was 19.2%, 40.6%, 41.3%, and 53%, respectively. Three variables were significantly associated with job satisfaction: having a partner (AOR=0.79; 95% CI 0.38-1.659), having work experience of 5-10 years (AOR=0.32; 95% CI 0.14-0.74), and holding a Ph.D. degree (AOR=0.40; 95% CI 0.18-0.91). Job satisfaction was significantly associated with depression (p=0.005) and stress (p<0.001).

CONCLUSIONS

Compared to previous research in this area, our findings reported a higher prevalence of psychological distress and dissatisfaction. Potential reason for higher rates of dissatisfaction may be the global disruption due to COVID-19 pandemic.

The effects of video-assisted breastfeeding education given to primiparous pregnant women on breastfeeding self-efficacy: randomized control study

BACKGROUND

Breastfeeding is vitally important for the health of the mother, baby, family and society. Especially the perception of breastfeeding self-efficacy of primiparous pregnant women is an important factor in breastfeeding. This study was conducted to determine the effects of online video-supported breastfeeding education on breastfeeding self-efficacy in primiparous pregnant women.

METHODS

This randomized controlled study was conducted with primiparous pregnant women admitted to a university hospital in northern Turkey. The study involved 80 pregnant women, with 40 assigned to the experimental group and 40 to the control group. Participants in the intervention group received online video-assisted education, which covered the first meeting of the mother and baby as well as the initial breastfeeding session. The data for the breastfeeding self-efficacy scale were gathered at the onset of the study and three weeks later. In data analysis, categorical variables were assessed using the chi-square test, continuous variables and intergroup comparisons were conducted through the independent sample t-test, and intragroup comparisons were performed using the paired sample t-test.

RESULTS

While the baseline breastfeeding self-efficacy levels of the primiparous pregnant women were similar between the groups, statistically significant differences were observed both within (p = 0.000) and between (p = 0.000) groups in the breastfeeding self-efficacy scores of pregnant women in the intervention group after the education intervention.

CONCLUSION

Breastfeeding self-efficacy levels in the education group showed a statistically significant increase compared to both the pre-education and control groups. This highlights the importance of nurses providing support to primiparous pregnant women through video-assisted education during pregnancy to enhance breastfeeding self-efficacy.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT06121973 date of first registration (27/10/2023), retrospectively registered (08/11/2023).

Raising patients hope in despair: The culture of nursing care of burn pain: An ethnographic study

BACKGROUND

Although many studies have been carried out to address burn patients' pain and suffering, pain relief still remains an immense unsolved challenge with individual, social, and cultural aspects.

MATERIAL AND METHODS

This study was conducted aiming to investigate and explain nursing care in burn patients. This was a semifocused ethnographic research conducted in burns units in a referral teaching hospital (Mazandaran, Iran). The data were collected through descriptive, focused, and selective participant observations and ethnographic interviews with burns unit nurses selected via a purposeful sampling method. The collected data were analyzed on the basis of James Spradley's approach.

RESULTS

Three main categories and nine subcategories were obtained from data analysis that are as follows: 1) Bending over backward (tenacity, altruism, dedication, and conscience and constancy), 2) Prevention is worth a pound of cure (unique clinical methods, enhanced frustration tolerance through self-motivation and self-efficacy, raise patient's hope in despair), and 3) undisputed dominance of nursing art (reduced unsettling experiences, burnt and ripped body rehabilitation, patient stress management, and avoidance of false hope).

CONCLUSIONS

Although burn nurses are under huge physical and mental pressure, they enhance patients' pain tolerance through their art of nursing, which is a collection of empirical knowledge, huge work conscience, unique clinical skills, and various therapeutic communication techniques.

Barriers and Facilitators to Clinical Supervision in Ghana: A Scoping Review

Background

Clinical supervision involves the professional relationship between an experienced and knowledgeable clinician and a less experienced clinician in which the experienced clinician provides support toward the skills development of the less experienced one. The concept, structure, and format of clinical supervision vary in various jurisdictions and is influenced by the availability of resources, the training needs of supervisees, and organizational structures.

Aim

The aim of this scoping review was to explore, map out and synthesize the available literature on the facilitators and barriers to clinical supervision in Ghana.

Methods

The methodological framework developed by Arksey and O'Malley and modified by Levac et al. for scoping reviews, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews were used to ensure a coherent and transparent reporting of literature. A systematic search was conducted in PubMed, CINAHL, Scopus, Medline, and Google Scholar using key words and key terms. Articles published between January 1, 2000, and February 28, 2023, were included in the review.

Results

The initial search across all the databases yielded 208 results. Two independent reviewers completed both the title and abstract, and full text screenings. A third reviewer helped to resolve all discrepancies that arose during the screening process. The review included 20 articles and generated four themes: clinical supervision as a collaborative effort, feedback mechanism, training and adaptation, and challenges with implementation.

Conclusion

Findings from this review highlight that healthcare professionals in Ghana valued clinical supervision. However, the implementation of clinical supervision is faced with individual and systemic challenges. There is the need for on-going collaboration between educational and clinical institutions to develop modalities that promote clinical supervision in Ghana.

Explaining the Nurses' Spiritual Needs in the Oncology Department: A Qualitative Study

Background

It seems that improving the spiritual dimension of cancer patients can play an effective role in their mental and emotional peace. Meanwhile, oncology ward nurses are one of the most important healthcare providers that can help improve patients' relationship with God due to their more interaction and communication with patients. For this reason, this study aimed at explaining nurses' spiritual needs in an oncology ward.

Materials and Methods

This study was conducted based on the qualitative content analysis method. The participants included 11 nurses from the oncology ward of Seyed Al Shahada Hospital in Isfahan from 2021 to 2022. A semi-structured interview was administered to determine nurses' spiritual needs.

Results

Analysis of 11 interviews conducted with nurses revealed a total of four main codes, 13 sub-codes, and four sub-sub-codes. According to nurses' point of view, their spiritual needs can be classified into four dimensions as follows: communication with God, communication with oneself (intrapersonal communication), communication with others (interpersonal communication), and communication with environment. Administered interviews revealed the role of communication with God with six sub-codes as nurses' most important point of attention.

Conclusions

According to nurses' point of view, nurses' spiritual needs were divided into the dimensions of communication with God, communication with oneself, communication with others, and communication with environment. Therefore, it is necessary to simultaneously pay attention to oncology nurses' personal and social aspects to increase their spirituality.

Nurses and doctors 's awareness and knowledge towards treatment and care of cervical cancer patients: a cross-sectional study

AIM

The present study aimed to investigate healthcare professionals' perceptions and experiences in caring for cervical cancer patients. The present study was also designed to assess the healthcare professionals' attitudes toward cervical cancer screening and its prevention.

METHODS

A cross-sectional quantitative descriptive study was conducted, and 540 participants (240 nurses and 300 doctors), from different hospitals of Pakistan have been selected and interviewed.

