Clinical Practicum Research Articles

Abusive supervision and nursing students’ intention to leave the nursing profession: a moderated mediation model of emotional exhaustion and the nurse-patient relationship

BackgroundExploration of the relationship between nursing students’ abusive supervision and their future intention to leave the nursing profession before completing the final clinical practicum is critical to the issue of nursing staff shortages and how to alleviate them. In order to further dissect the factors influencing turnover intention among student nurses in clinical practice, our study used the conservation of resources theory and job demands-resources model to explain the specific pathways that influence student nurses’ intention to leave the nursing profession, with particular focus on nursing students’ personality traits and certain organizational factors.MethodThis study followed a cross-sectional design. Between March and May 2022, a convenience sampling method was used to select 531 nursing students from two medical universities in Fuzhou. The Abusive Supervision, Emotional Exhaustion, Nurse-Patient Relationship, and Turnover Intention Scales were employed to collect data. The PROCESS macro (Models 4 and 7) for SPSS 25.0 by Hayes and 5,000 bootstrap samples were used to examine the moderation and mediation impacts.ResultsAbusive supervision was found to significantly positively predict nursing students’ intention to leave the nursing profession. Emotional exhaustion significantly mediated the relationship between abusive supervision and an intention to leave the nursing profession. The moderating effect of the nurse-patient relationship in the mediation model was also found to be significant.ConclusionsAbusive supervision by clinical teaching staff is a work-related stressor that leads to emotional exhaustion, consequently decreasing nursing students’ future intention to work as a nurse. A nurse-patient relationship based on trust could buffer the negative effect of abusive supervision on emotional exhaustion. Healthcare organizations and nurse educators should implement programs that educate and train individuals about abusive supervision, emotion regulation, and positive nurse-patient relationships; this would serve to decrease nursing students’ intention to leave the nursing profession. This study provides relevant implications for helping nursing instructors develop effective intervention strategies to retain talented nursing personnel.

A simulation educational intervention to enhance preclinical family nurse practitioner student preparation.

Simulation has been shown to improve communication and psychometric skills in advanced practice nursing students. Little is known about the impact of a simulation educational intervention with a faculty-facilitated debriefing on the preparation of novice nurse practitioner students for their first clinical practicum. This article describes the development of an educational intervention to accomplish this. The simulation education intervention was implemented with preclinical nurse practitioner students designed to improve their preparation for their first precepted clinical experience. Students were surveyed preintervention and postintervention to explore their self-perception of confidence and preparation for clinicals looking at six domains: health history, physical examination, diagnostics, differentials, final diagnosis, and plan of care. Quantitative results were statistically significant for each domain. Qualitative findings gave deeper insight into the students' perceptions of how the intervention prepared them for clinicals. Advanced practice educators can use educational interventions such as this to prepare students for their first clinical practicums.

Healthcare Students' Perceptions of the Quality of the Clinical Learning Environment in Morocco: A Cross-Sectional Study.

The clinical learning environment (CLE) is critical for developing the practical skills needed in healthcare professions. This study aimed to evaluate healthcare students' perceptions of the quality of the CLE using the Arabic version of the Clinical Learning Environment, Supervision and Nurse Teacher (ar. CLES + T) scale. The study also aimed to evaluate the tool's measurement invariance and compare perceptions among student groups. This cross-sectional study was carried out at two health education institutes in Morocco throughout the academic year 2018-2019 among 1550 undergraduate students who had just finished a clinical practicum in a hospital or primary healthcare facility. Data were gathered using the ar. CLES + T scale. Confirmatory factor analysis (CFA) and multigroup CFA were performed. The measurement invariance of the ar. CLES + T scale was assessed across gender, study year, and clinical practicum duration, using configural invariance, metric invariance, scalar invariance, and strict invariance. The t-test and analysis of variance were used to compare the mean scores of the student groups. Students expressed positive perceptions toward the CLE. The "Pedagogical atmosphere on the ward" dimension scored the highest, while the "Role of the nurse teacher" dimension received the lowest scores. The measurement invariance of the ar. CLES + T scale by gender, study year, and clinical practicum duration was established. First-year students and those with an extended practicum period were the most satisfied. To promote effective learning in the clinical environment, nurse teachers might use innovative teaching approaches tailored to their evolving role in these settings. Moreover, extending the duration of clinical practicum can further enhance student learning outcomes.

