Inclusive pedagogy in online simulation-based learning in undergraduate nursing education: A scoping review.

BACKGROUND: Equality, diversity and inclusion initiatives seek to embed the concept of inclusive pedagogy to promote inclusive educational environments. However, no evidence synthesis exists which examines whether and how the concept of inclusive pedagogy is addressed in online simulation-based learning in the undergraduate nursing education literature. AIMS: To map the evidence regarding the adoption of inclusive pedagogy in online simulation-based learning in undergraduate nursing education. DESIGN: A scoping review. METHODS: Data were extracted, synthesized and presented in narrative and table format. DATA SOURCES: A systematic search of five databases and five sources of grey literature was conducted to search literature published between 1st January 2010 to 1st June 2022. RESULTS: Thirty-eight papers published between 2011 and 2022 were included. The results are presented under three identified themes: (1) Learner diversity; (2) Theoretical frameworks promoting equality, diversity and inclusion in online simulation and (3) Online simulation feedback. CONCLUSION: Inclusive pedagogy has not been considered or embedded in its entirety in online simulation in undergraduate nursing education literature. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Utilizing an inclusive pedagogy framework may prove advantageous in generating inclusive teaching approaches to support all students. IMPACT: This review will interest educators and managers that wish to incorporate equality, diversity and inclusion initiatives in nursing education. REPORTING METHOD: This scoping review has adhered to the EQUATOR guidelines: the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

The effect of sleep problems on core self-evaluations in undergraduate nursing students and the role of emotion regulation and resilience: A cross-sectional study.

BACKGROUND: Nursing students are prone to sleep problems that affect their core self-evaluations. However, little attention has been paid to the specific roles of emotion regulation (including cognitive reappraisal and expressive suppression) and resilience in this process. OBJECTIVES: This study aimed to explore 1) the direct effect of sleep problems on core self-evaluations among nursing students; 2) the chain-mediating effect of cognitive reappraisal and resilience on the relationship between sleep problems and core self-evaluations; 3) the moderating effect of expressive suppression on the direct relationship between sleep problems and core self-evaluations; and 4) the moderating effect of expressive suppression on the indirect relationship between sleep problems affecting core self-evaluations through resilience. METHODS: A total of 345 nursing students completed a survey conducted between September and October 2022. Data was analyzed using descriptive analysis, Fisher exact test, Kruskal-Wallis H test, Spearman correlation analysis, and hierarchical regression analysis. Additionally, the SPSS PROCESS V4.0 plug-in was used to verify the moderated chain-mediating effect. RESULTS: Sleep problems directly affected core self-evaluations among nursing students. Cognitive reappraisal and resilience played a partial chain-mediating role in the relationship between sleep problems and core self-evaluations, with expressive suppression having a direct moderating effect. CONCLUSIONS: Opportunities exist for enhancing the core self-evaluations of nursing students by addressing their sleep problems, promoting cognitive reappraisal strategies, and increasing resilience. Additionally, encouraging expressive suppression can mitigate the negative impact of sleep problems on nursing students' core self-evaluations.

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

BACKGROUND: Clinical 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. METHODS: This 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. RESULTS: A 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. CONCLUSIONS: The 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.

Death education for undergraduate nursing students in the China Midwest region: An exploratory analysis.

AIM: The purpose of this study was to comprehend the need for incorporating death education within the curriculum of undergraduate nursing students and to assess the factors that impact the desire for such education. DESIGN: We enlisted undergraduate nursing students from several nursing colleges located in the central and west region of China. Undergraduate students who fulfilled the eligibility criteria between January and February 2021 were chosen to participate. Data were collected via an online platform called Questionnaire Star. The survey encompassed a general information questionnaire and a scale for assessing the need for education on the topic of death. Descriptive statistical analysis was performed using the SPSS 20.0 software, while multivariate stepwise regression was employed for more complex analysis. Statistical significance was indicated when the p-value was below 0.05, and high statistical significance was noted when the p-value fell below 0.01. METHODS: We designed a descriptive quantitative approach to investigate the need for death education and its associated factors. The research involved 907 undergraduate nursing students from the central and west region of China. The data collection was done through the Questionnaire Star platform. RESULTS: Following the collection of completed surveys, individuals displaying contradictory responses were omitted. Out of 911 surveys disseminated, 907 were successfully collected, resulting in a recovery rate of 99.6%. Among the participants, 769 identified as female, constituting 84.8% of the total, while 138 identified as male, making up 15.2%. The survey findings indicated that factors such as residency, parental educational history and exposure to hospice care education significantly impacted the need for death education among undergraduate nurses (p < 0.05). CONCLUSIONS: Among students pursuing a nursing degree at the undergraduate level, there was a pronounced need for education related to the topic of death. Offering such education to these students is essential, as it helps cultivate a proper understanding of death. This, in turn, contributes to enhancing the overall quality of patient care throughout their life journey. PATIENT OR PUBLIC CONTRIBUTION: A total of 907 nursing undergraduates from central and western China participated in the questionnaire.