RESULTS

Data was collected using structured questionnaires and SPSS was used to statistically analyze the data. Participants in the present study are questioned with respect to age, gender, and work experience. The mean age of the participants is 35 years. Among them, 41% of participants are < 35 years of age and 59% are > 35 years of age. In the case of gender, 22% of participants are males and 78% are females. 47% of the participants have work experience < 20 years and 53% have work experience > 20 years. Data from the present study showed that most of the nurses are less educated (basic education of middle and matric degree) with a simple diploma in nursing and midwifery. Nurses and doctors do not have any knowledge/experience of the patient's psychological counselling. Participants are also questioned with respect to HPV vaccination, 39% of nurses and 62% of doctors are vaccinated. The difference in vaccination frequency of participants was observed as statistically significant (p < 0.0001). In the case of treatment modalities, doctors have statistically more knowledge about the pap smear (p < 0.0001), cervical biopsy (p < 0.0001), colposcopy (p < 0.0001), and visual application after acetic acid application (p < 0.0001) compared to nurses. Data analysis showed that Pap smear was performed significantly higher in married females compared to unmarried (p < 0.0001).

CONCLUSION

our study provides a comprehensive and in-depth perspective of the nurses and doctors for cervical cancer patients. Cervical cancer prevalence is increasing due to inadequate knowledge and awareness among healthcare professionals. Improvement can be brought about by the regular use of treatment modalities in unmarried females also.

The effects of using the nurse self-concept mobile application on the retention of nursing students

BACKGROUND

The high dropout rate among nursing students has become a global concern as it leads to a shortage of nurses on the one hand and a negative impact on the professional motivation of nursing students on the other. The present study was conducted to investigate the effects of using the Nurse Self-Concept Mobile Application (NSCMA) on the retention of nursing students.

MATERIALS AND METHODS

The present study is an experimental work of research with a longitudinal design conducted from April to December 2021. The study population was second-year nursing students in a nursing school in the south of Iran who were randomly divided into an experimental (n = 49) and a control group (n = 50). The assessment was based on a pretest-posttest design and a one-month follow-up. The collected data were analyzed in SPSS v. 21 using descriptive statistics (frequency, percentage, mean, and standard deviation) and analytical statistics (repeated measures). The P value was set <0.05.

RESULTS

The means of the students' ages and grades were 21.31 ± 2.43 and 15.30 ± 2.13, respectively. The results showed a statistically significant increase in the experimental group's intent-to-stay mean scores as measured in three stages (P = 0.029), indicating that the intervention enhanced the nursing students' inclination to stay in nursing programs. However, the changes in the control group's mean scores were not statistically significant (P = 0.132).

CONCLUSION

The Nurse Self-Concept Mobile Application proved effective in enhancing nursing students' inclination to complete their education and follow a career as a nurse. Thus, it is essential that nursing students' education include programs designed to enhance the students' self-concept, especially in the first few years of their education. Also, nursing schools should use this software to encourage students to stay in the nursing major.

Investigating the factors affecting the self-care behaviors of patients with type II diabetes and the role of demographic variables: A case study in Iran

BACKGROUND

Self-care practices in diabetes patients are crucial to keep the illness under control and prevent complications. Effective management of diabetes will be a difficult task without an adequate understanding of the current level of practice related to diabetes self-care. Therefore, this study aims to assess the factors affecting the self-care behaviors of patients with type II diabetes and the role of demographic variables in Iran.

MATERIALS AND METHODS

The present study is a descriptive-analytical study that was designed and conducted in 2022. This study population was type II diabetic patients at the Diabetes Research Center of Ayatollah Taleghani Hospital in Kermanshah who were selected by available sampling method of 280 samples. Data collection tools included demographic characteristics questionnaire and standard self-care questionnaire for the Glasgow and Toobert diabetic patients. Data were analyzed using SPSS-23 software, independent t-tests, one-way analysis of variance, and stepwise regression.

RESULTS

The mean of self-care scores was 2.07 ± 2.08 and indicated an unfavorable condition. The highest mean scores of self-care were in the field of regular use of medications, and the lowest scores were in the field of blood-glucose testing. The mean scores of self-care were significantly different based on marital status, occupation status, residence, type of treatment, duration of diabetes, years, smoking status (P < 0.05). Regression results showed that the variables predictors; type of treatment, smoking status, the complication of diabetes, education level status, place of residence explained 515% of the variance of self-care.

CONCLUSIONS

The study showed that the extent to which individuals adhere to type II diabetes recommended management is substantially low. Improving awareness of patients and the community at large is imperative, especially on the diet, exercise, blood-glucose testing, foot care, and no smoking.

The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students

Objective

Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency.

Methods

A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups.

Results

There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000).

Conclusion

The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.

Multi-Method Approach of Teaching Professional Ethics to Improve Organizational Commitment and Job Involvement: A Quasi-Experimental Study

Introduction

Learning professional ethics can enhance the effectiveness of medical graduates as future health care providers. Therefore, this study was conducted to examine the effectiveness of professional ethics education based on a multi-method approach in organizational commitment and job involvement of senior nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences (AJUMS), Ahvaz, Iran, in 2022.

Methods

This was a quasi-experimental study with a pre-test post-test design including 64 senior nurse anesthesia students of AJUMS who were selected using census method and randomly divided )using simple random method( into two groups of intervention and control (n = 32 each). For the intervention group, two 5-hour training workshops were held in 2 consecutive weeks using different training methods offered in an integrated manner, while participants in the control group received no education. Finally, the data were collected and analyzed using SPSS version 16, based on Kolmogorov-Smirnov test, paired and independent t-tests, chi-square test, and analysis of covariance.

Results

Professional ethics education based on a multi-method approach had a positive effect on the organizational commitment and job involvement of senior nurse anesthesia students. There was a significant difference between the two groups in terms of their job involvement (P=0.005 and F=1.65) and organizational commitment scores (P=0.025 and F=35.56). These findings suggest that professional ethics education based on a multi-method approach can improve job involvement and organizational commitment and its dimensions (normative, continuance, and affective).

Conclusion

Teaching professional ethics by explaining the moral virtues of work, business affairs, and code of professional conduct promotes job involvement and organizational commitment of senior nurse anesthesia students.

Perceptions and experiences of diploma nursing students on clinical learning. A descriptive qualitative study in Tanzania

BACKGROUND

The quality of nursing education depends largely on the experience student receive in the clinical environment. The learning environment is complex with factors that may positively or negatively influence students learning. The current study aimed to explore the experiences and perceptions of diploma nursing students toward their clinical learning in Dodoma-Tanzania.

METHODS

A qualitative descriptive study design was employed. The study was conducted in four nursing schools involving 32 nursing students who were purposively selected. Data was collected using focus-group discussions and analyzed using thematic analysis.

RESULTS

Three main themes emerged during the discussions: experience on personal and technical support for clinical learning, the importance of the clinical environment in clinical learning, and insufficient clinical educational planning. The majority of students had negative experiences including poor clinical supervision, lack of equipment, congestion of students, and inability to meet clinical objectives. Few students had positive experiences related to exposure to a real clinical environment and great support from staff nurses.