Nursing students’ stressors and coping strategies during their first clinical training: a qualitative study in the United Arab Emirates

BackgroundUnderstanding the stressors and coping strategies of nursing students in their first clinical training is important for improving student performance, helping students develop a professional identity and problem-solving skills, and improving the clinical teaching aspects of the curriculum in nursing programmes. While previous research have examined nurses’ sources of stress and coping styles in the Arab region, there is limited understanding of these stressors and coping strategies of nursing students within the UAE context thereby, highlighting the novelty and significance of the study.MethodsA qualitative study was conducted using semi-structured interviews. Overall 30 students who were undergoing their first clinical placement in Year 2 at the University of Sharjah between May and June 2022 were recruited. All interviews were recorded and transcribed verbatim and analyzed for themes.ResultsDuring their first clinical training, nursing students are exposed to stress from different sources, including the clinical environment, unfriendly clinical tutors, feelings of disconnection, multiple expectations of clinical staff and patients, and gaps between the curriculum of theory classes and labatories skills and students’ clinical experiences. We extracted three main themes that described students’ stress and use of coping strategies during clinical training: (1) managing expectations; (2) theory-practice gap; and (3) learning to cope. Learning to cope, included two subthemes: positive coping strategies and negative coping strategies.ConclusionsThis qualitative study sheds light from the students viewpoint about the intricate interplay between managing expectations, theory practice gap and learning to cope. Therefore, it is imperative for nursing faculty, clinical agencies and curriculum planners to ensure maximum learning in the clinical by recognizing the significance of the stressors encountered and help students develop positive coping strategies to manage the clinical stressors encountered. Further research is required look at the perspective of clinical stressors from clinical tutors who supervise students during their first clinical practicum.

ENHANCING REFLECTIVE CAPACITIES IN EXERCISE PHYSIOLOGY: BRIDGING EDUCATION AND LIFELONG PROFESSIONAL LEARNING

INTRODUCTION & OBJECTIVES Essential to both students and experienced exercise physiology practitioners, reflective practice is a cornerstone of lifelong learning and improved client care. In clinical settings reflection, characterised by awareness, is the critical analysis of experience and requires integration into higher education curriculum. METHODOLOGY Final-year exercise physiology students (N = 21) and 5 clinical exercise physiology supervisors completed a reflective practice learning activity. The stepped process of SPROUT was utilised, via classroom teaching and 14 weeks of clinical practicum. SPROUT represents the Situation, Past experiences, Read and refer, Other influences, Understanding, and Taking it forward. Teaching modes included group discussion, clinical situations, and student-led practice along with the completion of written reflections. Each student responded to the Reflection in Learning Scale (RLS) and further questions about their confidence. Written scripts were analysed for meaning and each ranked. Supervisors responded to open-ended questions during a focus group. FINDINGS Student scores for the RLS revealed higher scores for planning, knowledge integration and mental processing and lower for interactions with knowledge, mindful summarising and coping with negative emotions. 75% of students indicated that they were confident with reflective practice and that SPROUT, however time-consuming, had been helpful. Written scripts showed a range of developing abilities, from novice requiring more depth to those more advanced who demonstrated meaningful engagement and solution-orientated reflective ability. Clinical supervisors supported the importance of reflective practice and were positive about the application of the stepped approach of SPROUT. CONCLUSIONS The SPROUT framework supported reflective practice learning, benefiting both students and qualified practitioners, facilitating not only increased confidence but also a more profound understanding of clinical encounters. The structured approach of SPROUT proved beneficial in guiding reflective thinking. This research underscores the importance of reflective practice in exercise physiology, endorsing its role in ongoing professional development.

