Senior Nursing Students Research Articles

Test-taking anxiety among nursing & general college students.

This study examined whether nursing students experience an unusual amount of debilitative anxiety in academic achievement, compared to general university students and provided senior psychiatric nursing students with a hands-on experience in research. A nonprobability convenience sample of 225 students was drawn from a university in the eastern United States. Alpert and Haber's Achievement Anxiety Test was administered to 94 nursing students and 131 general university students. Results indicated that nursing students do not have a statistically significantly higher debilitative anxiety than the general student population. However, all students experienced significantly higher levels of debilitative anxiety than were found by Alpert and Haber. Implications for academic nursing are discussed.

Determining the accuracy of pain assessment of senior student nurses: a clinical vignette approach

Pain is a commonly identified clinical problem and if not relieved, patients will suffer. Accurate pain assessment is essential for effective pain management. A theoretical model of factors has been constructed for this study, indicating how clinical signs can affect the accuracy of pain assessment by student nurses. The purpose of this study is to determine the accuracy of pain assessment, using a clinical vignette approach, by a group of senior student nurses. A survey design with two clinical vignettes and question method was used to collect data. Convenience sampling was used to seek voluntary participation from 198 senior student nurses with degree and diploma programs in Hong Kong. The results indicated that the pain assessment of the two patients in each clinical vignette documented by the senior student nurses differed significantly (P<0.01). Of all the student nurses, 40.8% (69/169) considered the subjective report of patients as the most reliable indicator of pain. The remaining senior student nurses (100/169 (59.2%)) tended to ignore this subjective sign of pain and relate the objective signs for pain assessment. It is recommended that the undergraduate curriculum in the aspect of pain assessment needs to be reviewed for a sound theoretical foundation of pain, and that the bias in pain assessment be corrected.

Senior nursing students' participation in a community research project: effect on student self-efficacy and knowledge concerning drug interactions arising from self-medication in older adults.

Senior nursing students' participation in a community research project: effect on student self-efficacy and knowledge concerning drug interactions arising from self-medication in older adults.

An analysis and evaluation of student nurses' participation in ethical decision making.

This study analyses the types and frequencies of ethical dilemmas and the rationale of ethical decision making in student nurses; it also evaluates their decision making. One hundred senior student nurses who were enrolled in a two-credit course in nursing ethics were asked to provide an informal description of a dilemma that they had experienced during their clinical practice. The results were as follows. The ethical dilemmas identified fell into four categories and were of 27 types. Those most frequently experienced were 'family giving up on a patient because he or she could not be cured', and 'not telling the truth to the patient'. The Korean Nurses' Code of Ethics was applied, in particular the preamble, and the third, fourth, seventh and tenth clauses. The most common rule of ethics and principle applied in these nurses' ethical decision making were veracity and nonmaleficence. With regard to the moral reasoning process, the primary concern was the welfare of the patients. These students were equipped with the ability to exercise critical and reflective thought when they experienced ethical dilemmas.

Problem-solving skills of senior student nurses: an exploratory study using simulation

The Stages Model of problem-solving as evidenced in the use of the nursing process is the key vehicle for the operationalisation of problem-solving in current nursing practice. An expanded variant of the model formed the theoretical framework for this study which aimed to explore and compare the problem-solving skills of senior student nurses ( n=253) from three pre-registration nurse education programmes (RGN, diploma RN, integrated degree). Students’ care planning skills were explored using a video-tape simulation exercise and data were subjected to statistical testing. Findings indicated a large range in the global care plan scores and while performance was similar in a number of areas independent of programme type, certain key differences also emerged. The findings are discussed in the wider context of professional education and practice and the potential for further development of problem-solving skills in pre-registration nurse education is explored.

