Veterinary Nursing Students' Experience in the Clinical Learning Environment and Factors Affecting their Perception

Student veterinary nurses (SVNs) spend a significant proportion of their training time within the clinical learning environment (CLE) of a veterinary practice. These clinical experiences are vital for building practical and professional skills. To evaluate the current satisfaction of SVNs in the CLE, a cross-sectional survey design was used incorporating a previously validated instrument. To provide understanding of factors that may affect the SVN satisfaction, additional validated tools were added across factors, including resilience, wellbeing, personality, and work place belonging. A total of 171 SVNs completed the survey. In addition, two open questions were included to provide greater depth of understanding of the SVN experiences. Results showed that 70.76% of respondents were satisfied/very satisfied with the CLE. Significant factors that affected the satisfaction scores included, depression, anxiety, and stress (p ≤ .001), psychological sense of organizational membership (p ≤ .001), agreeableness (p = .022), and emotional stability (p = .012). The qualitative data demonstrated shared SVN factors that are considered to contribute to clinical learning and those that detract from clinical learning. Educational facilities and training veterinary practices can support the SVN within the CLE by creating a greater sense of belonging, considering the SVN individual personality and wellbeing, and including the SVN in discussions around learning support needs.

Personal Factors and Clinical Learning Environment as Predictors of Nursing Students' Readiness for Practice: A Structural Equation Modeling Analysis

PURPOSE

It is essential to ensure the readiness for practice among undergraduate nursing students since the purpose of such education is to cultivate competent nurses who deliver high-quality and safe nursing. Astin's theory of student involvement suggests that this is affected by their personal factors and learning environment.

METHODS

We conducted a cross-sectional study between November 16, 2020 and December 21, 2020 which examined personal factors and aspects of the clinical learning environment among senior nursing students (n = 838) enrolled across 54 nursing schools in Korea. The participants were asked to fill out a self-administered online survey, which assessed demographic characteristics, self-esteem, depression, work-life balance, clinical learning environment, anxiety during clinical practicum, and readiness for practice. Readiness for practice was measured using the Casey-Fink Readiness for practice survey. We used structural equational modeling to test our hypothetical model.

RESULTS

The nursing students' readiness for practice was significantly affected by their self-esteem, work-life balance satisfaction, and clinical learning environment. Anxiety during clinical practicum directly influenced their readiness for practice.

CONCLUSION

Increasing self-esteem and work-life balance satisfaction, and improving their clinical learning environment by providing sufficient educational and clinical support, could help facilitate the transition from nursing schools to real-world practice for nursing students.

Positive and negative psychosocial factors related to healthy and unhealthy weight control among nursing students

BACKGROUND

Although nursing students are educated on the importance of exercising regularly and maintaining a well-balanced diet, many do not practice healthy weight management behaviors, and some even use unhealthy weight loss methods. Yet, little research has examined both positive and negative psychosocial variables related to weight control among nursing students.

PURPOSE

The present study aimed to identify the most salient psychosocial variables related to healthy and unhealthy weight control among nursing students.

METHOD

Using survey data from 241 nursing students, structural equation modeling was conducted to examine the relative contributions of eight interrelated psychosocial variables, including constructs from a strengths perspective (health-specific hope, health self-efficacy, social support, and body satisfaction) and from a deficit perspective (depression, anxiety, weight perception, and barriers to physical activity).

RESULTS

Results showed that the degree to which individuals perceive themselves to be overweight was related to both healthy and unhealthy weight control. Aside from weight perception, health self-efficacy produced the strongest association with healthy weight control, and anxiety produced the strongest association with unhealthy weight control. The structural model explained 23 % of the variance in healthy weight control and 29 % of the variance in unhealthy weight control.

CONCLUSIONS

These findings emphasize the need for tailored, integrated weight management interventions for nursing students that equip them with effective anxiety management skills and build self-efficacy.

