Nursing students' perceived stress, self-efficacy, control and evaluation of a course in systematic clinical observation, physical assessment and decision-making: An observational study in Norway.

AIM: Simulation-based nursing education interventions have a strong educational effect on psychomotoric skills, but students may experience physiological stress and anxiety during simulation. The aims of this study were to explore (1) nursing students' perceived stress, self-efficacy, control and evaluation before and after simulation as part a structured course in physical assessment, (2) whether factors such as gender, age or previous work experience were associated with perceived stress during simulation and (3) nursing students evaluation of the course. DESIGN: An observational, cross-sectional study before and after simulation and a course in physical assessment. METHODS: We utilized "the Self-Assessment Manikin for measuring emotion" before and after simulation, a questionnaire to identify symptoms of stress after simulation, and a questionnaire to evaluate the physical assessment course. RESULTS: A total of 59 students participated. Students perceived stress before simulation but reported a lower degree of activation, a more positive mood, increased feeling of control and self-efficacy after the simulation. They also felt more secure about their assessments. Even though students reported of several symptoms of stress before simluation, the course increased students' self-reported competence and feeling of security.

Impact of Initial Emotional States and Self-Efficacy Changes on Nursing Students' Practical Skills Performance in Simulation-Based Education.

Training through simulation has shown to increase relevant and specific skills sets across a wide range of areas in nursing and related professions. Increasing skills has a reciprocal relation to the development of self-efficacy. A study was conducted to assess changes in the development of self-efficacy in simulation training for 2nd year nursing students. Initial emotional states, pre and post self-efficacy, and expert ratings of simulation performance were assessed. Results show that students who displayed an increase in self-efficacy as a result of simulation training were also judged to perform better by expert ratings. The effect of simulation on self-efficacy could be influenced by initial states of physiological activation and over control. Results also showed that initial emotional states did not moderate self-efficacy development on outcome measures. These findings improve our understanding on the relationship between students' self-efficacy and performance of practical skills and inform pedagogical designs and targeted interventions in relation to feedback and supervision in nursing education.

Supervising students in a complex nursing practice- a focus group study in Norway.

BACKGROUND: The supervisory role of registered nurses and intellectual disability nurses will be even more essential in the future, to support the education of competent newly graduated candidates. To our knowledge few studies have explored nursing student supervisors' perspectives on supervision across primary- and hospital healthcare services and also across nurse educational programs. The aim of the current study was to investigate supervisors' perspectives on supervising from different clinical settings, and across registered nurses' and intellectual disability nurses' clinical practice. METHODS: The study had an exploratory and descriptive design. The study was conducted within one university college catchment area in Southeastern-Norway. Eight focous group interviews were conducted in primary healthcare (n = 4) and hospital (n = 4) wards. A total of 31 registered nurses and three intellectual disability nurses participated. Hsieh and Shannon's conventional content analysis was used to analyze the data. RESULTS: Participants across primary- and hospital healthcare agreed that clinical practice was complex, and required that students gained competence in both technical and non-technical skills. Moreover, needed skills were described both as general and arena specific, and as both basic and advanced. Participants perceived that technical and non-technical skills together, ideally should lead to students being able to «see the person¼ behind the patient. CONCLUSIONS: Supervisors emphasized the challenges of supervising students in a complex nursing practice. Students should gain both procedural competence and an ability to provide person-centred care, and this challenged the supervisors' own competence. Our findings indicate a need to support supervisors, to enable them to meet these challenges.