CONCLUSION

Students had mixed experiences, both positive and negative on their clinical learning. The majority of students had negative experiences. This may have a serious impact on the student completing their education, the services they will offer to patients when employed, and nursing professional development.

Health literacy and self-efficacy of the elderly with diabetes

Aim

This study aimed to investigate the relationship between health literacy and self-efficacy in the elderly with diabetes.

Method

This cross-sectional study was conducted on 375 diabetic elderly members from a diabetes association, in Iran. Self-efficacy and health literacy questionnaires were used. The Pearson test was used to determine the relationship between self-efficacy and health literacy and linear regression was used to predict self-efficacy by health literacy.

Results

Elderly men and women with diabetes showed a significant difference in terms of health literacy (P = 0.003). People over the age of 70 had a lower level of literacy (P < 0.05). The highest and lowest self-efficacy in the elderly patients were related to taking medications (89.75 ± 17.56) and physical activity (71.38 ± 24.40), respectively. The results of stepwise linear regression showed that health literacy is a predictor of self-efficacy in the diabetic elderly (r2 = 0.55, P < 0.001).

Conclusion

Health literacy is directly related to self-efficacy in older people with diabetes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01181-w.

Experiences of Student Nurses Regarding Experiential Learning in Specialized Psychiatric Hospitals in South Africa, a Qualitative Study

BACKGROUND

Experiential learning in specialized psychiatric hospitals is as essential as other learning in any discipline in nursing education as it allows student nurses to correlate theory to practice. Experiential learning in the mental health environment has been identified as a significant factor in promoting a more favorable attitude among student nurses toward mental health nursing.

AIM

The study explored student nurses' personal experiences regarding experiential learning in specialized psychiatric hospitals.

METHODS

A qualitative approach using explorative, descriptive, and contextual designs was used, and 51 student nurses were purposively sampled. Data were collected through six focus group interviews and analyzed using a thematic approach. Measures to ensure trustworthiness were also enhanced. Ethical considerations were adhered to throughout the study.

RESULTS

One theme and four sub-themes on the experiences of student nurses regarding experiential learning in specialized psychiatric hospitals were revealed, namely: theme: personal factors; sub-themes: fear of mental healthcare users, anxiety about clinical assessment, lack of interest in psychiatric nursing science, and stress due to social problems.

CONCLUSIONS

Based on the findings, student nurses experience many things during experiential learning, including personal factors. A further qualitative study should be conducted on strategies to support student nurses during experiential learning in the specialized psychiatric hospitals of Limpopo Province.

Perception, perceived scope, and potential barriers towards developing nurse practitioners cadre among health care providers and beneficiaries: A pilot study from Northern India

BACKGROUND

The role of nurse practitioner (NP) emerged in early 1965 when general practitioners began working with nurses. Evidence across the world highlights the benefits achieved by the NP role. The Indian Nursing Council (INC) implemented a country-wide NP in critical care (NPCC) program with the approval of the ministry of health and family welfare (MoHFW) in 2017. The NP role is in its infancy in India. Hence, there is a need to assess the perception among beneficiaries and healthcare personnel. This study was conducted to assess the perception, perceived scope, and potential barriers for developing the role of NPs in India among beneficiaries and healthcare providers.

MATERIAL AND METHODS

A descriptive, cross-sectional pilot study was conducted at AIIMS Rishikesh, Uttarakhand, India, among 205 participants (84 beneficiaries, 78 nurses, and 43 physicians) using a proportionate stratified random sampling technique. Likert scales and socio-demographic sheets were used to assess the perception, perceived scope of practice, and potential barriers in developing a NP cadre in India. Descriptive and inferential statistics were used for analyzing data.

RESULTS

The mean age of beneficiaries was 37.98, nurses was 27.58, and physicians was 28.13 years, respectively. 121 (61%) of participants were highly favored, and 77 (38%) were in favor of developing NP cadre in India. They considered it to be necessary, feasible, and acceptable in India. The feasibility and necessity of the perception domain were highly significant (P < 0.001 and P < 0.003, respectively). Nurses (mean ± SD: 35.36 ± 3.55) considered that NPs could have a wide range of practice followed by beneficiaries (mean ± SD: 38.17 ± 3.68) than physicians (mean ± SD: 34.75 ± 5.95). Lack of awareness, the nonexistence of cadre structure, lack of acceptance of the role of physicians, and lack of clear policy were the key potential barriers to develop an NP cadre in India.

CONCLUSIONS

In this study, participants had favorable views on employing NPs in India; thus, this role will improve healthcare access for beneficiaries. NPs can carry out a wide range of practices.However, a lack of awareness, no cadre structure, and a lack of a clear policy may hinder the development of the NP cadre in India.

The Challenges of Nursing Presence at the Patient's Bedside from the Perspective of Nurses: A Qualitative Study

Background

Presence is one of the vital aspects of nursing care that improves the outcome of treatment, self-care, satisfaction, loneliness, and anxiety of patients. The literature review shows that most of the studies have been conducted on the conceptual analysis of the presence of nurses, while there are many challenges for the presence of nurses at the bedside. Therefore, this study aimed to determine the perceived challenges of nurses from being at the bedside of patients.

Methods

This is a qualitative descriptive study. Conventional inductive content analysis was used. Field notes and in-depth semi-structured interviews were conducted with nineteen clinical nurses. Participants were selected from general and intensive care units. Data analysis was performed using Zhang and Wildemuth approach.

Results

Three categories emerged: (1) professional challenges with subcategories: Supervision of novice nurses, insufficient skills and cultural unfamiliarity, (2) Management challenges with subcategories: managers' negligence toward nurse's needs, Strategies of nursing managers, lack of medical staff, inadequate medical facilities, inappropriate planned visits and appointments, (3) work environment challenges with sub-categories: ward overcrowding and non-standard hospital environment.

Conclusions

This study identified the challenges and obstacles of nurses' presence at the bedside in different dimensions from the perspective of clinical nurses. To increase the presence of nurses at the bedside, nursing managers should create a standardized work environment.

The Relationship Between Job Crafting and Nurses' Happiness in Bisha Region, Kingdom of Saudi Arabia

Background Job crafting is an example of constructive behavior in which workers aggregate resources to meet their needs and succeed at work. Individuals may change job boundaries and social relationships at their convenience to feel closer to what they consider the perfect workplace. Aim To analyze the relationship of job crafting with nurses' happiness. Method A quantitative cross-sectional study was conducted on 441 nurses from Saudi Arabia. Data were collected using an electronic questionnaire (Google Drive). This questionnaire includes demographic factors, a Job Crafting Scale (JCS), and the Oxford Happiness Questionnaire (OHQ). Ethical considerations were strictly followed in the present study. Result The results revealed that most nurses had a high level of job crafting. The overall mean score of JCS was (91.2 ± 11.8). The present results demonstrate that the overall mean happiness score was at a moderate level. The overall mean OHQ score was 3.98 ± 4.25, and there was a significant positive correlation between the OHQ score according to the increasing structural domain (r=0.246), decreasing hindering job demands (r=0.220), increasing social job resources (r=0.176), increasing challenging job demands (r=0.212), and the overall total JCS (r=0.252). This indicates that the increase in job happiness is correlated with the increase in job crafting. Conclusion Job crafting has a positive significant relation with nurses' happiness. It is the responsibility of nurse managers and educators in the healthcare industry to provide a suitable work environment, beginning with including employees in decision-making and duties through leadership empowerment and providing support programs, and activities to increase the job happiness and job crafting experienced by nurses.