Diagnostic Concordance between the Visual Analogue Anxiety Scale (VAS-A) and the State-Trait Anxiety Inventory (STAI) in Nursing Students during the COVID-19 Pandemic

Anxiety is one of the most common problems among nursing students. The State-Trait Anxiety Inventory (STAI) is used to detect anxiety in this population; however, its length hinders speedy detection. For this reason, a faster and more efficient instrument is needed for early detection. This study aimed to determine the relationship between the anxiety measurement scales State-Trait Anxiety Inventory (STAI) and the Visual Analogue Scale for Anxiety (VAS-A) by establishing a discrimination threshold through the contrast of true positive rates (VPR) and false positive rates (FPR). To this end, a cross-sectional quantitative observational and analytical study was carried out on 185 fourth-year nursing students. The data collected were anxiety (STAI and VAS-A) and socio-demographic variables during the COVID-19 pandemic. The results showed a correlation between the two scales (VAS-A and STAI). The VAS-A is a useful instrument for assessing students in a crisis that could potentially generate anxiety. The study established a reasonably safe error probability range (>5%), allowing the VAS-A scale to be used as a rapid diagnostic or pre-diagnostic tool, depending on the scores. The study shows that speedy detection of anxiety using the VAS-A and an in-depth approach with the STAI by teaching staff in crises is possible.

Assessing the Impact of Unfolding Case Study Scenarios during High-Fidelity Pediatric Simulation among Undergraduate Nursing Students

Simulation helps to prepare prelicensure nursing students for practice by providing opportunities to perform clinical skills and make decisions in a safe environment. The integration of nursing knowledge, skills, and decision-making abilities during simulated unfolding case-study scenarios may enhance student self-confidence and foster clinical judgement skills. The purpose of this study was to assess the impact of simulation using unfolding case-study scenarios on undergraduate nursing students’ self-confidence in pediatric nursing knowledge, skills, and clinical judgment/decision-making abilities. This mixed methods study included a pre- and post-survey design to evaluate undergraduate nursing students’ confidence in pediatric nursing knowledge, skills, and decision-making abilities after participation in both an instructor-led (guided) and a student-led (decision-making) simulation involving unfolding case-study scenarios. Friedman’s ANOVA analyses revealed that all 16-items demonstrated statistically significant differences between the three measured responses (pre-simulation and both post-simulation surveys). Post-hoc Wilcoxon signed-rank tests revealed statistically significant differences in student ratings pre-simulation and post-instructor-led (guided) experience for all 16-scored items. The qualitative themes identified were perception of experience, pediatric nursing care, assimilation of knowledge, and critical thinking. Unfolding case-study simulation experiences positively impact the learning, self-confidence, and clinical judgement of undergraduate nursing students.

Associations between health-related quality of life and health behaviors in Australian nursing students

Health-related quality of life (HRQoL) is being increasingly studied as an indicator of wellbeing. This study evaluated the HRQoL of nursing students and relationships between lifestyle behaviors including smoking, diet, alcohol intake and physical activity. A cross-sectional study was conducted in 2018 using the Short-Form 12V2 to measure the HRQoL of 475 students from both regional and metropolitan universities in Queensland, Australia. z-scores were aggregated into a Physical Composite Score (PCS) and a Mental Composite Score (MCS). Multivariate linear regression was used to explore the associations. Nursing students (94.5% female) had lower HRQoL scores relative to the general Australian population. Students enrolled at the regional university, with higher income; higher intakes of vitamin A, calcium, and iodine; and more physical activity had a higher Mental Composite Score, but those with health conditions and high intakes of meat, fat, carbohydrates, and sugar reported lower Physical Composite Score compared to their counterparts. Skipping breakfast, physical inactivity, and alcohol score were inversely associated with HRQoL. This study highlights the need for strategies to address the poor lifestyle and HRQoL in nursing students to support their physical and mental health.

Nursing graduates' lived experiences of anxiety during their final year at University: a phenomenological study

BACKGROUND

Nursing students voiced that they were stressed or anxious during their final year at university. Further, they articulated that their anxiety affected their academic performance as well as their motivation to work on their clinical placement.