Nursing students learning transfer from classroom to clinical practice: An integrative review.

AIM: The aim of this integrative review was to examine the theoretical, qualitative, quantitative and mixed-methods literature focused on how nursing students transfer learning from theory courses into clinical practice. BACKGROUND: As nursing curriculum aligns with the growing body of nursing knowledge, nursing students continue to develop their knowledge base and skill sets to prepare for future nursing practice. The bulk of this preparation involves developing connections between classroom/lab knowledge and further demonstrating those connections in clinical practice. However, the extant state of evidence on undergraduate nursing students' learning transfer has not yet been synthesized. DESIGN: This integrative review was conducted using the Whittemore and Knafl framework. REVIEW METHODS: Eight databases were searched in June 2022: MEDLINE, APA PsycInfo, EMBASE, Web of Science, CINAHL, ERIC, Academic Search Complete and Education Research Complete. Literature was included if it focused on undergraduate nursing students who have participated in at least one clinical practicum and reported on learning transfer in clinical settings. Only English-language, peer-reviewed literature was included. Two researchers independently assessed the eligibility of articles at the title-and-abstract level and at the full-text level, followed by an assessment of methodological quality. The Joanna Briggs Institute's critical appraisal checklists were used to assess theoretical papers and literature reviews and the mixed-methods appraisal tool (MMAT) was used to appraise all studies. Reference lists of included articles were searched for additional relevant literature. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. RESULTS: Twenty-eight articles met our inclusion criteria and were included in this review, including 20 qualitative studies, one quantitative study, three mixed-methods studies, three theoretical articles and one integrative review. The results of this review highlighted that numerous facilitators and barriers influence nursing students' ability to transfer learning within clinical learning environments. Facilitators included having knowledgeable and supportive educators and nursing staff, using strategies to promote connections, fostering reflection and aligning theory and practice. Barriers included unclear connections between course content, incongruencies between classroom and practice, lack of nurse role models, lack of real-world applicability and unsupportive nurse educators. CONCLUSIONS: The information generated from this integrative review provides evidence about barriers that can be mitigated and facilitators that can be leveraged to facilitate undergraduate nursing students' learning transfer into clinical practice. The findings also highlighted gaps in evidence surrounding the need to understand how nursing students transfer learning from classroom settings to clinical practice settings.

Situación actual de la investigación enfermera en Galicia (España): influencia de la formación / Current status of nurse research in Galicia (Spain): influence of training

Objetivo principal: Conocer el perfil investigador, el tipo de investigación realizado y el grado de motivación para investigar de los enfermeros y enfermeras de Galicia (España). Metodología: Estudio descriptivo transversal con profesionales y estudiantes de Enfermería de Galicia (n =391; α=005, d=5 %, proporción 50 %). Se diseñó un cuestionario ad hoc de 12 bloques. La recogida de datos se realizó a través de Google Drive. Se realizó un análisis descriptivo de variables, análisis bivariado y multivariado para la variable Formación en Investigación. Resultados principales: La puntuación media sobre la importancia de la investigación fue 2.8/5 puntos. Las variables que influyen en la investigación enfermera en Galicia son: trabajar en área sanitaria de Ferrol o Lugo-Cervo-Monforte, estudiar en facultad de Ourense, realizar investigación previa, tener titulación de grado o estar motivador para investigar. Conclusión principal: Los enfermeros y enfermeras en Galicia consideran importante la investigación y están motivados para su desarrollo, pero necesitan más formación y ayudas institucionales.(AU)