A cross-sectional student survey of the impact of the Covid-19 lockdowns on clinical placement in England

INTRODUCTION

Clinical placement is an essential aspect of student radiographers' training. The Covid-19 pandemic proved challenging for diagnostic radiography students disrupting clinical placements. This study aims to explore the impact of Covid-19 on first and second year student diagnostic radiographers' in clinical practice during the Covid-19 lockdown periods and Covid-19 waves in England.

METHOD

A cross-sectional online survey was used to attain quantitative attitudinal 5-point Likert and qualitative free-text response data. Descriptive and inferential statistics data analysis applied the Mann-Whitney U test and Kruskal-Wallis H test. The qualitative data were thematically coded and analysed for patterns of reoccurring themes.

RESULTS

There were n = 85 responses from n = 9 different counties within England. Students reported missing between n = 1-14 weeks of placement. There was a lack of (41%; n = 35) or limited radiography staff (21%; n = 18) in the clinical departments and a lack of a range of X-ray examinations available (67%; n = 57) during the Covid-19 lockdowns, which affected completing practice assessments. Negative effects included stress, anxiety and worry (68%; n = 58); positive effects included team working (16.4%; n = 14), learning to work under pressure (12.9%; n = 11), and preparation for qualifying (8.2%; n = 7).

CONCLUSIONS

This study identified that students needed more support in this critical aspect of their training. There were both positive and negative responses; notably, the results highlight how the Covid-19 lockdowns have strained the National Health Service (NHS) and adversely affected radiography students.

IMPLICATIONS FOR PRACTICE

The findings underscore the need for university educators and student liaison radiographers within hospitals to have an awareness of the mental health and practical learning needs of the students they are instructing post-Covid-19 lockdown.

Factors that influence scope of practice of the five largest health care professions in Australia: a scoping review

INTRODUCTION

A well-functioning health system delivers quality services to all people when and where they need them. To help navigate the complex realm of patient care, it is essential that health care professions have a thorough understanding of their scope of practice. However, a lack of uniformity regarding scope of practice across the regulated health professions in Australia currently exists. This has led to ambiguity about what comprises scope of practice in some health care professions in the region.

OBJECTIVE

The objective of this review was to explore the literature on the factors that influence scope of practice of the five largest health care professions in Australia.

METHODS

This study employed scoping review methodology to document the current state of the literature on factors that influence scope of practice of the five largest health care professions in Australia. The search was conducted using the following databases: AMED (Allied and Complementary Medicine Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, EMBASE (Excerpta Medica Database), MANTIS (Manual, Alternative and Natural Therapy Index System), MEDLINE, PubMed, and SCOPUS. Additional data sources were searched from Google and ProQuest.

RESULTS

A total of 12 771 publications were identified from the literature search. Twenty-three documents fulfilled the inclusion criteria and were included in the final analysis. Eight factors were identified across three professions (nursing & midwifery, pharmacy and physiotherapy) that influenced scope of practice: education, competency, professional identity, role confusion, legislation and regulatory policies, organisational structures, financial factors, and professional and personal factors.

CONCLUSION

The results of this study will inform a range of stakeholders including the private and public arms of the healthcare system, educators, employers, funding bodies, policymakers and practitioners about the factors that influence scope of practice of health professions in Australia.

The effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran: study protocol

BACKGROUND

Mothers' knowledge about the infant's problems and will provide the necessary care can increase the mother's confidence in providing care for her infant and eliminate misconceptions in primiparous mothers. The present study will be conducted to evaluate the effect of educational support intervention including peer groups for infant care on the growth rates of infants, breastfeeding self-efficacy and quality of life of their mothers in Iran.

METHODS

This quasi-experimental study is an educational support intervention protocol for infant care which will be conducted in two phases. The educational support program will be designed in the first phase. The program includes educational sessions on breastfeeding, growth and development of infants and care for children under 1 year of age in a virtual group where a physician, a nurse, a midwife and a healthcare provider are also present. Using the opinions of the experts, the peer group will discuss various points and the research team will finalize the program based on priorities. The second phase of the educational intervention will be conducted experimentally as a pretest-posttest design for the intervention and control groups.

DISCUSSION

The present study will provide useful protocol about the effect of educational support intervention for infant care and the sharing of peer group experiences on infants' growth rates, breastfeeding self-efficacy, and quality of life of their mothers. The current educational package not only combines virtual education and peer experiences in strengthening the education of mothers, but also it can improve mothers' physical and mental health and reduce medical costs by using telephone follow-up in supporting of the mothers of infants.

TRIAL REGISTRATION

Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20210913052457N1, registered 9/10/2021, https://www.irct.ir/trial/59093 .

Using LEGO® Serious Play® Methodology in supporting Nigerian nursing students' sociocultural transitions to UK higher education: A phenomenological research study

INTRODUCTION

From an historical perspective the United Kingdom (UK) has been the first European country of choice for Nigerian students wishing to study overseas. As an international contingent, Nigerian students continue to represent the UK's third largest international student body. This paper provides an insight into research undertaken to examine students' capacity to transition into the UK Higher Education system from a sociocultural perspective. Across the UK Higher Education Institutions (HEI's) have addressed issues surrounding internationalisation and decolonisation of the portfolio of programmes available to overseas students, with strategic curriculum design and justification processes evident in the extant literature. This project uses an innovative approach for the facilitation of dialogue with international students about their experiences of transitioning into UK systems of learning and teaching using a social constructivism approach.

AIMS

The aim of the research was to explore sociocultural perspectives which impacted on self-reported transitions to UK HEI's by Nigerian students. The objectives of the study were to a) provide a reflective lens of perspective on international student transitioning experiences for HEIs, educators and policymakers b) illuminate the challenges and barriers faced by Nigerian students during their transition from Nigerian to UK HE systems and infrastructures and c) to co-construct authentic and pragmatic knowledge of how best Nigerian students can be supported in their transition to UK HEI's.

METHODS

Smith (2010) interpretive phenomenological analysis, integrating qualitative research methods was implemented as a means of undertaking research facilitated using LEGO® Serious Play® Methodology as an innovative method of data collection. Twenty participants were recruited purposively to the study from an annual cohort of nursing students at a satellite Higher Education Institution (HEI) campus in Metropolitan city. Quirkos was used as a software package in analysing the data and establishing the salience as well as the commonality of emergent themes.

