Clinical Internship Research Articles

Nurse Interns’ Perception of Clinical Preparation and Readiness for Clinical Internship Experiences

Background. As nursing interns enter challenging clinical settings, evaluating their preparation and readiness is vital for adaptation success. Sufficient real-world experience and patient care are crucial preparation components that enable effective practice and higher competencies. Aim. This study aimed to assess nurse interns’ perception of clinical preparation and readiness for clinical internship experiences. Methods. A self-administered questionnaire was distributed, comprising three sections on demographics, clinical preparation requirements, and the Casey–Fink Readiness for Practice Survey. Descriptive statistics as the mean and standard deviation, numbers and percentages, linear regression model, and Pearson correlation coefficient were used for reporting normal distribution, categorical variables, and relationship between a scalar response and one or more explanatory variables and to calculate statistics between two continuous variables. Results. The participants were 130 nurse interns who were involved in an internship between 2016 and 2020, 50% of the nurse interns. They had a moderate level of clinical preparation, and 28.5% of them exhibited a low level. In addition, 53.8% were found to be moderately ready for practice, while 22.3% had a low level of readiness Conclusion. The observed significant positive correlation between perceived preparation and readiness underscores the pivotal role of clinical preparation in influencing practice readiness. Implications. These findings emphasize the importance of targeted interventions aimed at enhancing clinical preparation to directly bolster overall readiness for professional practice among nurse interns.

Vicarious learning and graduates' adaptive career behaviours: the case of graduates on clinical internships

PurposeThe effect of vicarious learning during clinical or medical internships on graduates' adaptive career behaviours has attracted scant attention from healthcare researchers, particularly, in the developing world context. Drawing upon the social cognitive career theory model of career self-management (SCCT-CSM), the current study examines how vicarious learning influences the clinical graduates' adaptive career behaviours (i.e. career exploration and decision-making) via career exploration and decision-making self-efficacy (CEDSE) and career intention.Design/methodology/approachData were collected from 293 nursing graduates undertaking clinical internships in 25 hospitals across Nigeria who willingly participated in this study as they were also assured of confidentiality at two-waves. The proposed hypotheses were tested using a path analysis.FindingsThe findings showed that vicarious learning during clinical internship had a direct effect on career exploration, decision-making and career decision self-efficacy among graduate trainees. Also, the findings revealed that the effects of vicarious learning on the graduates' career exploration and career decision-making were significantly mediated by career decision self-efficacy and career intentions.Practical implicationsThe findings of this study have important practical implications for higher education institutions and industries that send and receive clinical graduates for clinical internships to gain more skills. More emphasis should be on encouraging learners to learn vicariously in addition to other forms of learning experiences available during clinical internships.Originality/valueThe study explains that the graduates' higher engagement in clinical career exploration and decision-making was based on a higher level of vicarious learning during internships. The results suggest that higher education institutions and healthcare service providers can derive greater benefits from more emphasis on promoting vicarious learning during clinical internships.

The effects of clinical learning environment and career adaptability on resilience: A mediating analysis based on a survey of nursing interns.

The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. To evaluate the resilience level of Chinese nursing interns and explore the effects of factors affecting resilience early in their careers, focusing on the mediating roles of career adaptability between clinical learning environment and resilience. The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment Scale for Nurse and the Career Adapt-Abilities Scale. Structural equation modelling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped confidence intervals. The nursing interns showed a moderately high level of resilience [M (SD) = 70.15 (19.90)]. Gender, scholastic attainment, scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns' resilience. Male interns with good academic performance showed higher levels of resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.62, 0.18, respectively, p < .01). Career adaptability was also positively affected by the clinical learning environment (β = 0.36, p < .01), and mediated the effect of clinical learning environment on resilience (β = 0.22, p < .01). Clinical learning environment can positively affect the resilience level of nursing interns. Career adaptability can affect resilience directly and also play a mediating role between clinical learning environment and resilience. Thus, promotion of career adaptability and clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for female nursing interns with low academic performance.

Clinical internship environment and caring behaviours among nursing students: A moderated mediation model.