OBJECTIVES

This study was designed to describe nursing graduates' perceptions of their lived experiences of anxiety during their final year.

DESIGN

Phenomenology was chosen.

SETTINGS

Three universities in Taiwan.

PARTICIPANTS

A purposive sample of 18 nursing graduates with experiences of anxiety.

METHODS

Data were collected using a semi-structured interview and analyzed utilizing Colaizzi's seven-step method.

RESULTS

Four themes emerged from the findings. The first was: uncertainty about future employment. This included negative clinical practicum experiences impacted on future career choices and uncertainty about future workplace choices. The second theme was: emotional relationships and life experiences becoming chaotic. This included anxiety about the loss of established relationships and financial insecurities. The third theme was: three phases of anxiety experienced in preparation for the national examination. They comprised: feeling anxiety but not taking action to study; increasing anxiety and beginning to study and, exacerbated anxiety and cramming for the national examination. The fourth theme was: adjustment strategies. They involved; looking for support to release emotional stress; changing the situation and fine-tuning the stress; positive thinking and self-affirmations and also, self-reflecting and consolidating learning.

CONCLUSIONS

Finding could inform nursing teachers on nurses' lived experiences of anxiety during their final year, especially that related to the national examination before registration. Further, findings could be used as a map to facilitate nursing teachers in the provision of suitable teaching and counselling for final year students to alleviate their anxiety.

Disease Prevention Knowledge, Anxiety, and Professional Identity during COVID-19 Pandemic in Nursing Students in Zhengzhou, China

PURPOSE

This study aimed to evaluate nursing students' understanding of the prevention of COVID-19, as well as their anxiety towards the disease and their perception of their professional identity in the wake of the pandemic, in Zhengzhou, China.

METHODS

A cross-sectional study was designed to investigate 474 nursing students by cluster sampling using a stratified questionnaire from February 15 to March 31, 2020. Multiple linear regression was used to identify the factors affecting professional identity. Binary and multiple logistic regression were used to identify the factors affecting anxiety.

RESULTS

Responders with a high level of understanding of COVID-19 and frequent use of behavioral strategies for its prevention comprised 93.2% and 30.0% of the cohort, respectively. Professional identity was significantly associated with gender and anxiety (p < .050). The prevalence of anxiety among nursing students was 12.4%. Male (odds ratio [OR] = 2.39; 95% confidence interval [CI] = 1.26~4.52), sophomores (OR = 5.30; 95% CI = 1.61~7.45), and infrequent use of prevention measures (OR = 3.49; 95% CI = 1.16~5.19) had a significant effect on anxiety.

CONCLUSION

Anxiety during the COVID-19 epidemic gives an adverse effect on the professional identity of nursing in students. Nursing education institutions need to provide psychological counseling services for nursing students, in addition to improving their teaching of COVID-19 prevention strategies.

Experiences and responses of nursing students as second victims of patient safety incidents in a clinical setting: A mixed-methods study

AIM

To investigate the degree of second victim syndrome among nursing students in clinical practice and determine the rehabilitation process.

BACKGROUND

Empirical evidence suggests that health care providers who are considered second victims suffer from various difficulties. Nursing students in a clinical setting could be potential second victims, but few studies have quantitatively investigated the experiences and explored their response processes.

METHODS

A mixed-methods design was used. A questionnaire was sent to nursing students via a link to an electronic survey, and a semi-structured interview was conducted to explore their response process as second victims.

RESULTS

The quantitative results showed that nursing students in the clinical setting suffered second victim-related distress and that the most significant influences were psychological distress and professional efficacy. Four stages of rehabilitation experiences emerged from the qualitative data.

CONCLUSION

Being a second victim for nursing students in a clinical setting is psychological suffering, and although they can be expected to recover, an impact on professional efficacy is inevitable.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers must be aware that nursing students in a clinical setting might experience difficult situations after patient safety incidents and that developing appropriate programmes to support at-risk students is important.