From 'getting to know you' to 'soloing': The preceptor-student relationship

A preceptored practicum for senior students is seen by many to be an important transition to the graduate nurse role, although there is very little literature describing the development of the student during these clinical experiences. Furthermore, the exact role of preceptors in facilitating students' learning and socialisation into the nursing profession is not well defined. This descriptive exploratory study sought to elucidate the meaning of the experience of preceptorship to senior baccalaureate nursing students during their senior practicum. To that end, audiotaped interviews were conducted with 15 senior Canadian baccalaureate nursing students at the end of the first, second and third months of their practicum. Students were asked to describe a recent significant incident from their practice experience, the context of the situation, and why the incident was significant. The research team analysed the interview transcriptions, extracted significant statements, and identified themes and patterns relating to the students' perceptions of their experiences. The relationship with the preceptor was perceived by students as pivotal to their development as a nurse. Emerging themes that described this experience were: 'developing a productive relationship', 'creating a safe environment for learning', 'teaching strategies employed by preceptors', and 'soloing'. An understanding of the experiences of senior student nurses during their practicum will assist both faculty staff and preceptors to develop strategies to facilitate student growth and comfort during the experience.

A precepted experience for senior nursing students.

The author discusses an undergraduate course that provides students with a clinical experience focusing on setting priorities, managing time, and organizing assignments and responsibilities, with the support of, and under the direction of, an experienced RN preceptor. In addition to building confidence and making students more competitive during job interviews after graduation, the preceptorship course promotes collaboration between academia and service, provides students with the opportunity to implement their professional practitioner role, and promotes the personal and professional development of the preceptors and nursing staff.

Preserving moral integrity: a follow-up study with new graduate nurses.

The purpose of this follow-up study was to describe, explain and interpret how new graduate nurses perceived their adaptation to the 'real world' of hospital nursing and what they perceived as major influences on their moral values and ethical roles in the 2 years following graduation. The method was qualitative, specifically grounded theory. The earlier study took place when informants were senior nursing students. The follow-up study began after the informants had been practising for 1 year. Research questions guiding the study were: How do new graduate nurses describe their adaptation to the 'real world' of hospital nursing? What do they describe as factors influencing their moral values and ethical roles in hospital nursing? Preserving moral integrity was the basic psycho-social process that explained how these new graduate nurses adapted to the real world of hospital nursing. Six stages of this process were identified: vulnerability; getting through the day; coping with moral distress; alienation from self; coping with lost ideals; and integration of new professional self-concept. Moral distress was a consequence of the effort to preserve moral integrity. It is the result of believing that one is not living up to one's moral convictions. Data supported that the most pervasive attributes of moral distress were self-criticism and self-blame, as informants judged their actions against their moral convictions and their standards of what a good nurse would do. Moral distress was an acute form of psychological disorientation in which informants questioned their professional knowledge, what kind of nurses they were and what kind of nurses they were becoming. Theoretical explanations of these findings are grounded in social interaction and moral psychology theories.

MARVELOUS MENTORS

We're senior nursing students writing to add our perspective on "Charged to Mentor" (Editorial, February). We wholeheartedly agree with the concept of mentorship programs. As students, we crave the knowledge that experienced nurses hold. The mentor/protégé relationship is a vital component of our education and growth. Our curriculum includes a 160-hour preceptorship program that allows us to work one-on-one with a registered nurse in a clinical specialty area. We are experiencing firsthand the rewards of this modality of learning, and are grateful that there are nurses willing to enter into such a relationship. Thank you for challenging nurses to assist in the development of, and transition into, the profession. Laura Johnson Kimberley Hubert Canton, MA

Measuring clinical nurse performance: development of the King's Nurse Performance Scale

The development of the King's Nurse Performance Scale to measure clinical nurse performance is described. Instrument construction was informed by the Slater Nursing Competencies Rating Scale [Wandelt, M. A. and Stewart, D. S. (1975) Slater Nursing Competencies Rating Scale. Appleton-Century Crofts, New York] together with key literature and the use of expert opinion. The instrument was utilised to observe the clinical performance of senior student nurses ( n = 99) and data which were at the ordinal level were statistically analysed using a variety of non-parametric tests. Key findings of students' observed nursing practice are presented in a separate paper (While et al., unpublished document). Internal consistency testing of the King's Nurse Performance Scale using Cronbach's alpha coefficient revealed a promising alpha for the total instrument ( r = 0.93). The subsection alphas indicated that further refinement may enhance the strength of the instrument as a tool for the measurement of performance in different domains of practice. The possible use of the Scale in the professional development of newly qualified nurses is suggested.