Caring behaviour is critical for nursing quality, and the clinical internship environment is a crucial setting for preparing nursing students for caring behaviours. Evidence about how to develop nursing students' caring behaviour in the clinical environment is still emerging. However, the mechanism between the clinical internship environment and caring behaviour remains unclear, especially the mediating role of moral sensitivity and the moderating effect of self-efficacy. This study aimed to examine the mediating effect of moral sensitivity and the moderating function of self-efficacy on the association between the clinical internship environment and caring behaviours. A cross-sectional design used acceptable validity scales. The hypothesised moderated mediation model was tested in the SPSS PROCESS macro. This survey collected data from 504 nursing students in an internship at a teaching hospital in Changsha, China. This study was pre-approved by the ethics committee of the medical school (No. E2022210). Informed consent was obtained from all students. The clinical internship environment (B = 0.450, 95% CI = [0.371, 0.530]) and moral sensitivity (B = 1.352, 95% CI = [1.090, 1.615]) had positive direct effects on nursing students' caring behaviours. Clinical internship environment also indirectly influenced students' caring behaviours via moral sensitivity (B = 0.161, 95% CI = [0.115, 0.206]). In addition, self-efficacy played a moderating role between the clinical internship environment and caring behaviours (B = 0.019, 95% CI = [0.007, 0.031]), as well as the relationship between the clinical internship environment and moral sensitivity (B = 0.006, 95% CI = [0.003, 0.010]). Moral sensitivity mediates the effect of the clinical internship environment on caring behaviour, and self-efficacy strengthens both direct and indirect effects. This study emphasises the importance of self-efficacy in developing moral sensitivity and caring behaviours in nursing students.

Effectiveness of an Informationized Teaching-management Strategy to Enhance Performance in National Nursing Licensure Examination: A Quasi-experimental Study

Objective: This study was to verify the effectiveness of an information-based teaching-management strategy applied during students’ clinical internship, designed to improve their performance in the National Nursing Licensure Examination (NNLE) Methods: All nursing students of eleven classes from grade 2017 in a vocational school were included (n=547). Considering the convenience of operational interventions, the experimental group consisted of students from Class 8, where the teacher in charge is the first author (n=49). The control group (n=498) comprised individuals selected from the other ten classes, with each class serving as an independent control group. From January 2020 to April 2021, a teaching-management strategy containing two stages was implemented in both groups from the students’ one-year clinical internship until the overall review period. In addition to this, a cloud-based knowledge-review program (e.g., layered teaching, four-step method, and paired assistance) was used in experimental group. The main outcome measures were the scores and pass rate of each examination. Results: Experimental group performed better than control group in both the simulation tests and the NNLE, in which the pass rate was 100%, showing a statically significant difference (P&lt;0.01). Conclusion: Information-based teaching-management strategy is beneficial for long-distance education during students’ clinical internship, and it can effectively help students prepare for the NNLE to get a higher score.

CLINICAL INTERNSHIP PROGRAM DEVELOPMENT IN AN ACADEMIC CARDIOPULMONARY EXERCISE LAB

https://youtu.be/L4guyGQnFdQ BACKGROUND Programs in exercise physiology, exercise science, kinesiology, sports sciences, and human performance encompassing both undergraduate and graduate studies are increasingly popular, providing education for a growing career field. Preparing students for healthcare careers requires adequate exposure and hands-on learning using experiential internship and practicum opportunities. An initiative to formalize the exercise science academic requirements for university programs is already in place and requires institutional program CAAHEP accreditation by 2027. Participation in a clinical internship and the hours required vary among college programs. This retrospective study performed on the cardiopulmonary internship program at a large Midwest pediatric hospital provides insight to clinical education and research skill development for undergraduate and graduate exercise science students. METHODS A retrospective review of program metrics and outcomes was analyzed regarding university affiliations with the internship program, number of students accepted into the internship program, completion rate, training and competencies, student academic level and associated culminating student presentations, and program satisfaction surveys for students completing their internship experience. RESULTS Between 2012 to 2023, the program grew from 3 to 40 university affiliation agreements/institutions. 143 students participated in the internship program: 32 fulfilled shadowing experiences, 90 were undergraduate interns and 21 were graduate interns. Internship hour requirements varied from 100 to 600 hours, with most students completing 350-450 hours. In 2012, the program enrolled 1 student per year, and by 2013 the capacity expanded to 4 student positions per semester (each spring, summer, fall). Internship students have presented 38 poster/abstract presentations at regional conferences and seminars. Students achieved 99% completion of site-specific sign-off competencies in cardiopulmonary exercise testing, including expanded requirements for cardiac rehabilitation starting in 2018. 98% of the student interns completed the program. CONCLUSIONS The cardiopulmonary internship program has continued to expand additional affiliate universities from both local and out of state institutions referring students to the pediatric internship program. Secondary to our cardiology program’s growth to include pediatric and now adult congenital patients, our outreach sites, and the expansion into cardiac rehabilitation and exercise prescription, the lab team members and allocated space have increased to accommodate increasing patient volumes. This has led to the ability to increase student interns per semester and expand their preparation for transition into the healthcare workforce. Understanding of the skills and competencies obtained during the practicum experience may help to enhance academic curriculum to transition students into clinical opportunities.