Perceived professional preparedness and identity among senior nursing students: a latent profile Analysis

BackgroundSenior nursing students’ perceptions of their professional preparedness help them for expectations of their future nursing role with more confidence, and professional identity may contribute to cultivating nursing students’ perceptions of professional preparedness. In this study we applied latent profile analysis to identify the latent profiles of perceived professional preparedness among senior nursing students and to examine their identity and predictors.MethodsThis was a cross-sectional descriptive study. A total of 319 senior nursing students from five universities in China were enrolled. Data were collected using the Perceived Professional Preparedness of Senior Nursing Students’ Questionnaire and the Professional Identity Scale for Nursing Students.ResultsThree latent profiles were identified and labeled as “low perceived professional preparedness” (n = 90, 28.2%), “low clinical competency-low EBP (Evidence-Based Practice)” (n = 190, 59.5%), and “high perceived professional preparedness” (n = 39, 12.2%). Place of residence, average clinical practicum hours per day, part-time experience, good relationships with classmates, and feeling nobility toward nursing due to COVID-19 significantly predicted profile membership. The average professional identity score was also statistically different across the three profiles (F = 54.69, p < 0.001).ConclusionsSenior nursing students’ perceptions of their professional preparedness were divided into three profiles, and out results show that promoting professional identity may effectively foster their perceived professional preparedness. This study therefore highlights the importance of targeted interventions by considering their distinct perceptions of professional preparedness patterns.

Effect of simulation-based zoom learning on clinical decision-making among undergraduate nursing students and experiences of students and instructors: A mixed methods study

AimTo determine the effect of simulation-based Zoom learning (SBZL) on perceived capabilities and clinical decision-making skills among undergraduate nursing students and to explore experiences of the instructors and students participating in SBZL. BackgroundNursing is a practice profession and students acquire clinical decision-making skills in clinical settings. However, the COVID-19 pandemic has disrupted conventional clinical learning activities. In this study, the outcomes of implementing SBZL in an undergraduate programme to support students’ clinical learning were examined. DesignA mixed methods design was employed. MethodsThis study recruited 195 final-year students to participate in the SBZL programme, which was developed based on the NLN Jeffries Simulation Theory to guide its design, implementation and evaluation. Case scenarios were developed and simulated through Zoom. Students’ perceived capabilities, perceptions of the learning environment and clinical decision-making skills were assessed before and after SBZL. A historical control group of 226 previous final year students who had received a clinical practicum was included for comparison. Semi-structured interviews were conducted with 11 instructors and 19 students to explore their experiences of participating in SBZL. ResultsA total of 102 students completed the post-SBZL questionnaire. An increase in perceived creative thinking (mean difference = 0.24, p < 0.001) was observed post-SBZL. After SBZL, the perceptions of the learning environment were significantly improved. However, the SBZL group demonstrated lower perceived problem-solving capability than the control group (mean difference = 0.14, p = 0.007). Clinical decision-making was significantly improved in the SBZL group than in the control group (p < 0.001). Both the instructors and students reported positive experiences with SBZL, and highlighted challenges and factors for improving its implementation. ConclusionsSBZL showed improvement in perceived creative thinking, perceptions of the learning environment and clinical decision-making. This innovative teaching and learning method can be valuable for nursing education in various regions to prepare students for real-life roles. Tweetable abstractSimulation-based Zoom learning is better than traditional teaching in improving clinical decision-making skills among undergraduate nursing students.

Nursing students’ readiness towards the ‘new normal’ in clinical practice: a distributed cognition qualitative perspective

BackgroundClinical practicums are a core component of baccalaureate nursing education. Following the coronavirus pandemic, there have been extensive changes in the workforce environment that may potentially affect nursing students’ experience and readiness for clinical practicums.MethodsA qualitative study was conducted to explore final-year nursing students’ experiences and readiness for their final clinical practicum before becoming a registered nurse. A purposive sample of 24 final-year baccalaureate nursing students was included in this study. Individual semi-structured interviews were conducted face-to-face via Zoom. The data was analysed using an inductive thematic analysis approach.ResultsThree themes depicting students’ experiences and clinical readiness were elucidated. The themes included: (1) Experiencing multiple concerns, (2) requiring a network of support, and (3) easing the transition to professional practice. Students considered the final clinical practicum as challenging and demanding which evoked numerous concerns.ConclusionsConsidering the stress that final-year nursing students experience, it will be important to devise strategies ranging from personal, relational, and environmental protective factors to enable their successful transition and completion of clinical practice.

