[Comparison of the sources of stress among the senior nursing and midwifery students of Tehran medical sciences universities]

Nursing and Midwifery students experience different and numerous sources of stress. Stress is a complex phenomenon that may be experienced by all. Nursing and midwifery students have multiple sources of stress due to their work environment. In order to reduce their stress and prevent the complications, all sources of stress should be recognized. This study was carried out to compare sources of stress between midwifery and nursing students of Tehran universities of medical sciences. This is a cross-sectional study. All senior midwifery and nursing students of Tehran and Shahid Beheshti Universities were invited to participate in the study [n=380]. Data were collected using a questionnaire including demographic section [15 questions] and sources of stress of educational environment, clinical environment, and social-personal problems [54 items]. Data were analyzed using SPSS and tested with chi-square test. 363 students participated in the study. Research findings showed that the followings are the most cited sources of stress among the students: ambiguous professional view, incompetent professional knowledge after graduation, caring for terminally ill patients, discordance between theory and clinical education, concerns about employment. Also results showed that there were significant differences between some sources of stress and the study programs. The nursing and midwifery students had numerous sources of stress in the educational, clinical, and social-personal domains of their life that can affect their physical and psychological health and cause learning problems. Using appropriate approaches to control and manage these sources of stress are recommended

[Effect of test item analysis of summative exams on quality of test designing]

Item analysis is a process in which both test items [questions] and students' answers are examined in order to assess the quality and quantity of the items and test as a whole. The purpose of this study was to investigate the effect of analysis of multiple choice test items of summative exams on quality of the test design by faculty members of Tehran Nursing and Midwifery School. A quasi experimental method [pre-test and post-test] without control group was used in this study. After a pilot study, 33 nursing faculty members of school of nursing and midwifery at Tehran University of Medical Sciences were chosen through census sampling. Then one of their exams designed in the second semester [83-84] were chosen to be analyzed. The analysis results were reported to the faculty members. Then their designed tests for the next semester were analyzed again. The analysis was carried out using a checklist which included item structure, whole structure of exam, content validity, and levels of thinking skills reflected in questions and criteria for holding an exam. Moreover, for the quantitative analysis of questions, item difficulty and discrimination index were calculated. Item distracter analysis was examined by calculating the percentage of examinees who selected incorrect alternatives. Integrated t-test, Pearson and Spearman correlation coefficients, and Fisher's exact test were used for the statistical analysis. 1056 questions before presenting the feedback and 803 questions at the end were analyzed and then the results were compared. According to the results, there was a significant difference between before and after intervention in variables item structure [P<0.001], levels of thinking skills [P<0.05], and item distracter analysis [P<0.001].While there was not significant difference between item difficulty, discrimination index, whole structure of exam, content validity, and criteria that should be considered on holding of an exam. Although, Pearson correlation coefficient showed that variables such as age [r=-0.535, P=0.004], and years of services [r=-0.546, P=0.003] with difficulty index were statistically significant. The results emphasized that item analysis, providing feedback to the faculty members and offering educational booklets to assist them were effective means on improving some qualitative and quantitative items analysis measures

[Nursing students' viewpoints about their clinical competencies and its achievement level]

Clinical competency is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions and values in the clinical environments. Competency is a complex concept that encompasses such attributes as knowledge, skills, and attitudes. Acquirement of competency is final outcome and product of an educational system. The purpose of this study is to determine the viewpoint of nursing students about clinical competency and its level of achievement. A Descriptive-analytic design was applied for 91 undergraduate nursing students from Tehran school of nursing and midwifery. The data was collected by a questionnaire consisted of two parts: 1] demographic characteristic, 2] clinical competencies included: systematic assessment and data gathering, care planning, ethical points, professional improvement, client and family comfort, effective care management, and collaboration with health team. [p<0.05]. Among 91 students, 70 cases participated in this study .The results showed that most of the students were agree with the competencies: systematic assessment and data gathering 81.4%, care planning 78.65%, ethical points 81.4%, professional improvement 78.6%, client and family comfort 84.3%, effective care management 77.5%, and collaboration with health care team 80%. Also the most participants had amoderate view about their achievement to systematic assessment and data gathering 58.6%, care planning 52.9%, ethical points 68.6%, professional improvement 64.3%, client and family comfort 60%, effective care management 64.3%, and collaboration with health team 60%. There were not any significant correlations between demographic characteristic of participants and their view about clinical competency and its level of achievement. The results indicated that all participants had not any agreement about production of clinical competency by current nursing education program. On the other hand the achievement level of competency by nursing students was moderate and weak. This study can be useful as a guideline to determine practical solutions of changing students' view and their achievement to the clinical competency