Online Learning Self-efficacy in Cardiopulmonary Physiotherapy: Perceptions of New Graduates

Background and Purpose: Rapid transition to distance learning during COVID-19 pandemic induced educators of hands-on professions to explore effectiveness of online learning. We aimed to investigate online learning self-efficacy in cardiopulmonary physiotherapy.&#x0D; Methods: Group 1 included graduates underwent only face-to-face learning while group 2 consisted of graduates underwent face-to-face and online learning. A questionnaire was developed by the authors including competencies in cardiopulmonary physiotherapy assessment and treatment skills to assess self-efficacy. The questionnaires were sent via e-mail.&#x0D; Results: Fifty-four graduates in group 1 and 82 graduates in group 2 responded to the questionnaires (response rate: 27%). No significant difference was found between groups in terms of self-efficacy in cardiopulmonary physiotherapy assessment and treatment skills. Self-efficacy in practical domain of exercise tests was higher in group 1 (p=0.021). Practical courses related to cardiopulmonary physiotherapy and type of education had negative effects on career plans in cardiopulmonary physiotherapy in group 2 (p=0.032 and p=0.001, respectively). Duration of clinical practice was positively correlated with practical cardiopulmonary physiotherapy assessment (p=0.005) and treatment (p=0.047) in group 2.&#x0D; Conclusion: Online learning seems to be a feasible option to develop adequate self-efficacy in cardiopulmonary physiotherapy. However, practical courses, type of education and duration of clinical internship are important for future career plans in cardiopulmonary physiotherapy.

A comparative study on health quotient of nursing students before and after the clinical internship

A comparative study on health quotient of nursing students before and after the clinical internship

Development of a Clinical Nurse Specialist Internship to Promote Evidence-Based Practice and Improve Outcomes

Development of a Clinical Nurse Specialist Internship to Promote Evidence-Based Practice and Improve Outcomes

Practical Application and Students&amp;apos; Abilities Assessment of Blended Teaching in Breast Oncology Department Clinical Internship

Practical Application and Students&amp;apos; Abilities Assessment of Blended Teaching in Breast Oncology Department Clinical Internship

Reflecting on Relationally Focused Critical Incidents: Investigating the Use of Reflective Writing to Support Conflict-Handling Skills During Speech-Language Pathology Student Internships

Purpose: Handling conflict successfully is an important professional competency. This study examined whether integrating relationally focused critical-incident reflections into graduate speech-language pathology student internships improved conflict-handling skills. The study also analyzed the breadth and depth of reflections and identified student variables associated with improved conflict handling. Method: Participants were a convenience sample of 49 graduate speech-language pathology students. A quasi-experimental design was used to compare participant conflict-handling skills at baseline, after a 7-week control period, and after 7 weeks of biweekly reflections. Students were provided with an orientation and writing prompt to guide their reflections. Relationships were examined between participant conflict-handling abilities, reflective capacity, emotional intelligence, number of reflections completed, and years of speech-language pathology–related experience. Results: Significant changes did not occur in conflict-handling skills after completing 7 weeks of relationally focused critical-incident reflections. Students demonstrated measurable ability to reflect on their experiences but appeared unable to achieve deep reflection. Significant correlations were revealed between emotional intelligence, number of reflections completed, and changes in conflict handling. Students with 2–4 years of prior speech-language pathology–related experience appeared to increase their conflict-handling skills during the clinical internship. Conclusions: Students were unable to critically reflect with guided questions and a training session alone. Reflection did not result in changes to conflict-handling skills, although individual student variables did impacted conflict handing. Implications for clinical education are discussed.

