Factors Affecting Clinical Practicum Stress of Nursing Students: Using the Lazarus and Folkman's Stress-Coping Model

PURPOSE: This study was conducted to test a path model for the factors related to undergraduate nursing students' clinical practicum stress, based on Lazarus and Folkman's stress-coping model. METHODS: This study utilized a path analysis design. A total of 235 undergraduate nursing students participated in this study. The variables in the hypothetical path model consisted of clinical practicum, emotional intelligence, self-efficacy, Nun-chi, and nursing professionalism. We tested the fit of the hypothetical path model using SPSS/WIN 23.0 and AMOS 22.0. RESULTS: The final model fit demonstrated a satisfactory statistical acceptance level: goodness-of-fit-index=.98, adjusted goodness-of-fit-index=.91, comparative fit index=.98, normed fit index=.95, Tucker-Lewis index=.92, and root mean square error of approximation=.06. Self-efficacy (β=−.22, p=.003) and Nun-chi behavior (β=−.17, p=.024) were reported as significant factors affecting clinical practicum stress, explaining 10.2% of the variance. Nursing professionalism (β=.20, p=.006) and self-efficacy (β=.45, p<.001) had direct effects on emotional intelligence, explaining 45.9% of the variance. Self-efficacy had indirect effects on Nun-chi understanding (β=.20, p<.001) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. Nursing professionalism had indirect effects on Nun-chi understanding (β=.09, p=.005) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. The variables for self-efficacy and nursing professionalism explained 29.1% of the Nun-chi understanding and 18.2% of the Nun-chi behavior, respectively. CONCLUSION: In undergraduate nursing education, it is important to identify and manage factors that affect clinical practicum stress. The findings of this study emphasize the importance of Nun-chi, self-efficacy, emotional intelligence, and nursing professionalism in the development of an educational strategy for undergraduate nursing students.

A Phenomenological Study on the Experiences of Nursing Students' Communication in Clinical Nursing Practicum / 의료커뮤니케이션

BACKGROUND: Unlike traditional quantitative study, this qualitative study is designed to understand andexplore the experiences of nursing students's communication in clinical nursing practicum.METHODS: Participants were 15 nursing students from a university in Seoul who were selected by purposive sampling. They had been participated in clinical nursing practicum more than one semester. Data were collected through in-depth interviews and observation from May 29, 2017 to June 8, 2017. Collected data were analyzed by Colaizzi's phenomenological methodology.RESULTS: As a result, 5 theme clusters were derived as follows: 1) the modeling of communication, 2) treatment as a student nurse, 3) respect as a nurse, 4) trauma after communication, and 5) sympathy in communication. This study identified the desire for nursing professionalism, psychological difficulties as negative emotionality, as well as positive emotionality of nursing students in clinical practicum.CONCLUSION: We should consider a nursing curriculum to prepare and improve the communication of nursing students before participating in clinical practicum. The concrete and systematic communication education would be useful for nursing students to participate clinical practicum effectively.

Analysis of the Contents and Importance of Clinical Practicum Education in Adult Health Nursing According to Nursing Intervention Classification (NIC) System / 의료커뮤니케이션

BACKGROUND: The purpose of the study was to analyze the contents and importance of clinical practicum education in adult health nursing.METHODS: This is a descriptive study using content analysis for identifying the items of clinical nursing checklists gathered from 13 university nursing programs accredited by Korean Accreditation Board of Nursing Education. Items in the checklist were standardized in accordance with the Nursing Intervention Classification (NIC) and categorized into simple-technical skill, complex-technical skill, and disease-specific care. The perceived significance of each item was examined by surveying nurses who in charge of nurse education from various clinical setting.RESULTS: A total of 182 items in the clinical practicum contents were analyzed, and the terminologies of each item were variously described among nursing schools. Fifty percent of the total items were categorized into simple-technical skill. In terms of clinical importance, expert validity results showed that nurses considered infection control, infection protection, and fall prevention as the most significant items, which was not the same as the most common items in the clinical nursing checklist.CONCLUSION: These findings suggest that standardized nursing terminologies are needed to describe a nursing practicum checklist. Clinical importance of each item in the checklist should be taken into consideration in developing a clinical nursing checklist to assist the students in achieving the competencies as a clinical nurse.