Objective: To know the research profile, the type of research and the degree of motivation for research nurses in Galicia (Spain). Methods: Cross-sectional descriptive study with professionals and students of Nursing in Galicia (n =391; α=005, d=5%, proportion 50%). An ad hoc 12 blocks notebook was designed. Data were collected through a Google Drive form. A descriptive analysis of variables, bivariate and multivariate analysis were carried out for variable Training in Research. Results: The average score on importance of research was 2.8/5 points. The most influence variables in Galician Nursing Research are to work in health area of Ferrol or Lugo-Cervo-Monforte, to study in Ourense Faculty, to carry out previous research, to have the university degree or to be motivating to investigate. Conclusions: Nurses in Galicia consider research as an important activity and they are motivated to develop it, but they need more training and institutional support.(AU)

The application of "organ system-based learning" digestive system teaching model in the clinical internship teaching of undergraduate nursing students / 中华医学教育探索杂志

Objective:To explore the effect of the "organ system-based learning (OBL)" digestive system teaching model in the clinical internship teaching of undergraduate nursing students.Methods:A total of 84 nursing undergraduates who practiced in the digestive system department of a third-grade Class-A general hospital from July 2020 to May 2022 were selected as the research objects. According to the historical control study, they were divided into control group ( n=42) and experimental group ( n=42). The control group adopted traditional practice teaching, and the experimental group adopted OBL teaching. The admission theory scores of the two groups of nursing students in the department, graduation theory scores and technical scores, nursing students' core competency and clinical teaching satisfaction were compared. SPSS 24.0 was used for t-test and chi-square test. Results:There was no significant difference between the experimental group and the control group in admission theory scores. The graduation theory scores of the experimental group (93.27±1.47) and the control group (90.91±1.32) were statistically significant ( t=7.72, P<0.001). The graduation technical scores of the experimental group (94.51±1.81) and the control group (94.00±2.35) were not significantly different ( t=1.12, P=0.268). The core competency of nursing students in the experimental group (164.21±20.81) and the control group (152.79±15.76) was statistically significant ( t=2.84, P=0.006). Clinical teaching satisfaction of the experimental group (173.33±17.58) and the control group (152.67±19.74) was statistically significant ( t=5.07, P<0.001). Conclusion:The application of the OBL practice teaching model in the digestive system department is conducive to improving the theoretical knowledge of nursing students, and improving the core competence and clinical teaching satisfaction.

Impact of the nurse-related information through social media use on undergraduate nursing students' professional identity in nursing: A mixed-methods study.

AIM: To understand the impact of nurse-related information, through social media usage on undergraduate nursing students' professional identity. BACKGROUND: Previous research has addressed professional knowledge and practice that affect the development of undergraduate nursing students' professional identities. As an increasingly crucial factor in the internet age, social media needs to be explored in-depth for its influence on the professional identity in nursing. DESIGN: Sequential explanatory mixed method was used in this study. METHODS: In this quantitative study, participants (N = 698) completed an e-questionnaire survey between June and July of 2020. The relationship between main variables was analyzed by linear regression using SPSS 20.0. Then, face-to-face semi-structured and audio-recorded interviews were carried out among participants (N = 16) between January and March of 2021. RESULTS: The quantitative findings indicated that the mean score of professional identity was 93.07 ± 11.96 in participants. The results of the linear regression showed that the year in school, whether nursing was the first choice, online time per day, frequency of reading official accounts related nursing on WeChat and appraisal of the online nurse-related information and so on explained 49.0 % of the variance in professional identity. Four major themes emerged from the qualitative study: 1) increased concern; 2) few and non-professional information; 3) encouraged by positive information; 4) limited impact of negative information. CONCLUSIONS: Nurse-related information on social media has the potential to have an impact on undergraduate nursing students' professional identity. Nursing educators should guide undergraduate nursing students to use social media appropriately and assist them in developing their professional identity with it.

Clinical teaching practices of nurse educators: An integrative literature review.