Improving self-efficacy in behavioral health through interprofessional education.

Interprofessional education (IPE) is important in preparing health profession students to practice in a workforce dependent on teamwork and collaboration. Many health profession students graduate without ever having active shared learning experiences in the academic setting. Opportunities for students to participate in activities that promote self-efficacy in competencies related to interprofessional collaborative practice are essential. The purpose of the project was to assess health profession students' perception of self-efficacy related to the core competencies of IPE. The project used a pre/post quantitative survey research design comprising a sample of students enrolled in clinical practicums in behavioral health care settings. Using standardized patients, students participated in timed simulated encounters. Participants ( n = 36) completed the 16-item Interprofessional Education Collaborative Competency Self-Assessment Tool on conclusion of the learning activity. Survey responses were scored on a 5-point Likert-type scale, with high scores indicating a stronger level of agreement of perceived self-efficacy. On the postsurvey, most items were rated as "agree" or "strongly agree." Item means ranged from 4.64 to 4.81. A positive association was found between students' self-efficacy and the utilization of standardized patients within an interprofessional experiential learning activity. The intervention contributed to improving self-efficacy in interprofessional competencies related to collaborative interaction and values.

Exploratory pedagogical research of a bespoke eye movement desensitisation and reprocessing therapy training for midwives

AbstractEye movement desensitisation and reprocessing (EMDR) therapy is a transdiagnostic, comprehensive, integrative, evidence‐based treatment intervention for post‐traumatic stress disorder (PTSD), complex PTSD, and perinatal PTSD. PTSD can arise from an experience of pregnancy or birth related trauma. Despite this, there is limited availability and access to EMDR therapy within the United Kingdom National Health Service. EMDR is a psychotherapeutic intervention which is usually delivered by highly specialist mental health professionals. However, with such a robust protocol, it is appropriate to consider if other health professionals should be trained to deliver EMDR. Humanitarian trauma capacity‐building projects in a global context have shown that task shifting can assist with addressing unmet mental health therapy needs. Midwives are highly skilled graduates working in the perinatal period who understand that women's emotional health is as important as their physical health. Therefore, it was proposed that EMDR knowledge and skills could be efficiently task shifted to midwives. The aim and objectives were to train midwives to deliver modified EMDR scripted protocols and techniques and explore qualitative and quantitative outcomes of a bespoke EMDR for midwives (EMDR‐m) educational programme. The online training was delivered to the midwives over 4 days with clinical practicums incorporated throughout. Pre and post‐tests demonstrated an increase in their EMDR knowledge, skills and confidence. EMDR Group Supervision provided by three experienced EMDR Accredited Practitioners was mandatory for 6 weeks post‐training and ongoing one‐to‐one supervision was made available. Midwives scored the course 9.6/10 (range 8–10) and described it as ‘amazing’ and ‘invaluable’. Challenges for the future include ring‐fenced time and an appropriate space to deliver the therapy. Those midwives who completed the training have progressed to deliver early EMDR‐m interventions in a perinatal mental health research study in their own Health and Social Care Trust (reported elsewhere).

Trajectory of change in perceived stress, coping strategies and clinical competence among undergraduate nursing students during clinical practicum: a longitudinal cohort study