Effects of the Flipped Classroom Approach on the Psychiatric Nursing Practicum Course / 정신간호학회지

PURPOSE: In this study effects of a flipped learning-based psychiatric nursing practicum were evaluated for appropriateness with undergraduate nursing students who are digital natives and tech-savvy millennial students. METHODS: For this retrospective comparative study data from 146 undergraduate students (flipped learning group n=70, traditional learning group n=76) were evaluated for academic performance and life core competencies. RESULTS: There was no significant difference between the flipped and traditional learning groups in prior homogeneity tests. The academic performance of the flipped learning group was higher than the control group in all aspects, except for practical quiz scores. The flipped leaning group had significantly higher self-assessment scores for academic performance (t=2.77, p=.006) and therapeutic communication simulation scores (t=3.18, p=.002). In addition, they showed a significant increase in core life competencies after participating in the flipped-learning practicum (t=-8.56, p<.001). They showed significant increases in all subdomains except Identity-value [Socialization (t=-5.13, p<.001), Responsibility-practice (t=-3.52, p=.001), Problem-solving (t=-2.67, p=.010), Knowledge-construction (t=-2.48, p=.016), and Information-management (t=-5.54, p<.001)]. Nursing students in the flipped learning-based clinical practicum showed significant improvement in performance and life core competencies. CONCLUSION: These results suggest that as a student-centered pedagogy, flipped learning is an effective strategy for improving academic performance and core competencies.

Predictors associated with Occurrence of Needlestick Injuries in Clinical Practicum among Nursing Students / 기본간호학회지

PURPOSE: The purpose of this study was to identify prevalence and risk factors of needlestick injuries (NSI) among nursing students. METHODS: Data were collected using self-administered questionnaires which included general and practical characteristics, safe environment risk factors, knowledge, attitude, and preventive behavior associated with NSI. Data were conducted from December 14-20, 2014 and analyzed using χ² test and multiple logistic regression. RESULTS: The incidence rate of NSI was 20.2%. Multiple logistic regression analysis identified four predictors for NSI which were statistically significan; carelessness (OR=1.49, 95% CI=1.04~2.11), status of hospital, university affiliated (OR=1.93, 95% CI=1.35~2.75), knowledge about handing the needle after NSI (OR=1.42, 95% CI=1.00~2.03), and barriers to NSI preventive behavior (OR=1.48, 95% CI=1.04~2.12). CONCLUSION: Management of carelessness and barriers to NSI preventive behavior are essential elements for reducing the risk of NSI in nursing students. It is necessary to develop a specific NSI precaution program for nursing students.

Role Transition of Senior Year Nursing Students: Analysis of Predictors for Role Transition / 간호행정학회지

PURPOSE: The purpose of this study was to identify the perception of role transition from a student nurse to a registered nurse among senior year nursing students and to examine factors affecting their role transition. METHODS: A descriptive survey with convenience sampling was conducted in four nursing colleges in Seoul, South Korea. Data were collected using a self-administrated questionnaire. Four instruments including role transition, self-esteem, interpersonal relationships and anxiety during clinical practicum were used and the students'demographics were also collected. A multiple logistic regression was used to identify predictors for the role transition. RESULTS: A total of 233 nursing students were surveyed and final analysis was conducted utilizing 226 participants. Mean point of perceived role transition (5 point scale) was 3.34+/-0.44. In a multiple regression model, high self-esteem, good interpersonal relationships, low anxiety during clinical practicum, and high satisfaction in college life were significant predictors of a smooth transition (Adj. R2=.32, F=22.28, p<.001). CONCLUSION: The findings suggest that role transition from a student nurse to a registered nurse is facilitated through the establishment of programs to improve self-esteem and interpersonal relationships and to reduce anxiety during clinical practicum.

Evaluation of Clinical Practicum for Child Health Nursing for Baccalaureate Student Nurses in Korea / 아동간호학회지

PURPOSE: The purpose of study was to describe and evaluate the educational status regarding clinical practicum for child health nursing to facilitate student's clinical compliance for the bachelor's degree in Korea. Methods: The study was a descriptive study and included data from 40 institutions among the 53 university nursing programs in Korea(75.5% response rate). Data were collected using mailed semi structured questionnaires and content analysis was done. RESULTS: Findings show that most institutions have common learning objectives for the clinical practicum; neonatal care, high risk infant care, hospitalized child care, and advanced nursing practice. The mode for theoretical credits in child health nursing was 5 to 6 and 3 to 4 credits for clinical practice. The practice settings were prepared to provide diverse experiences, including childcare centers, and community centers with various learning activities. Evaluation for learning outcomes included faculty and instructors. It was pointed out that updating evaluation based on student and faculty feedback is important for a comprehensive practicum evaluation. Conclusions: Findings suggest that there is a -need for a generalized curriculum for clinical practicum and for the expanding role of advanced nursing practice-, a need for diverse clinical settings for practice, and effective guidance and learning activities. It is significantly noted that the attitude and teaching methodologies of clinical instructor's are highly important to effective clinical learning outcomes.