Clinical teaching practice of nurse educators is important in the development of clinical competence of undergraduate nursing students, but it is often not done according to best practice standards. This study aimed to summarise the best clinical teaching practices of nurse educators teaching undergraduate nursing programmes. An integrative literature review was conducted according to Whittemore and Knafl's adapted stages. A systematic search of electronic databases, including EBSCOhost and ScienceDirect, for applicable papers from January 2001 to June 2021, was followed by a manual search. The review resulted in selection of 67 papers, and critical appraisal had been completed by two independent reviewers using relevant critical appraisal tools. Papers that were selected revealed six main themes, with sub-themes, outlining best practices for clinical teaching, namely: (1) planning for clinical teaching practice: self-preparation and planning for clinical placement; (2) facilitation of students' clinical learning: orientation of students, planning for clinical teaching and the clinical teaching process; (3) evaluation of students' clinical skills: reflection by the nursing student and feedback; (4) modelling professional clinical teaching practice: emotional intelligence, self-evaluation, role modelling and continuous professional development; (5) work-based assessment in the clinical environment: clinical assessment process and clinical assessment tools and (6) clinical teaching in the simulation laboratory. The six identified best practices could assist nurse educators to provide comprehensive clinical teaching. Contribution: The review's results can be used in the development of a best practice guideline for clinical teaching. This guideline will aid nurse educators in achieving best clinical teaching practices.

Understanding nursing students' perceptions of the general practice environment and their priorities for employment settings.

AIM: To explore final year nursing students' perceptions of the general practice environment and their priorities when choosing a workplace. DESIGN: Online survey, reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS: The validated Profession Scale from the Scale on Community Care Perceptions (SCOPE) tool was used to identify characteristics within the general practice environment and the importance of these in choosing a workplace. To explore the factor structure, exploratory factor analysis was undertaken which was used to revise the survey language and flow before widespread dissemination. RESULTS: Three hundred and fifty-five responses were received. Factor analysis revealed three factors: Provision of care, Employment conditions and Nature of work. Respondents exposed to general practice in the Bachelor of Nursing program or who had a general practice clinical placement had significantly different perceptions across all factors. Although wages, advancement opportunities, work pressures and the physical nature of work were perceived as important in choosing a workplace, they were seen as only moderately present in general practice.

Development of the professional competence and professional self-concept of undergraduate nursing students during the clinical practice period: A cross-lagged panel analysis.

AIM: To explore the relationship of the development of professional competence and professional self-concept of undergraduate nursing students during the clinical practice period. BACKGROUND: Clinical practice is one of the most important aspects of nursing education. Nursing students combine theoretical knowledge, psychomotor skills and emotions in a professional socialization process through clinical practice sessions. DESIGN: A two-time point longitudinal design was performed. A cross-lagged model was employed to analyze the relationship between the development of professional competence and professional self-concept of undergraduate nursing students during their clinical practice period. METHODS: A total of 210 undergraduate nursing students were included in this study. The questionnaire was distributed two months and six months after their clinical practice started. Professional Self Concept of Nurses Instrument and Professional Competence Scale for Undergraduate Nursing Students were the two main instruments. RESULTS: Both the professional competence and professional self-concept of Undergraduate nursing students increase at the end of the sixth month compared with the end of the second month after their clinical practice started. The results of the cross-lagged analysis showed that the professional self-concept was partially responsible for the development of professional competence. The effect of professional competence on the development of professional self-concept, in contrast, was not found in this study. CONCLUSIONS: Clinical nursing educators should pay greater attention to the development of the professional self-concept of undergraduate nursing students. More attention should be paid to creating a supportive clinical learning environment to facilitate the improvement of undergraduate nursing students' professional self-concept and professional competence.

Factors influencing nursing students' ability to recognise and respond to simulated patient deterioration: A scoping review.