BackgroundClinical practicum is crucial for strengthening nursing students' clinical competence. However, nursing students often experience considerable stress during clinical practicum, and so they employ coping strategies to alleviate it. There is almost no empirical evidence on the change trajectory of perceived stress, coping strategies, and clinical competence among nursing students during a one-year clinical practicum. This study aimed to investigate the trajectory of change in perceived stress, coping strategies, and clinical competence among undergraduate nursing students during a one-year clinical practicum.MethodsThis study used a longitudinal cohort design. Undergraduate nursing students were recruited from a science and technology university in Taiwan to participate from February 2021 to January 2022. Perceived stress, coping strategies, and clinical competence among students in basic training practicum (T1), advanced training practicum (T2), and comprehensive clinical nursing practicum (T3) were surveyed by using the Perceived Stress Scale (PSS), Coping Behaviour Inventory (CBI), and Clinical Competence Scale (CCS). PSS, CBI, and CCS in T1, T2, and T3 were compared using a generalized estimating equation (GEE) to deal with correlated data. The level of statistical significance was set at α = 0.05.ResultsA total of 315 undergraduate nursing students completed the questionnaire. The study results show that the overall perceived stress of the students is the highest in T2 and the lowest in T3. The main source of stress of the students is 'taking care of patients' at T1 and 'lack of professional knowledge and skills' at T2 and T3. Students' perceived stress in 'taking care of patients' gradually decreases over time. The four coping strategies of CBI, which are 'stay optimistic', 'problem-solving', 'transference' and 'avoidance' in this order, remain the same ranking in three surveys.The main stress coping strategy used by students is 'stay optimistic', while the coping strategy 'avoidance' is used more frequently in T2 than in T1 and T3. Students' mean scores of the overall clinical competence and in the 'general nursing' and 'management' subscales in T3 are higher than those in T1 and T2. However, their mean scores in 'self-growth' and 'positivity' subscales are the highest in T1 and the lowest in T2.ConclusionsThe results show that through experiential learning in clinical practicum at different stages time after time, students' overall perceived stress is the lowest and their overall clinical competence is the highest in T3. The main coping strategy used when students managed stress is 'stay optimistic'. According to the results, we suggest that clinical educators provide students with appropriate guidance strategies at different stages of stress and continue to follow up the clinical competence and retention rates of these nursing students in the workplace in the future.

Project Building Bridges: A Framework for Preparing Highly Qualified Speech-Language Pathologists to Serve Culturally and Linguistically Diverse Students With Augmentative and Alternative Communication Needs.

Project Building Bridges was funded by the U.S. Department of Education Office of Special Education Programs to address the shortage of speech-language pathologists qualified to serve students with complex communication needs who benefit from augmentative and alternative communication (AAC) and are culturally and linguistically diverse. The purpose was to train future speech-language pathologists in culturally responsive AAC practices through coursework and fieldwork in AAC integrated into the Master of Science degree in Speech, Language and Hearing Sciences. Fifty-seven graduate students completed the project. The scholars' curriculum consisted of two AAC courses, both on-campus and externship AAC clinical practicum experiences to provide services to multicultural and linguistically diverse students, a U.S. or international service-learning opportunity, and cumulative portfolio presentations. Mixed-methods outcome measures consisted of four sets of pre- and postsurveys and qualitative feedback from exit interviews to assess changes in graduate student competencies. Significant differences were demonstrated between scholars' pre- and post-assessments of confidence ratings. Significant differences were also demonstrated in both scholars' and school mentors' pre- and post-assessments of competency ratings. No significant differences were found between evaluations of AAC preparation by Clinical Fellowship (CF) candidates and their CF mentors at 1 year postgraduation. Project Building Bridges provides a framework for preparing highly qualified speech-language pathologists to serve culturally and linguistically diverse students who benefit from AAC as evidenced by pre- and postsurvey results. The project can serve as a model for other university programs in the development of preservice preparation programs focusing on culturally and linguistically diverse students with AAC needs.

Evaluation of antenatal simulation-based learning on satisfaction and self-confidence levels among Thai undergraduate nursing students during the COVID-19 pandemic: a mixed-method study