RESULTS

Findings reveal the extent to which sociocultural acclimation is of importance in the process of transition to UK HEIs. The perception of complex ambiguity surrounding the design and delivery of UK academic curricula was also reported as challenging by Nigerian students. Self-reported comments from Nigerian nursing students revealed the priori existence of negative learning experience, including lack of IT facilities, culturally rooted family expectations and responsibilities which then influenced perceptions and experiences of learning and teaching in the UK. Negative experiences included perceptions of racism regarding skin colour, fashion sense and UK practice focused on authentic assessment opportunities.

CONCLUSION

The small purposive sample of participants who engaged in this study, illuminated that students' prior experiences have the potential to influence their current pedagogical experience, in accordance with the principles of social constructivism. Most participants reported their experience of the transition period of entry to UK education varied between individuals, perhaps most significantly that perceptions of acculturation, acclimatisation and overall transition to the UK took between four and six months for a programme that may only have one year's duration.

Nursing students' experiences of service-learning at community and hospital pharmacies in Belize: Pedagogical implications for nursing pharmacology

OBJECTIVES

Many students seem to find pharmacology learning very challenging due to the complexity and variety of drugs they have to study. The number of drugs the students have to learn, the duration of time to learn the medications, and the evolving nature of diseases demanded learning beyond the classroom walls. This study explored and described nursing students' experiences in community and hospital-based pharmacy practice sites during their service-learning and its implications for pharmacology pedagogical practices.

METHODS

Kolb's learning theory provided the framework to explore nursing students' 48-hour service-learning experiences at community/hospital-based pharmacies in Belize and its implications for pharmacology pedagogy. The study utilized two qualitative approaches, reflective journals and focus group interviews, to collect data from 46 second-year nursing students. NVivo software and coding schemes were employed to analyze the data from the interviews and reflective journals.

RESULTS

Students reported learning medications, integrating classroom pharmacological knowledge at pharmacy practice sites, acquiring and enhancing communication skills, interpreting prescriptions, dispensing medications, drug calculations, taking inventory, doing vital signs, and patient education. In addition, students reported experiencing inter-professional relationships as healthcare team members. Anxiety was a major challenge experienced by many students at the beginning of the service-learning experience.

CONCLUSIONS

This study highlights the importance of experiential learning of pharmacology amongst second year nursing students, offering the opportunity to inform and support pharmacotherapeutics educators in designing strategies for more effective teaching of medications to nursing students. It also supports the addition of pharmacy placements to the nursing curriculum' as it shows that nursing students can learn medications, skills, and teamwork from experiential pharmacy site posting. Combining classroom instruction with pharmacy experiential service learning might be an effective complement for teaching nursing pharmacology.

Clinical learning opportunity in public academic hospitals: A concept analysis

BACKGROUND

Clinical learning opportunities (CLO) are vital educational encounters occurring in various clinical areas to provide the student nurses with clinical knowledge and experiences to develop their competencies for professional practice. However, CLO is a broad concept with varied characteristics that allow ambiguity, limiting its understanding and use. Its ambiguous nature leads to uncertainties and poor development of the required clinical attributes of successful theory to practice integration, higher-order thinking skills (HOTS) and clinical competencies.

AIM

The aim of the study was to explore and describe the conceptual meaning of CLO, have a clear understanding and insight into the concept and identify the antecedents and consequences for pragmatic purposes.

SETTING

The study took place in a public academic hospital in Gauteng.

METHODS

The eight steps of concept analysis by Walker and Avant were followed. Multiple data sources not limited to nursing were explored and critically analysed for the definitions, characteristics, nature and uses of CLO from different fields of study.

RESULTS

The defining attributes of CLO were identified, namely the context, antecedents, processes, consequences and outcomes. The context within which CLO occurs was dynamic, multidimensional, real-life healthcare settings; antecedents included planning of clinical placement, provision of learning outcomes and consideration of the cognitive level of the students. Engagement and active participation in collaborative, problem-based learning activities, community-based research and the use of emerging technologies were the processes identified. The outcomes were autonomous, confident, competent professional nurses with critical thinking, clinical reasoning, judgement, critical decision making and problem-solving skills.

CONCLUSION

A theoretical and operational definition of CLO was developed. The findings and results of concept analysis identified and specified the defining attributes of clinical learning opportunity. The findings can assist nurse educators, Clinical Education and Teaching Unit (CETU) personnel and operational managers to enhance CLO for student nurses to achieve their clinical learning goals and outcomes. The evaluation tools that may be adopted to assess the acquired clinical skills were also identified.

CONTRIBUTION

An increase in the existing body of knowledge in nursing education, considering that enhancing the CLO exposes students to various clinical experiences contributing to their development of clinical competencies to solve complex problems. The strategies to enhance the CLO will be developed, which may also provide vital information for policy development. Conceptualisation of the findings to nursing practice and quality patient care will be integrated into relevant literature.

Implementing midwifery services in public tertiary medical college hospitals in Bangladesh: A longitudinal study

BACKGROUND

A necessary precursor for quality maternity care provision is high quality education. The quality of care that students are exposed to during clinical education on maternity wards shapes their competencies and professional identities. In this study, we look at the introduction of midwives educated to international standards - with facility mentorship - deployed in tertiary level teaching hospitals in Bangladesh with the intention of improving the use of World Health Organization (WHO)-recommended birth practices.

AIM

To examine the outcomes of introducing midwifery services into tertiary level care facilities in Bangladesh, on the use of WHO-recommended birth practices.

METHODS

A retrospective review of patient register data was carried out to understand level of changes in use of WHO-recommended birth practices after the introduction of a midwifery service. Multivariate linear regression was applied using an interrupted time series analysis, with and without a delayed effect, to assess both level and trend change following the introduction of the midwifery service.

FINDINGS

A significant increase (p < 0.001) in use of WHO-recommended birth practices was found, both immediately following the midwives' introduction and after one year. Quality improvement was observed not only in births attended by midwives, but also in those attended by doctors and nurses.

CONCLUSION

By introducing quality maternity care provision through midwives in clinical sites, especially in tertiary-level care hospitals with large numbers of students, international standard midwives can improve the quality of clinical education in maternity wards, a critical priority for maternal health worldwide.

Learning on the periphery: a modified Delphi study of a nursing student communities of practice model

OBJECTIVES

To develop a contemporary student placement model to address current placement challenges, impact student learning, and alleviate supervisor burden.

METHODS

A modified Delphi technique was used to seek opinions, insights, and creative solutions.

RESULTS

A draft Communities of Practice placement model, based on a systematic literature review, was introduced to a heterogenous expert panel (n=12). A contemporary placement model was developed and refined via video conference and email over three rounds.