AIM: The aim of this scoping review was to identify empirical literature on simulation used to develop undergraduate nursing student's clinical assessment skills to recognise and respond to patient deterioration. BACKGROUND: Early recognition and response to clinical deterioration is necessary to ensure the best outcome for the patient. Undergraduate nursing students have limited exposure to deteriorating patient situations, therefore simulation is widely implemented in nursing courses to address this educational need. It is imperative to identify the simulation modalities and features that best optimise student learning. DESIGN: Scoping review using the Joanna Briggs Institute scoping reviews methodology and the Arksey and O'Malley framework. REVIEW METHODS: Seven health databases were searched electronically for relevant literature and complemented with hand searching for additional relevant sources. A total of 344 potential articles were identified from the seven databases: Cumulative Index to Nursing and Allied Health Literature (n = 234); PubMed (n = 16); Medline (n = 51); Scopus (n = 21); Embase (n = 3); American Psychological Association PsychInfo (n = 13); and JBI (n = 6). After applying inclusion and exclusion criteria, 15 research articles were included in the review. RESULTS: Most research on clinical deterioration simulation was quantitative (n = 12), two were qualitative and one used a mixed method approach. Findings included a lack of situational awareness, distractors causing incomplete patient assessment and failure to recognise deterioration. Repeated simulation showed positive results. CONCLUSIONS: Findings of this review suggest students lack situational awareness, perform incomplete assessment and fixate on single cues rather than an entire clinical picture. The use of a variety of simulation modalities was effective in improving student performance. Repeated practice within a single simulated learning experience, was shown to improve performance and situational awareness. This approach to simulation is under-researched in nursing and needs further exploration.

Inclusive pedagogy in online simulation-based learning in undergraduate nursing education: A scoping review protocol.

Background: Education is recognised as a constitutional right, however, access to and participation in higher education can be challenging for some students. This has led to the development of various international and local initiatives promoting inclusion, which has increased student representation from marginalised groups. In order to support growing student diversity, teaching and learning (T&L) strategies must encompass inclusive pedagogical principles. Technological advancements have improved opportunities for online T&L strategies and these are becoming an integral component of curricula in undergraduate nursing programmes. Online simulation-based learning (SBL) has gathered momentum in nursing education over the past twenty years. However, it is unclear from the evidence-base how inclusive this educational approach is, and how it can best support the growing diversity among nursing students. This paper outlines the protocol for a scoping review that aims to systematically and comprehensively map the available published and unpublished literature on inclusive pedagogy in online SBL in undergraduate nursing education.  Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for systematic review protocols (PRISMA-P) guided this protocol. Arksey and O'Malley (2005) six-stage methodology framework, the Joanna Briggs Institute (JBI) guidelines (Peters et al., 2020) and the PRISMA extension for scoping reviews (PRISMA-ScR) will guide the proposed scoping review (Tricco et al., 2018). Conclusion: It is envisaged that this scoping review will give a broad overview of the evidence for inclusive pedagogy in online SBL at this point. The findings of this review will be used to inform future policy and the pedagogical and technological design of online SBL activities and assist nurse educators to meet the current requirement of inclusive practice.

Application of interactive communication mode combined with problem-based learning in clinical teaching of undergraduate nursing students / 中国实用护理杂志