BackgroundDuring the COVID-19 pandemic, simulation-based learning (SBL) serves as an alternative teaching strategy for nursing students facing restricted access to antenatal clinical practicum. However, the factors predicting nursing students’ satisfaction, self-confidence, and their learning experiences remain unclear.ObjectiveTo identify factors predict satisfaction and self-confidence and explore the learning experiences of antenatal SBL.MethodsA Mixed methods research of the cross-sectional study design and descriptive qualitative research was conducted. A total of 100 third year nursing students who finished the Maternity-Newborn Nursing and Midwifery Practice course using antenatal simulation-based learning were invited to complete the online questionnaires. A total of seven questionnaires were administered, including a demographic questionnaire, the Attitude Scale toward Simulation-Based Education (SBE), the Professional Identity Scale for Nursing Students, the Perceived Stress Scale, the Evaluation of Teaching Competencies Scale, the Simulation Design Scale: Student Version, and the Student Satisfaction and Self-Confidence in Learning. The 20 nursing students who completed survey were asked to participate a qualitative focus group discussion. Multiple regression analysis was performed to investigate predictors, while qualitative data were analyzed using content analysis.ResultsThe quantitative results showed high levels of satisfaction (mean = 20.55, SD = 3.17) and self-confidence (mean = 32.44, SD = 4.76) after completing the antenatal SBL. In regression analysis, attitude toward SBE (Beta = 0.473, t = 5.376, p < 0.001) and attitude toward antenatal care simulation design (Beta = 0.338, t = 2.611, p < 0.011) were significantly associated with a high level of satisfaction with antenatal SBL, which accounted for 44.0% of the variance explained in satisfaction. Only attitude toward SBE was significantly associated with a high level of self-confidence in antenatal SBL (Beta = 0.331, t = 3.773, p < 0.001), which accounted for 45.0% of the variance explained in self-confidence. The qualitative results generated four themes: (1) positive attitude toward antenatal simulation; (2) turning reassurance into confidence; (3) I am really happy to learn; and (4) being a good nurse motivates and stresses me.ConclusionsAntenatal SBL is an effective teaching strategy that can support nursing students to build clinical confidence. Creating a positive learning environment allows students to have a positive attitude and experience with simulations.

Comparing the effect of assessment-simulation-animation-based against traditional education on nursing students’ anxiety and self-efficacy in maternity clinical practicum

BackgroundThe clinical practicum is the practical course that causes the most anxiety in nursing undergraduates. Although high-fidelity simulation education has been demonstrated to boost nursing students' self-efficacy and decrease anxiety in patient care, it is also associated with excessive psychological stress. Assessment-simulation-animation-based (ASA-based) education has been developed to solve the drawbacks of simulation-based education while preserving positive learning outcomes. ObjectivesTo compare the effects of ASA-based education and traditional education in reducing anxiety and improving self-efficacy of junior nursing students in their maternity clinical practicum. DesignThis study used a two-group pre-post quasi-experimental design. The comparison group was studied first followed by the experimental group. SettingsDepartment of Nursing and affiliated medical center at a medical university in southern Taiwan. ParticipantsWe enrolled 114 junior nursing students from two different class years. MethodsA convenience sample of junior nursing students was used in this study, with 55 in the experimental group and 59 in the comparison group. The intervention included online ASA-based education videos with pamphlets and was conducted three days a week for five weeks encompassing the maternity nursing clinical practicum. We developed and applied the Clinical Situation Anxiety Scale (CS-AS) and Clinical Situation Self-Efficacy Scale (CS-SES) before and after the intervention. Qualitative feedback was assessed after the intervention. Data were collected from both the comparison and experimental groups during the fall and spring terms of both the 2019–2020 and 2020–2021 academic years. ResultsCompared with the comparison group, the total CS-AS and CS-SES scores significantly improved from before to after the intervention in the experimental group. The students responded to the intervention by demonstrating clinical consistency, knowing what to do and how to do it and more confidently practicing health education. ConclusionOur results suggest that ASA-based education with videos and pamphlets contributed to reducing anxiety and increasing self-efficacy in nursing students during their maternity clinical practicum.

Nursing students’ satisfaction and clinical competence by type of pediatric nursing practicum during the COVID-19 pandemic