CONCLUSIONS

Despite initial reluctance concerning a new model, participants became conversant with the concept of peer-to-peer learning, where incidental, albeit essential, learning and support occurs between students, which also supports supervising staff. Greater flexibly and student screening were also incorporated to enable greater learning, confidence building, and reflection. The model's success is contingent upon students working within their scope of practice and provides a contemporary approach to best responds to student, education provider, and health service needs.

Nursing practicum equity for a changing nurse student demographic: a qualitative study

Background

The nursing practicum (clinical practice) is an essential but often highly stressful aspect of the nursing degree. A review of the published literature reveals a strong focus on the stressors that originate within the practicum environment, rather than the student’s life outside the university and practice setting. This article reports on an Australian study, completed before the COVID-19 pandemic, of the university experiences of undergraduate women nurse students with family responsibilities. The findings reveal the importance of factors outside the university on the women students’ practicum experience and their ability to engage and achieve.

Methods

The study was qualitative, guided by Gadamer’s hermeneutic philosophy. Twenty-nine women students with family responsibilities (partners and children) were interviewed at two stages of their degree journey. Over 50 h of data were thematically analysed.

Findings

The themes ‘family pressure’ and ‘practicum poverty’ describe the impact of domestic work, family finances and practicum organisation on student stress, wellbeing, achievement, thoughts of attrition, and family tension. These findings are particularly pertinent to Australia and other developed nations where the nurse student demographic continues to age. An interpretation of these findings against the recent impact of COVID-19 on nurse education and women’s life choices reveals the likelihood that these difficulties have intensified for women students with family responsibilities since the pandemic began.

Conclusions and Recommendations

Many developed nations, including Australia, are increasingly reliant on older women nurse students to maintain the future graduate nursing workforce. This change in nurse student demographic to the mature-age student requires a revision of the organisation of the nursing practicum. Recommendations to nurse education to improve practicum accessibility for women students who have family responsibilities include the application of a flexible and collaborative approach to practicum organisation and communication. Wider recommendations to Government include a revision of the way the nursing student is financially supported during the practicum. Further research that explores the practicum experience for women nurse students during and following the COVID-19 pandemic is also recommended.

Unveiling how Clinical Nursing Education can be Improved in Northern Ghana: The Perspectives of Key Informants

Introduction

Clinical nursing education is an important component of the professional development of nursing students. Key informants such as nursing lecturers, nurse managers and clinical placement coordinators play an essential role in clinical education.

Purpose

The purpose of the study was to explore the perspectives of key informants on how the current state of clinical nursing education in Northern Ghana can be improved.

Methods

The study used an exploratory qualitative design. Sixteen participants were purposively selected and data were collected through face-to-face individual interviews. Data were analysed using framework analysis.

Findings

The study findings indicate that clinical nursing education can be improved by decreasing the overcrowding of students in the clinical setting, decreasing the theory-practice gap and providing relevant material resources in the clinical facilities. Also, nursing education institutions can improve clinical nursing education by equipping the skills laboratories, engaging an adequate number of lecturers, and carrying out clinical accompaniment.

Conclusion

There is a need to improve clinical education through collaboration between nursing education institutions and clinical facilities. Effective collaboration will ensure the planning of clinical placement to avoid overcrowding, provision of continuous professional development programmes for preceptors and improvement in clinical supervision. Also, the provision of material resources in skills laboratories and clinical facilities to enhance clinical teaching should be given priority.

Patient Commitment to Cardiac Rehabilitation: A Qualitative Study

BACKGROUND

Commitment to Cardiac Rehabilitation (CR) is one of the essential strategies to reduce the long-term complications of cardiovascular disease. The attributes of patients' commitment have not been defined distinctly. Thus, the present study aimed to describe the attributes of commitment to CR from the participants' perspective.

MATERIALS AND METHODS

This qualitative study was carried out in Tehran from 2018 to 2019. Data were collected using semi-structured interviews with 30 participants, including 13 CR specialists, 13 patients, and four caregivers, through purposeful sampling. The analysis was performed through the conventional content analysis using the Elo and Kyngäs approach.

RESULTS

Commitment to CR has one theme titled the attitudinal-motivational aspect that consists of four categories including attitudinal-cognitive, attitudinal-behavioral, attitudinal-emotional, and motivational as the core features. The commitment to CR is devotion, internal desire, and voluntary obligation to initiate and continue CR cooperatively, all of which are accompanied by the purposeful initiation of the treatment plan.

CONCLUSIONS

The patient's commitment to CR is an intrinsic interest in achieving health that stems from the acceptance of the disease and the need for treatment. Besides, the rehabilitation team facilitates purposeful interpersonal relationships between the patient and the treatment group. It provides the basis for the patient's active efforts to meet the challenges of the treatment process.

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

OBJECTIVES

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

DESIGN

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

DATA SOURCES

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

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

Aims

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

Design

Data‐based convergent mixed‐method systematic review.

Methods

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

Discussion

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

Impact

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

Experiences of undergraduate nursing students during clinical practice at health facilities in Western Cape, South Africa

BACKGROUND

This study explored the experiences of undergraduate nursing students during clinical practice at healthcare facilities in the Boland Overberg area in Western Cape, South Africa. Few studies have been done on experiences of nursing students during clinical practice. However, there are still inadequacies, which lead to the deterioration of clinical practice quality.

OBJECTIVES

To explore and describe the experiences of undergraduate student nurses during clinical practice in healthcare facilities in Boland Overberg, in Western Cape, South Africa.

METHOD

A qualitative, exploratory descriptive design was applied. Data collection was done using focus-group interviews to ascertain the undergraduate student nurses' experiences during clinical practice in healthcare facilities in the Boland Overberg area in Western Cape Region. Thirty-eight undergraduate nursing students from Boland Campus were selected, using purposive sampling. The sample size was based on data saturation. Colaizzi's method of coding and thematic content analysis was used to interpret the data. Ethical principles were adhered to.

RESULTS

After data analysis, the following themes emerged: clinical learning environment, challenges and inability to reach objectives.

CONCLUSION

During clinical practice in healthcare facilities, students were confronted with dilemmas which must be addressed with proper planning to decrease the challenges in clinical education of future nurses. The findings can be used in planning of nursing education, could provide help to develop effective clinical teaching strategies in nursing education and to support these undergraduate nursing students.

Barriers to and facilitators of nursing students' adjustment to internship: A qualitative content analysis

BACKGROUND

Identifying factors affecting nursing students' adjustment to the internship conditions can enable nursing officials to make important decisions that can help students benefit more from their internship period according to expected goals.

OBJECTIVES

The present study was conducted to explain the facilitating and inhibiting factors of nursing students' adjustment to the internship.

DESIGN

The qualitative content analysis approach was used.

SETTING

The present study was conducted at a nursing and midwifery school affiliated with a large metropolitan medical university in northern Iran.

PARTICIPANTS

A total of 17 final-year nursing students who did morning shifts during the week and a day-long (morning and evening) shift per week, were selected through purposive sampling with maximum variation.