Objective:To explore the application of interactive communication mode combined with problem-based learning in clinical teaching of undergraduate nursing students so as to provide basis for nursing teaching reform.Methods:A total of 62 undergraduate nursing students in Beijing Jishuitan Hospital were selected. Among them, 32 cases from September to November 2018 received traditional teaching (the control group), and 30 cases from September to November 2019 were given interactive communication mode combined with problem-based learning (the observation group). The assessment results, comprehensive ability, clinical communication ability, scientific research ability, and feedback results of teaching quality were compared between the two groups.Results:After intervention, the total score of assessment in the observation group was (90.62 ± 4.75) points, higher than that in the control group (83.84 ± 5.01) points, there was significant difference ( t=5.46, P<0.05). After intervention, the scores of observation ability, operation ability and teamwork ability in the observation group were (3.51 ± 0.59), (3.75 ± 0.50), (4.30 ± 0.77) points, higher than those in the control group (3.18 ± 0.44), (3.22 ± 0.46), (3.53 ± 0.81) points, there were significant differences ( t=2.51,4.35, 3.83, all P<0.05). After intervention, the scores of clinical communication and keen listening, determining patients′ problems, participating together, sending effective information, establishing harmonious doctor-patient relationship, and verifying perception ability in the observation group were (83.61 ± 10.18), (81.66 ± 8.92), (84.01 ± 9.17), (83.25 ± 9.73), (80.90 ± 9.99), (84.15 ± 8.08) points, higher than those in the control group (73.91 ± 9.73), (74.95 ± 8.05), (76.02 ± 8.22), (73.16 ± 8.02), (74.61 ± 8.54), (76.08 ± 8.25) points, there were significant differences ( t values were 2.67-4.47, all P<0.05). After intervention, the scores of literature reading ability, data processing ability and paper writing ability in the observation group were (14.29 ± 1.54), (13.02 ± 1.29), (14.91 ± 1.50) points, higher than those in the control group (13.08 ± 1.43), (11.44 ± 1.24), (12.36 ± 1.28) points, there were significant differences ( t=3.21, 4.92, 7.22, all P<0.05). The feedback scores of students about improving nursing humanistic quality, professional self-identity, learning interest, communication ability, clinical thinking ability and innovation ability in the observation group were (4.26 ± 0.75), (4.43 ± 0.81), (4.25 ± 0.77), (4.18 ± 0.66), (4.44 ± 0.90), (4.38 ± 0.94) points, higher than those in the control group (3.51 ± 0.64), (3.79 ± 0.70), (3.48 ± 0.84), (3.40 ± 0.76), (3.83 ± 0.89), (3.60 ± 0.89) points, there were significant differences ( t values were 2.68-4.30, all P<0.05). Conclusions:The interactive communication mode combined with problem-based learning can effectively improve assessment results of undergraduate nursing students, and promote the improvement of their comprehensive quality, which is conducive to the improvement of clinical communication ability and scientific research ability in nursing students.

Clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students.

Evaluation and cultivation of clinical competence in undergraduate nursing students are essential in nursing education. Self-efficacy and good clinical learning environments are expected to have a positive influence on the clinical competence of undergraduate nursing students, but few studies have focused on the relationships among clinical competence, self-efficacy, and clinical learning environments. This study aimed to examine clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students. A cross-sectional questionnaire survey was conducted with 1518 undergraduate nursing students being recruited from five medical colleges in China. The nursing students' clinical competence, self-efficacy, and clinical learning environments were assessed using a set of self-reported questionnaires, including Chinese versions of the Holistic Clinical Assessment Tool; General Self-Efficacy Scale; and Clinical Learning Environment, Supervision, and Nurse Teacher Evaluation Scale. Factors significantly associated with the clinical competence of undergraduate nursing students were professional interest, self-efficacy, and clinical learning environments, accounting for 36.1% of the total variance. Self-efficacy played a mediating role between clinical learning environments and clinical competence. The results of this study can be applied as reference for the enhancement of a nursing education program to improve the clinical competence of Chinese undergraduate nursing students.

Caring Behavior Coding Scheme based on Swanson's Theory of Caring - development and testing among undergraduate nursing students.

RATIONALE: To maintain patients' dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers' non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients. AIM: The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson's Theory of Caring. METHOD: An instrument development process was used for behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient. RESULT: The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson's Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson's Theory of Caring were observed and coded in the interaction. DISCUSSION/CONCLUSION: The CBCS is a theory-based instrument that contributes to research on healthcare providers' behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers' caring behaviour with the intended outcome of patient well-being.

Analysis of the Training Effect of a Nursing Undergraduate Course on the Management of Radiation-Related Health Concerns-A Single Group Experiment.

After the 2011 Fukushima Daiichi accident, demands regarding nursing staff's management of nuclear disasters have increased. This study aimed to evaluate a basic training program to teach undergraduate nursing students on how to deal with public anxiety following a nuclear disaster. We analyzed the data of 111 third-year nursing students attending a Japanese university. We set attainment goals in three domains (cognitive, affective, psychomotor) regarding their acquisition of consultation techniques for radiation-related health concerns. We compared pre- and post-class response scores on a knowledge test and calculated word frequencies in health consultation scenarios. The pre-class mean score was 12.2 out of 27 points and the post-class mean score (directly after the course) was 21.0, a significant increase (p < 0.001). The mean level of attainment in each of the three domains increased significantly from pre-test to post-test (p < 0.001). The variety and number of words in the health consultations also increased. Students attained the program goals for radiation-related health concerns in all domains. During disasters, there is a great need for nursing staff to administer physical and mental care to the public. This program was evaluated to be one wherein nursing staff can acquire fundamental knowledge about radiation in a short time.