Link teacher behaviours: student nurses' perceptions

The role of the nurse teacher in the clinical area is a major issue in nurse education today. When attempting to define the role, identification of teacher behaviours that are effective and valued by students is essential. Whilst there is no shortage of literature addressing nurse educationalists' opinions of the nature of the present and future role, there is a paucity of papers reflecting students' views, and UK students in particular. The aim of this descriptive survey was to discover the views of third year RGN diploma level student nurses regarding the link teacher behaviours that help them to learn. One hundred and two student nurses completed a written questionnaire seeking information about the number and length of link teacher visits, and ratings of the level of helpfulness of 5 categories of link teacher behaviours. The Statgraphics statistical package aided the production of descriptive statistics, and also validation of the internal construct of the behaviour categories. Results showed that the majority of students were dissatisfied with the amount of link teacher contact they receive. A minimum length of time for each visit was established. The link teacher behaviours found to be most helpful were related to interpersonal skills and personality followed by nursing competence, evaluation and teaching ability. The findings contribute to the literature addressing UK students' views, and will inform the development of a higher quality link teacher support system for senior student nurses.

Meeting the learning needs of senior citizens and nursing students through a community-based pharmacology experience.

Senior citizens commonly take multiple medications and lack knowledge about proper use and side effects. They often have no access to health professionals to clarify any misconceptions about their medications. Nursing students often learn pharmacology in the classroom with no opportunity to apply the knowledge as it is learned. Within one community, a creative strategy was developed to meet the learning needs of both groups. At a local senior center, clients with drug-knowledge deficits or compliance difficulties were identified. Pharmacology nursing students were then assigned to collect drug histories from these clients. Following analysis of gathered data, students were required to develop individualized drug teaching tools for their assigned client. Through these activities, the learning needs of both groups were met.

Pictorial art as a teaching strategy in death education

Caring for cancer patients in advanced stages of the disease is a professional challenge for the nurse. At the same time, the close proximity with death and dying may call forth in the nurse feelings of anxiety and apprehension, leading to inner struggle and stress. One mode of alleviating stress is through self-expression by means of pictorial art. In the study described here, senior student nurses drew their perception of death before and after a three-month seminar on coping with life-threatening situations. The aim was two-fold: to make students aware of their perception of death, and to examine whether their attitude towards the concept of death had been altered as a result of the seminar. Comparison of the pre- and post-seminar drawings showed that their perception of death and dying had undergone a change, in that the concept had lost something of its ominous power. [ NT Research 1996; 1: 3, 198-203]

Role perceptions of freshman and senior nursing and medical students and attitudes toward collaborative decision making.

David Kolb's (1981) experiential learning theory was used to examine differences between first- and fourth-year nursing and medical students' perceptions of competencies important for nursing and medicine. A convenience sample of nursing (n = 109) and medical (n = 108) students from a large Canadian research university was surveyed. Respondents completed the Environmental Press Questionnaire, the Adaptive Competency Scale, and a 6-item measure of attitudes toward collaborative nurse-physician patient care decision making. Nursing students' perceptions of competencies important for medicine were found to be more congruent with medical students' perceptions of these competencies than were medical students' perceptions of competencies important for nursing as seen by nursing students. Gaps in perceptions of each others' roles were significantly negatively related to attitudes toward collaborative patient care decision making.

Senior Nursing Students' and Professional Nurses' Perceptions of Effective Caring Behaviors: A Comparative Study

Care forms the basic core of nursing actions. Traditionally nurses have described the acts of administering to patients as care behaviors. Many nurses find it difficult to define these caring behaviors. It is important that nurses have insight into the specific behaviors that patients perceive to be most important. Several studies have examined and compared nurses' and patients' perceptions of effective care behaviors. The literature supports an incongruence of what nurses perceive and what patients perceive as effective. This study identifies and compares student nurses' and professional nurses' perceptions of effective caring behaviors. The Caring Assessment Report Evaluation Q-sort (CARE-Q) was used to obtain the data. The participants included senior baccalaureate nursing students (n = 30) at Thomas Jefferson University, College of Allied Health Sciences, and professional nurses (n = 30) with 1 or more years experience. The significance of the difference between the groups was tested using the Mann Whitney U test. Results indicate agreement between the students and the nurses in all categories except trusting relationship (p = .06). The ages within the groups varied from 21 to 47 years. The difference in ages between the nurses and the students is significant (p = .0002). Findings provide a better understanding of student nurse perceptions of caring behaviors and provide implications for further research for nurse educators.