Clinical placement anxiety in undergraduate nursing students: A concept analysis

OBJECTIVE

The primary aim of this review was to complete an in-depth analysis of clinical placement anxiety in undergraduate nursing students. Our overall goal was to establish a strong foundation for clinical education strategies and future research on clinical placement anxiety in nursing education.

DESIGN & METHODS

We utilized Walker and Avant's systematic 8-step approach to concept analysis as a framework to develop a comprehensive understanding of clinical placement anxiety in undergraduate students.

DATA SOURCES

A review of existing literature on clinical placement anxiety was conducted using the electronic databases of PubMed, CINAHL, and PsychInfo, as well as a grey literature and snowball search. Search terms included clinical placement, clinical experience, nursing students, undergraduate nursing students, and anxiety.

RESULTS

The literature search resulted in 81 articles that met the inclusion criteria. Five defining attributes were identified: a vague or unknown threat, psychological-emotional responses, psychological-cognitive responses, physiological responses, and unfamiliar environments or situations. Antecedents, consequences, and empirical referents of the concept were also highlighted.

CONCLUSIONS

Insights gleaned from this concept analysis may enhance the ability of clinical nursing educators to effectively prevent and manage student anxiety in the clinical setting. By contextualizing anxiety, we have also validated the importance of further exploration of the anxiety experienced by undergraduate nursing students during their clinical experiences. Thus, this concept analysis establishes the foundation for educational strategies, as well as future research in nursing education.

Impact of Socio-Emotional Skills On The Performance of Clinical Nursing Practices

Aim To analyze the Socio-emotional (SE) skills of the students in the Nursing Degree, and their relationship with their clinical practice in hospital centers. Methods Cross-sectional descriptive study of a sample of 91 nursing students. SE skills were analyzed through self-administered questionnaires, and the clinical practices through the instrument "Clinical Practices Evaluation Notebook". Findings The students obtained medium and high scores in the SE skills and in the clinical practices. Most of the SE skills had a positive and statistically significant relationship (p < 0.05) between them. A relationship was observed between SE skills with performance in clinical practices, through a multiple linear regression. Discussion It is suggested that the development of the SE skills of the nursing students within the Nursing degree curriculum has an influence on their performance during their clinical practices. Conclusion The SE skills are a potential predictor of the performance of the nursing students in clinical practices.

Undergraduate nursing students' experiences of anxiety-producing situations in clinical practicums: A descriptive survey study

BACKGROUND

Clinical practicums are regarded as one of the most anxiety-producing aspects of the curriculum by nursing students. Practicum-associated anxiety has negative impacts on learning, performance, and well-being. Little is known about what makes final year nursing students anxious during their practicum experience and the impact of clinical and student characteristics on their level of anxiety.

OBJECTIVES

The objectives of the study were (1) to explore which clinical situations final year nursing students perceive as anxiety-producing; (2) to identify if perceived level of anxiety associated with clinical tasks differ by clinical and student characteristics; and (3) to determine the relationship between clinical and student characteristics and perceived level of anxiety among nursing students.

DESIGN

Descriptive, cross-sectional survey.

SETTING

One university in Ontario, Canada.

PARTICIPANTS

A convenience sample of 93 final year undergraduate nursing students.

METHODS

The Clinical Experience Anxiety Form (CEAF) was administered to assess perceived level of anxiety associated with common practicum tasks. Descriptive statistics, one-way analysis of variance, and Pearson's correlation tests were used to address the research questions. Content analysis was conducted for open-ended questions.

RESULTS

Participants reported the following three situations as most anxiety-producing: fear of making mistakes, being observed by instructors, and initial clinical experience on a unit. Differences were noted between younger (18 to 24 years-old) and older (25 to 34 years-old) students, with the older student group reporting lower levels of anxiety associated with the following clinical situations: being observed by instructors and asking questions of faculty. Age was also found to be negatively correlated with CEAF scores wherein younger students reported higher CEAF scores. Content analysis indicated common areas that worried participants most about their practicum and their academic year.

CONCLUSIONS

Findings emphasize the importance of nursing educators to recognize anxiety-producing practicum situations and develop anxiety management interventions to ensure optimal learning.