Purpose: This study aimed to investigate student nurses’ satisfaction by type of clinical practicum and to determine predictors of clinical competence in pediatric nursing.Methods: A total of 189 Junior and Senior student nurses across seven colleges in the Busan Metropolitan City were enrolled in the study. The participants completed a structured questionnaire containing items about their learning satisfaction with different types of pediatric nursing practicums and their clinical competence. Data were analyzed using the mean, standard deviation, independent t-test, ANOVA, and multiple regression analysis.Results: Regarding satisfaction with each type of clinical practicum, the mean satisfaction score (out of 10) was 8.18±2.26 for on-site clinical rotations and 7.35±2.20 for alternative practicums. Among the different types of alternative practicum approaches, those with a satisfaction score of 7 or higher included fundamental nursing skills, watching videos, simulation etc., while those with a satisfaction score of less than 6 were virtual simulation and problem-based learning. The predictors of clinical competence in pediatric nursing were learning satisfaction with practice, school year, and alternative practicum, accounting for 35.0% of the variance in clinical competency.Conclusion: It would be helpful to combine on-site clinical rotations with alternative practicum approaches and to develop various alternative practice programs using simulation practice, virtual reality, immersive interactive systems, and standardized patients to enhance students’ clinical competency.

Academic Stress: Coping Strategies by Nursing Students

Students across a wide range of industries and educational levels frequently feel academic stress. It is defined as the body's and mind's reaction to the demands and strains of education, such as homework, projects, exams, and clinical training. Particularly when it comes to juggling the demands of their education and their clinical training and practicum, nursing students confront special stresses. To uncover practical coping mechanisms that assist nursing students in their academic endeavors, this study examines the coping mechanisms used by these students to deal with academic stress. Data were gathered from 196 nursing students at St. Michael's College of varying academic levels using a descriptive-correlational study approach. The study looks at how respondents' characteristics, academic stress, and the coping mechanisms they use—such as problem-, emotional-, and avoidant-focused coping mechanisms—relate significantly. The results add to the understanding of how nursing students cope with academic stress by highlighting the importance of including stress management programs into the nursing curriculum to teach a variety of student-specific coping mechanisms. A preliminary investigation including thirty-two nursing students yielded significant information for improving the research questionnaire. Results revealed that there exist notable differences in the academic pressures experienced by the respondents when classified based on their profile. The stresses related to personal time management do not significantly differ according to age, sex, parental marital status, or family rank, except for year level, where fourth-year students exhibit greater stress levels. However, there are notable differences in the stresses associated with academic burden according to age and year level. Participants who are 20 years of age or younger report feeling less stressed than older participants, while first-year students report feeling more stressed than second- and third-year students. In conclusion, the results show that year level and age have a major impact on the stress that academic overload causes for the respondents. To lessen academic stress and improve students' general well-being, recommendations include encouraging peer-to-peer connection to create a friendly environment in educational institutions and advocating for self-care techniques. Important insights from nursing students helped to improve the research technique. One suggestion is to create a welcoming atmosphere in educational institutions by encouraging self-care behaviors and peer-to-peer engagement lessen the burden of school and improve the general wellbeing of children. These suggestions are pertinent to nursing educators and educational establishments that aim to provide nursing students with all-encompassing assistance in efficiently handling academic stress, therefore enhancing their general welfare and scholastic achievement.

Factors Associated With Sleep Quality Among Undergraduate Nursing Students During Clinical Practicums.

Limited evidence exists on factors influencing nursing students' sleep quality during clinical practicums. This study examined the sleep quality of nursing students and factors that affect sleep quality during clinical practicums. Undergraduate nursing students (n = 135) enrolled in clinical practicums in 3 universities completed questionnaires including sociodemographics and the Pittsburgh Sleep Quality Index (PSQI). Stepwise linear regression evaluated factors predicating sleep quality. Seventy percent of nursing students reported poor sleep quality. Weekly work hours and clinical hours were significant factors in predicting global PSQI scores, subjective sleep quality, sleep duration, sleep efficiency, and daytime dysfunctions. The students' race was related to sleep latency and sleeping medication. Clinical hours and living on campus were associated with sleep disturbances. Knowing the factors that influence nursing students' sleep during clinical practicums, nurse educators can help students improve sleep health and clinical experience.

Competency-Based Virtual Clinical Practicum in Response to COVID-19 Pandemic: A Quality Improvement Project.