The relationship between self-efficacy and error orientation of nursing students during clinical internships: a cross-sectional study.

Nursing students often make clinical errors due to their limited clinical experience and their orientation toward errors, revealing their attitude and behavioral tendencies regarding nursing errors. Understanding how self-efficacy, motivation, and a sense of security influence the error orientation of nursing students is important for developing strategies to enhance their error orientation. This study aimed to explore the relationship between self-efficacy, motivation, and error orientation of nursing students during clinical internships. This was a cross-sectional study. An electronic questionnaire was distributed to nursing students from 14 September 2023 to 30 September at a comprehensive tertiary A teaching hospital in Zhengzhou, Henan province. The instruments used in this study included the General Information Questionnaire, General Self-efficacy Scale, Achievement Motives Scale, Security Scale, and Error Orientation Scale. Statistical Product and Service Software Automatically (SPSSAU) was used to perform statistical description, mediation analysis, and moderated mediation analyses. A total of 510 nursing students were included in this study. The motivation for success and failure-escaping fully mediated the relationships between self-efficacy and error orientation of nursing students, with a mediation effect of 0.101 (95% CI: 0.058-0.144). The security of nursing students moderated both the direct effect of this model and the indirect effect of motivation for failure-escaping. When security was high, the self-efficacy of nursing students was positively correlated with their error orientation, with an effect of 0.059 (95% CI: 0.003~0.116). When security was high, the moderation effect was significant, with an effect of -0.012 (95% CI: -0.026~-0.002). However, at low and median levels of security, the mediation effect was non-existent. The motivation for success and failure escaping play different roles in the paths between self-efficacy and error orientation. Clinical nursing teachers should take measures to enhance the motivation for success but reduce the failure-escaping motivation to improve the error orientation of nursing students. Additionally, it is crucial to pay attention to and improve the sense of security of students during clinical internships.

The effect of COVID-19 fear on midwifery students anxiety, self-confidence.

Several studies have investigated independently of clinical education, it has been emphasized that students experience fear, anxiety, sadness and uncertainty during the pandemic. This study aimed to investigate the effect of fear of COVID-19 on the level of anxiety and self-confidence of midwifery students who did their clinical internship during the pandemic. Convenience sampling yielded 181 senior midwifery students who had experienced clinical internships during the COVID-19 pandemic. Two state universities conducted an online cross-sectional predictive study from February to June 2021. Data were collected by an Information Form, the COVID-19 Fear Scale, the State-Trait Anxiety Inventory, and the Self-Confidence Scale. The study findings were that the students' fear of COVID-19 (16.72 ± 4.89), state anxiety (52.65 ± 8.41), and trait anxiety (48.66 ± 6.80) were above average, and their self-confidence was moderate. The result indicated that midwifery students' fear of COVID-19 increased, their state anxiety increased (p < 0.01), and their self-confidence decreased (p < 0.01). Fear of COVID-19 accounted for 47% of state anxiety, 6% of trait anxiety, and 22% of self-confidence. The level of COVID-19 fear of midwifery students who did clinical internships during the pandemic negatively affected their anxiety and self-confidence levels (Tab. 4, Ref. 34). Text in PDF www.elis.sk Keywords: pandemic, midwifery, fear of COVID-19, anxiety, self-confidence.

Insights into the meaning of medical students' studies. An online survey at two medical faculties.