METHODS

Data were collected over 17 months through face-to-face semi-structured interviews, then carefully transcribed and analyzed using Graneheim & Lundman qualitative content analysis approach.

RESULTS

Support systems, the internship structure and its setting, and personal and professional factors were the three themes identified as facilitators and barriers of adjustment.

CONCLUSION

According to the results, factors affecting students' adjustment to internship manifest their effect over a continuum, in the form of adequate/poor support, high/low self-efficacy, and appropriate/inappropriate internship structure and setting. Moreover, support systems are among the most important factors affecting nursing students' adjustment to the internship. Furthermore, the role of hospital staff in accepting or rejecting the conditions and issues that participants face during their internship is very important.

From Learning on Mannequins to Practicing on Patients: Nursing Students' First-Time Experience of Clinical Placement in Jordan

Introduction

Although clinical nursing placement is an indispensable component of student nurses' education, data on students' first clinical experiences is scarce in developing countries.

Objectives

The study aim is to uncover nursing students' first-time clinical placement experience and identify related influencing factors in Jordan.

Methods: Focus group discussions (n=4) were used.

Results

The results showed that the transition from learning with mannequins to practicing on real patients in the clinical placement involved both effective learnings through hands-on practice to dealing with clinical challenges. Students perception of nursing ranged from positive comments such as “humanistic” and “nursing almost medicine” to negative images such as “nursing is all about bedside care” and “nursing has poor social status.”

Conclusion

Students' experience in their first clinical placement is multifaceted, and incorporation of student's perspective in the first clinical placement is a crucial component of educational planning.

Implementation of an educational module on nosocomial infection control measures: a randomised hospital-based trial

Background

Previous cross-sectional studies have reported limited knowledge and practices among nurses regarding controlling nosocomial infections (NIs). Even though health institutions offer many irregular in-service training courses to solve such issues, a three year-nursing educational programme at institutions is not adequate to enable nurses to handle NIs. Therefore, this study aims to evaluate the implementation of an educational module on NIs control measures among Yemeni nurses.

Methods

A single-blinded randomised hospital-based trial was undertaken involving 540 nurses assigned to two intervention groups and a waitlist group. Intervention group-1 received a face-to-face training course comprising 20 h spread over six weeks and a hard copy of the module, while intervention group-2 only received the hard copy of the module “without training”. In contrast, the waitlist group did not receive anything during the period of collecting data. A self-administered NI control measures-evaluation questionnaire was utilised in collecting the data from the participants; before the intervention, at six weeks and 3 months after the end of the intervention. The period of data collection was between 1^st May and 30^th October 2016.

Results

The results from collecting and analysing the data showed a statistically significant difference in the mean knowledge scores between the intervention groups that were detectable immediately post-intervention with a mean difference (MD) of 4.31 (P < 0.001) and 3 months after the end of the intervention (MD = 4.48, P < 0.001) as compared to the waitlist group. Similarly, the results showed a statistically significant difference in the mean practice scores between the intervention groups immediately post-intervention (MD = 2.74, P < 0.001) and 3 months after the intervention (MD = 2.46, P < 0.001) as compared to the waitlist group. Intervention-1 (face-to-face training + module) was more effective than intervention-2 (module only) in improving Yemeni nurses’ knowledge and practices regarding NI control measures compared to the waitlist group.

Conclusion

The findings of this study found that intervention-1 could be offered to nurses in the form of an in-service training course every six months. The NI course should also be included in nursing curricula, particularly for the three-year-nursing diploma in Yemen.

Trial registration

Nosocomial infection educational module for nurses ISRCTN19992640, 20/6/2017. The study protocol was retrospectively registered.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00551-0.

Health Professionals Job Satisfaction and Associated Factors in Ethiopia: A Systematic Review and Meta-analysis

BACKGROUND

Health professionals' job satisfaction is crucial for health professionals' life which determines health care service quality. This study aimed to estimate pooled prevalence of job satisfaction of health professionals and associated factors in Ethiopia.

METHODS

Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) was followed to prepare this study. Studies were searched from PubMed (EBSCOhost), Directory of open access journals (DOAJ), Global health, African Index Medicus, IRIS (WHO digital publication), African Journals Online (AJOL), Google Scholar, and Google. Random-effect model was used to estimate the pooled prevalence of job satisfaction and associated factors. Heterogeneity was assessed using I 2 test statistics. Publication bias was checked using funnel plot, Egger's regression test, and sensitivity analysis.

RESULT

The pooled prevalence of health professionals' job satisfaction was computed from 35 studies, and it was 46.68% (95%, confidence interval (CI): 41.82, 51.54, I 2 = 95.8%). Specifically, job satisfaction was 57.56%, 48.80%, 48.57%, 48.48%, 44.56%, 39.20%, and 16.5% among pharmacy professionals, health officers, midwives, nurses, anesthetists, physicians, and health extension workers, respectively. Secured working environment (pooled odds ratio [POR] = 6.50, 95% CI: 3.41-9.58), coworkers relationship (POR = 5.14, 95% CI: 1.27, 9.02), good relationship with supervisors (POR = 5.86, 95% CI: 2.56-9.16) and having bachelor's degree (POR = 2.52, 95% CI: 1.31, 3.72) were significantly associated with job satisfaction.

CONCLUSION

Job satisfaction among Ethiopian health professionals is considerably low. Secured working environment, positive relationships among staff, and having a bachelor's enhanced the job satisfaction. Designing strategies to improve safety in the work environment and improved communication among workers could improve job satisfaction.

Hofstede's cultural dimensions as the explanatory framework for performance issues during clinical placement: A mixed methods study

AIMS AND OBJECTIVES

The objectives of this study were to examine a) if those with reported clinical performance issues were more likely to experience course progression issues or withdrew from the program; b) the relationship between clinical and academic performance; c) the relationship between students social-demographic characteristics and clinical performance issues; and d) the utility of Hofstede's cultural dimensions theory in explaining the clinical performance issues students may experience during clinical placement.

METHOD

Retrospective textual reports of clinical issues from 2014 to 2018 were collected. A mixed methods design, particularly Embedded Design, was used. The qualitative data was analysed using Directed Content Analysis using Hofstede's six dimensions as the coding categories, which were further broken down into high and low poles, making a total of 12 subcategories. Univariate and multivariate logistic regression was utilised to analyse the quantitative data.

RESULTS

Using Hofstede's framework, it was determined that nursing students 21 years and younger were more likely to have issues related to low long-term orientation. Male students were more likely to have issues related to low uncertainty avoidance and also displayed masculinity related issues. Overseas-born students were less likely to experience issues related to low power distance and students that had not failed a unit of study were less likely to have issues related to low long-term orientation. The study also found that students experienced issues related to poor psychomotor skills and language barriers. Furthermore, the study identified that students who experienced clinical placement issues were three times more likely to leave the course.

CONCLUSION

Hofstede's cultural dimensions framework can be used to explain clinical performance issues among undergraduate nursing students. Early identification of the students likely to experience these issues can lead to targeted and preventative interventions.

Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey

OBJECTIVE

To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type.

BACKGROUND

Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date.

METHODS

The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha.

RESULTS

Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest.

CONCLUSION

The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.

Nursing students' experience of clinical supervision and contributing factors in Jordan

BACKGROUND

Although clinical supervision is a vital component of nursing education, data on students' experiences of clinical supervision and contributing factors remain limited.

AIM

The study explores nursing students' experience of clinical supervision and contributing factors in Jordan.

DESIGN/METHODS

An explorative design with a qualitative approach using focus group discussions (n = 6) was used. A convenient sample consisting of 48 participants was recruited from second, third and fourth year nursing students. Data were thematically analysed using N VIVO 12.

RESULTS

The analysis revealed two overlapping experiences. First, the empowering supervision experience comprising: "being willing and patient" and "working hand-in-hand" with students. Second, the disempowering supervision experience, including: abuse of power and grade obsession, incompetent supervision and lack of time detected for students. While the former has positivity which enhanced students' clinical learning, the latter reduced their motivation for gaining knowledge and skills and negatively impacted their self-confidence.

CONCLUSION

Students' experience of clinical supervision is multifaceted. Thus, there is a pressing need for establishing a preparation programme for newly employed supervisors focusing on annual training updates, identifying their competency level and understanding the way their supervisory role is operationalised.

The Influence of Managerial Psychology on Job Satisfaction among Healthcare Employees in Ghana

Background: Employee job satisfaction has been established to be one of the important factors that work towards addressing the subject matter of productivity in organizations. Healthcare professionals deserve some level of basic psychological need satisfaction in the area of job autonomy. Reasons that lead to employees achieving job autonomy and job satisfaction have been researched by industrial and organizational psychologists but very few of such studies have directed their attention towards the role psychological capital can play. Therefore, this study sought to find out how much of an impact positive psychology can make on the job autonomy of healthcare employees leading to the fulfillment of job satisfaction. Methods: Data were collected from 385 healthcare professionals from the public sector. A structural equation model was performed to analyze the relationship that exists between the constructs of psychological capital and job autonomy leading to job satisfaction on the part of the employees. Results: Results showed both a direct and indirect positive relationship between hope and job satisfaction and indirect through job autonomy. Apart from self-efficacy, that had a very low positive relationship, optimism largely influenced job autonomy of healthcare professionals. Results also showed that psychological capital positively related to job autonomy while job autonomy minimally influenced job satisfaction. Conclusions: It is concluded from this study that healthcare professionals deserve some level of basic psychological need satisfaction in the area of job autonomy and that can stimulate positive work ethic.

Exploring the meaning of night shift placement in nursing education: A European multicentre qualitative study

BACKGROUND

An appropriate clinical learning environment has been identified as pivotal in nursing undergraduate education and should be planned responsibly. Specifically, night shifts placements have been documented as an important opportunity for developing a full understanding of the nursing profession and the whole process of nursing care. However, night shifts during placement have been reported to be stressful and anxiety-provoking, so their usefulness for nursing students is still debated.

OBJECTIVES

To elicit nursing students' perceptions of night shift placement through metaphors, with the aim of discussing the pedagogical and ethical implications.

DESIGN

A descriptive qualitative study was performed based on metaphors collected in an international cross-sectional study in 2016.

SETTINGS

A network comprising five Bachelor of Nursing Science degrees located in the Czech Republic, Italy, Poland, Portugal, and Slovakia was established.

METHODS

A total of 907 out of 1347 eligible nursing students from the five European countries described their learning experience on night shifts using a metaphor.

RESULTS

Overall, 288/907 (31.7%) metaphors emerged as being negative-oriented and 137/907 (15.1%) as positive, while the remaining students (482; 53.2%) did not report any metaphors. In all five countries, negative metaphors prevailed: 'Wasting time' (37/288), 'Useless' (32/288) and 'Handyman' (22/288) were the most negative reported metaphors on working a night shift. However, doing a night shift is also perceived as a 'Learning opportunity' (22/137), a 'New experience' (20/137) and an 'Opportunity to socialize with the profession' (14/137) as underlined by the positive metaphors.

CONCLUSIONS

Students perceive night shift placements mainly as a negative experience, which has little to do with education. While planning night shift placements, nursing educators should responsibly consider the whole process of education, analysing not only the learning outcomes that should be achieved but also the position of students and their experience as a person. Clinical mentoring can be a key resource in supporting students in transforming their night shift placements' experiences into a more meaningful or worthwhile experience. Moreover, night shifts should be offered to more experienced students, independent in their self-learning processes and capable of managing the limited possibility of interacting with other team members and patients.

Night shifts as a learning experience among nursing students across Europe: Findings from a cross-sectional survey

BACKGROUND

Organising clinical placements during nights has been reported as an additional opportunity to introduce students to the whole picture of their future responsibilities. However, studies in this field are still lacking.

OBJECTIVES

To describe and compare (a) the night shift experience of nursing students across Europe, (b) the patient-related problems that they face during night shifts, (c) the night care activities nursing students are called to perform, and (d) the perceived effects of night shift work on learning outcomes.

DESIGN

A cross-sectional study, 2016.

SETTINGS

Five European countries: Czech Republic, Italy, Poland, Portugal, and Slovakia.

PARTICIPANTS

Nursing students from nine Bachelor of Nursing Science degree programmes attending night shifts during their study period and who were willing to participate were included. A total of 907 out of 1347 (67.3%) eligible students participated.

METHODS

Questionnaire based on the available literature, translated into five languages.

RESULTS

The duration of the night shift was from an average of 9.8 (CI 95% 9.6-10.0) in Italy to 11.9 (CI 95% 11.7-12.0) in the Czech Republic. Students faced mainly patients' pain without statistical differences across countries (at the overall level, 717 out of 907; 79%; p = .318). However, significant differences in the tasks performed during nights emerged: Polish students reported being more involved in performing basic nursing care (72; 93.5%) as compared to other countries (e.g., Portuguese students 337; 84.9%), (p = .02). Overall, an average of 28.9% of the night shift time was reported to be free of commitments, with higher values among Polish (38%, CI 95% 33.6-42.3) and Slovakian students (33.4%, CI 95% 30.6-36.3) and lower values among Czech Republic students (20.4%, CI 95% 17.6-23.2) (p .001). Boredom and satisfaction were reported as the main feelings during night shifts, with significant differences (p .001) across countries. Students reported significant different effects (p .001) of night shifts on their understanding of a nurse's role (from 5.2 out of 10 in Poland to 6.5 in the Czech Republic), on the understanding of the continuity of nursing care (from 5.2 in Poland to 6.7 in Italy), and on having a relationship with the clinical mentors (from 2.7 and 4.2 in Poland and the Czech Republic, respectively, to 6.9 in Italy).

CONCLUSIONS

Night shifts can be both a valuable and a non-valuable learning experience, suggesting the need to carefully plan and assess their effectiveness at the unit level.