The purpose of the quality improvement (QI) project was to provide a learner and faculty preceptor high quality virtual clinical practicum (VCP) for Wound, Ostomy, Continence (WOC) Nurse learners during the COVID-19 pandemic and disseminate findings. Project participants were registered nurses post-bachelor's degree or higher with a minimum of 1-year clinical experience who had completed and passed the didactic portion of a Wound Ostomy Continence Nursing Education Program (WOCNEP). Learners completing the WOCNEP's VCP and the faculty preceptors were the subjects for this QI report. The setting was a virtual platform allowing live time visibility and interactions between learners and faculty preceptors including the ability to share documents and procedural videos. An initial group of 62 learners were asked open-ended questions after completion of the VCP; the most frequently recurring themes were converted into 5-point Likert scale questions as the evaluation tool completed by an additional 234 learners. In total, 296 learners completing the VCP evaluated this novel 100% simulation virtual practicum. This QI project evaluated a 100% simulation-based practicum at a WOCENP based in the United States. A competency based VCP used the Competency Outcomes and Performance Assessment (COPA) model. Learners were taught competencies via a preparatory virtual lab and then had to prepare documents and videos or pictures with step-by-step instructions prior to attending a Live Competency Assessment Lab with faculty preceptors and a small group of peer learners. Appraisal of the VCP was based on course evaluations anonymously completed by each of the 296 learners. Faculty preceptors were queried regarding their VCP evaluation and certification exam pass rates were tallied. Findings indicate positive outcomes of the VCP competency-based practicum from student and faculty preceptor perspectives along with higher certification pass rates; specifically, wound care pass rates increased by 16%, ostomy care increased by 18% and continence care pass rates increased by 13%. Our reported experiences strongly suggest a VCP offers an attractive option for fulfilling practicum requirements while reducing barriers of the in-person split option practicum.

Effectiveness of Clinical Practicum Experience in Drug Addiction Treatment Facilities in Nursing Students' Attitudes Toward Alcohol, Alcohol Use Disorders, and Alcoholics: Systematic Review and Meta-Analysis.

The aim of this study was to identify, analyze, and synthesize the best evidence on the effectiveness of clinical practicum experience in drug addiction treatment facilities on nursing students' attitudes toward alcohol, alcohol use disorder (AUD), and persons with AUD. This systematic review followed the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and used the System for the Unified Management of the Assessment and Review of Information to assess methodological quality and extract data for meta-analysis. A comprehensive literature search of the EBSCO databases, Embase, PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde, PsycINFO, Scopus, Web of Science, Mednar, Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior, and ProQuest Dissertations & Theses catalog was conducted. The System for the Unified Management of the Assessment and Review of Information tool was used for the extraction and critical evaluation of the selected articles followed by a meta-analysis. After removing duplicates, 2,831 publications were identified, and eight met the inclusion criteria. More positive attitudes were observed after performing practicum experience in specialized services (-1.27, 95% confidence interval [-2.85, -0.30]), and an increase in the motivation and satisfaction among the students to care for patients with AUD was also noted. In conclusion, the review suggests that clinical practicum experience in a drug addiction treatment facility has the potential to change the attitudes of nursing students toward AUD and persons with AUD.

Utilizing a HRSA Training Grant to Promote PMHNP Student Resilience: Answering the Call to Enhance Trauma-Informed Teaching and Learning Practices in Nursing Education

Nursing burnout has reached a new level of prevalence among professionals and is rising among nursing students and can impact student success in the classroom and clinical areas. Among advanced practice nurses, psychiatric-mental health nurse practitioners have the least favorable combination of low compassion satisfaction and high secondary traumatic stress, placing them at even greater risk for burnout compared to other specialties. Trauma informed teaching and learning principles can serve to prevent burnout and have a positive impact on learning outcomes. Through these teaching methods, nurse educators have the opportunity to both support students during their nursing education and prepare students for the professional stressors that contribute to burnout. This quality improvement project involved implementation and evaluation of a HRSA funded program to train PMHNP students interested in working in rural and underserved areas. The training intervention included didactic curricular enhancements, a trauma resiliency training and a longitudinal clinical practicum. Qualitative program outcomes indicated that trainees were implementing trauma-informed principles and skills with patients and for self-care during their nursing training and at one year follow-up. The program may offer practical upstream solutions for nurse educators and future studies should explore concepts more formally to develop best practice models.