The aim of the study was to investigate how medical students' deal with their own questions of meaning during their studies, how they cope with patients' questions of meaning or crises of meaning, to what extent their experience of meaning changes during their studies, and what role medical studies play in this. In 2022, we conducted an exploratory cross-sectional study in the form of an online survey at two German universities with students in the clinical part of their studies. Quantitative data were analyzed descriptively, and group differences were analyzed using Mann-Whitney U tests. Free-text comments were analyzed using thematic analysis. Of the 111 participants (response rate 12%), 92% had addressed questions of meaning. 64% of the students felt that their studies were meaningful, and 45% felt that their clinical internships were meaningful. 59% reported that they had been confronted with questions of meaning in their contact with patients, although many of them felt that they had been inadequately prepared for this (56%). This impression was stronger among respondents at the beginning of the clinical phase compared to respondents at the end (U(56,34)=660, p=0.012). According to the students, strategies for dealing with questions of meaning were active engagement with topics of meaning, tolerance of uncertainties, or avoidance. In addition to the basic requirement of openness to all topics of meaning, students expressed the wish to be better prepared for professional questions of meaning and for follow-up work on stressful events. A wide range of critical experiences with training and the healthcare system had an inhibiting effect on the experience of meaning. Since a higher sense of purpose can be associated with improved health and motivation, university programs might have the potential to support students' sense of purpose and, in the long term, improve their capacities to support patients who grapple with questions of meaning.

Design thinking como metodologia na elaboração de uma proposta de matriz curricular

Abstract Introduction: The medical school curricular structure may vary according to the educational planning of each higher education institution (HEI). The viewpoint of the coordination and the medical school faculty is not always aligned with the students’ opinions. Thus, using a methodology to identify the students’ point of view would be essential. Design thinking (DT) is a process that proposes a search, in an empathetic, collaborative, and creative way, for solutions to complex problems. Objectives: To present DT as a methodology to identify how clinical internship students believe the curricular structure from the 1st to the 4th year of a São Paulo state medical school should be, by collecting suggestions and points that require a re-evaluation process of the current curricular structure. Methods: This is a qualitative assessment, which will use the DT model. Students were divided into three groups of five, and each group was committed to having a free discussion on its ideas concerning the curricular structure. Then, a panel was presented to each group, dividing the semesters from the 1st to the 4th year with post-it notes representing the current curricular structure of the medical school, and each group had one hour to reassemble the curricular structure as they deemed appropriate. Results: After the discussion stage, each group assembled its curricular structure. Some changes concerning the year in which the discipline was provided were proposed, and the inclusion of others. Most of the suggestions were considered valid and were incorporated into the curriculum. Conclusions: The DT methodology contributed to the identification of several demands regarding the curricular structure in an orderly, empathetic, and collaborative way, taking into account the students’ opinions. It is, therefore, a planning strategy able to evidence weaknesses and strengths of the curriculum that might not have been noticed by the use of other strategies.

Análise da tuberculose e hanseníase nos projetos pedagógicos das faculdades de Medicina e a relação espacial dos casos

Abstract Introduction: Medical education is crucial for the training of healthcare professionals. In Brazil, medical training has advanced, focusing on the Unified Health System and primary care. The inclusion of tuberculosis and leprosy in the medical curriculum is essential due to the impact of these diseases on public health. Medical schools should ensure that students learn about these diseases to improve health outcomes in the country. Objective: This study aims to analyze how the topics of leprosy and tuberculosis are included in the pedagogical projects of medicine courses at university institutions in the Southern region of Brazil. Method: A documentary and exploratory study with a qualitative approach was conducted. Pedagogical projects were collected between January and August 2023. The analysis of the pedagogical projects focused on identifying the keywords “leprosy” and “tuberculosis” and evaluating how these diseases were addressed in the documents, both in theoretical contexts and in practical teaching intentions. Content units were identified and grouped into two main categories: Theoretical Learning and Clinical-Practical Learning. Results: The results indicated that references to tuberculosis were more frequent than leprosy in the analyzed pedagogical projects. Most institutions prioritize teaching these diseases in the early years of medical school, with little emphasis during the clinical internship phase. Furthermore, the analysis revealed that the teaching of these diseases tends to be more theoretical, with few references to clinical practice. A spatial distribution of leprosy in Santa Catarina was also conducted, correlating the presence of medical courses in certain municipalities with the number of leprosy cases diagnosed in those areas. Conclusion: This study highlights the importance of reviewing and improving the pedagogical projects of medical courses in Santa Catarina to enhance the teaching of leprosy and tuberculosis. This includes incorporating practical approaches and considering the epidemiological relevance of these diseases in the regions where courses are conducted. The study also emphasizes the need to rethink how these topics are taught and how medical students can play an active role in detecting and managing these diseases in the community.