The Effects of a Synthesis of Nursing Practice Course on Senior Nursing Students' Self-Concept and Role Perception

This study investigated the effects of a Synthesis of Nursing Practice course on senior nursing students' self-concept and perception of role competencies. Seventy senior baccalaureate nursing students enrolled in the Synthesis of Nursing Practice course participated in the study during their last semester in the program. The Tennessee Self-Concept Scale was used to measure self-concept and the Slater Nursing Competencies Rating Scale was used to measure perception of role competencies. These instruments were administered at the beginning of the Synthesis of Nursing Practice course and immediately following completion of the course. A t-test was used to assess the differences between pre- and posttest group means. The study findings indicated a significant increase in the students' self-concept (p = .10) and perceived role competencies (p = .001). Implications of the findings for nursing education are discussed.

Humor: A coping response for student nurses

This qualitative study describes various situations that elicited a humorous coping response in student nurses assigned to a state psychiatric hospital. The research question asked was: Under what circumstances do student nurses choose to use humor as a coping method? Forty-three senior student nurses enrolled in a north-central United States university were invited to participate anonymously in the study. A content analysis of 38 narratives describing humorous situations was conducted and the emergent categories were evaluated for compatibility with Lazarus's theory of stress and coping. Novel and bizarre behaviors, novel and bizarre thoughts, negative evaluations of self and role, perceived threats to physical well-being, and wit were common antecedents fostering tension in the form of anxiety, frustration, fear, and puzzlement. Students used cognitive appraisal and humorous coping to mediate the stressful person-environment relations for positive outcomes. The cognitive and behavloral efforts to manage these emotions in a humorous manner were identified.

The Relationship Between Clinical Decision-Making Skills in Nursing and General Critical Thinking Abilities of Senior Nursing Students in Four Types of Nursing Programs

This descriptive study was undertaken to investigate the relationship between clinical decision-making skills in nursing and critical thinking abilities of senior nursing students in four types of nursing education programs: generic baccalaureate, associate, and diploma--the basic RN programs, along with the upper division baccalaureate (specifically RN completion) program. Fifty senior students from each type of program were conveniently selected. Clinical decision-making in nursing was measured by the Nursing Performance Simulation Instrument. General critical thinking abilities were determined by the Watson-Glaser Critical Thinking Appraisal. Among the basic RN programs, the higher level of general critical thinking ability was attained by generic baccalaureate seniors (mean score, 61.3) compared with the associate (50.0) and diploma (51.3) seniors. The clinical decision-making scores in nursing skills were virtually identical for the three basic programs--generic (32.2), associate (32.2), and diploma (32.3). That is, mean performance scores of the 2-year associate degree, 3-year diploma, and 4-year generic baccalaureate degree students on the Nursing Performance Simulation Instrument showed no statistically significant difference. The mean critical thinking score for the upper division baccalaureate seniors (61.1) was comparable to that of the generic baccalaureate seniors. Clinical decision-making mean score for the upper division seniors was significantly higher (38.0) than those of the other three groups. A weak though significant positive correlation (r = 0.249) between clinical decision-making and critical thinking across all four types of programs was found.

AIDS Education and Patient Care Experiences of Senior Nursing Students in Buffalo, New York: A Research Brief

AIDS Education and Patient Care Experiences of Senior Nursing Students in Buffalo, New York: A Research Brief

Effects of faculty practice on student learning outcomes.

Faculty practice purports to positively affect outcomes for patients, students, faculty, and the nursing care delivery system. The purpose of the research reported here was to study the relationship between faculty practice and student acquisition of beliefs, values, and attributes associated with professional craftsmanship. The dependent variables studied were autonomy, locus of control, self-concept and self-esteem, professional and bicultural role behavior, and characteristics associated with the professional role. The treatment variables were intensity and length of exposure of students to faculty engaged in faculty practice. Based on Bandura's social learning theory, it was hypothesized that students exposed to practicing faculty would score significantly higher on the dependent variables than would students taught by nonpracticing faculty. The sample for the study was 134 baccalaureate senior student nurses and the 14 faculty teaching those students in the clinical area. In general, the hypotheses were confirmed; there were significant differences in the hypothesized directions.