Research on the Clinical Internship Teaching Model for Undergraduate Nursing Students in Traditional Chinese Medicine

Research on the Clinical Internship Teaching Model for Undergraduate Nursing Students in Traditional Chinese Medicine

Exploring strategies to improve the effectiveness of neurology ideology teaching team building using machine learning techniques

Abstract This paper takes the students of neurology specialty in a medical school as the research object and analyzes the current situation of its educational team construction. A machine learning algorithm based on weighted plain Bayes is used to construct an evaluation model, through which different weights are given to each index to explore the effectiveness enhancement strategy of neurology ideology and politics teaching team construction. Finally, the teaching performance and comprehensive ability of Civics and Politics were compared between the two groups of students to explore the effect of infiltrating the course Civics and Politics in neurology teaching. The results showed that 54.65% believed that teaching neuroscience ideology and politics in team construction should be improved as soon as possible. The mean value of “exerting the guiding role of professional teachers of Civics and Politics” was 23.76 points, which was also the furthest away from a perfect score, and was the focus of the subsequent team-building concern. The teaching performance and comprehensive ability of the students in the experimental group were better than that of the reference group (P&lt;0.001), and the full penetration of the relevant elements of the course Civics in the teaching of clinical internships can transform the students’ ideological concepts and conscious behaviors.

Analysis of the Application Value of Micro-Course Combining PBL Teaching Method in the Clinical Practice of Anesthesia Graduate Students

Objective: Exploring the Application Value of Micro lessons Combined with PBL Teaching Method in Clinical Internship of Anesthesiology Graduate Students. Methods: Through controlled experiments, 42 anesthesia graduate students who were interning in hospitals were selected as the research subjects. They were divided into two groups using a random number table: the traditional group using traditional teaching and the combined group using micro lessons combined with PBL teaching, with 21 people in each group.Collect and compare data on teaching effectiveness and method satisfaction for two groups. Results: In terms of teaching effectiveness, the theoretical knowledge score of the joint group was (91.61 ± 3.97) points, the clinical operational skills score was (93.74 ± 4.44) points, and the total score was (92.90 ± 3.16) points, which showed a significant improvement compared to the conventional group's (85.44 ± 2.89) points, (87.92 ± 5.25) points, and (86.57 ± 4.71) points (P&lt;0.05); the satisfaction rate of the joint group with teaching methods is 95.24%, which is significantly higher than the conventional group’s 61.90% (P &lt;0.05). Conclusion: The application value of combining micro-course and PBL teaching method in the clinical practice of anesthesia graduate students is high, which can not only significantly improve the teaching effect, but also be favored by clinical practice graduate students, which is worthy of promotion.

INTERGENERATIONAL BONDING: A PATHWAY TO CAREER READINESS IN SPEECH LANGUAGE PATHOLOGY GRADUATE STUDENTS

Abstract We present a new experiential learning activity for graduate students in two core courses in Speech-Language Pathology. Speech-Language Pathology is a healthcare profession that provides care to people of all ages, including older adults with language, communication, and cognitive disorders. Students typically find these course contents heavy and have limited opportunity to practice the required skills for their future profession. In this multi-faceted program, we provide cognitive intervention to community older adults via telepractice with an intergenerational approach. Students receive real-life interaction to practice the knowledge and skills learned in their academic program. These interactions provide hands-on experience that facilitates better preparation for their future healthcare career. We measure students’ perception of competency pre and post-intervention. Additionally, we survey alumni and their supervisors on students’ preparedness (required skills) and performance during their clinical internship experience. This intergenerational bonding program creates a fun and enjoyable experience that impacts students’ active engagement with older adults. Students report an easier application of academic material, great ownership of learning, and increased motivation to learn new skills. Further, this real-life, interactive experience will impact their career success as future aging healthcare professionals (SLPs).