Peer-mentees' challenges in an undergraduate peer-group clinical mentoring programme in a nursing education institution.

BACKGROUND: Clinical competency and professional growth amongst nursing students is the cornerstone of a nursing education programme. The demanding and complex training of nursing students requires various clinical teaching and learning strategies such as peer-group clinical mentoring. AIM: The objective of this research was to explore and describe the challenges that peer-mentees experience in an undergraduate peer-group clinical mentoring programme in one-specific nursing education institution in the North West Province. SETTING: The study was conducted at a nursing education institution in North West Province. METHODS: A qualitative, retrospective case study research design was used. Two separate World Café sessions following a semi-structured schedule based on Gibbs Reflective Cycle were conducted with 51 peer-mentees who were mentored in clinical practice. Four levels of qualitative thematic data analyses were employed to analyse the data. RESULTS: Five themes emerged from the findings of the study, namely, poor implementation of the peer-group clinical mentoring programme, ineffective undergraduate peer-group clinical mentoring programme, undesirable attitudes of the mentors, mentors unprofessional conduct as well as communication challenges. Ten sub-themes emerged from the findings. Literature control was done to support the findings. CONCLUSION: The findings showed that undergraduate nursing students faced a diversity of challenges in the effective learning and teaching of peer-mentees in a clinical context. Limitations and recommendations of the study were given. Recommendations were given for nursing practice, education and research.

The relationship among BSN students' employment, educational, and health-related characteristics and semester grades: A multi-site study.

BACKGROUND: While many nursing students work during clinical semesters, little is known about employment characteristics and relationships among employment, academic success and other variables. PURPOSE: To describe the demographic, educational, and health-related characteristics of clinical nursing students and the relationships among employment, semester grades and other characteristics. METHOD: Descriptive, correlational. RESULTS: Participants were BSN students (N = 1014) from four southern US universities who were 22.6 years old (SD = 4.6) and most likely to be Caucasian (N = 832, 82%) never married (N = 852, 84%) females (N = 886, 87%) with mean GPA of 2.97 (SD = 0.61). Most students (N = 670, 66%) reported semester employment averaging 16.7 (SD = 8.3) hours/week. Although no relationship was found between hours worked and semester GPA (r = -0.017, p = .588), race/ethnicity (F [2, 1003] = 19.87, p < .0001) and nighttime sleep hours (F [3, 997] = 7.841, p < .0001) had significant effects. Students working in healthcare had higher GPAs (M = 3.09, SD = 0.61, p < .0001) than non-healthcare workers. Students working daytime (M = 3.04, SD = 0.65, p = .031) or irregular shifts (M = 3.04, SD = 0.56, p = .036) had higher GPAs than students working evenings. CONCLUSION: While employment status did not influence GPA, race/ethnicity and amount of reported sleep did. Additional research is needed to provide evidence-based advisement recommendations for employed students.

Caring for patients in the end-of-life from the perspective of undergraduate nursing students.

BACKGROUND: Caring for patients in the end-of-life is an emotionally and physically challenging task. Therefore, undergraduate nursing students (UNS) need opportunities to learn to care for the dying patient. This study aimed to describe UNS' experiences of caring for patients at end-of-life. METHODS: Interviews with 16 UNS in their last semester of nursing education were conducted. Data were analyzed with a phenomenological approach. RESULTS: The UNS created a professional relationship with the dying patient. It meant that when the patient was unable to speak for themselves, the UNS could still meet his/her wishes and needs. The UNS believed they could take responsibility for the patient who was no longer able to take responsibility for themselves. Meeting with the patient's family could be experienced with anxiousness but was dependent on the personal chemistry between the patient's family and the UNS. CONCLUSION: The UNS creates a relationship with the patient and their family. To be knowledgeable about the patient's physical and psychosocial needs means that the UNS can support the patient in the end-of-life phase. Being close to the patient and the family results in an intensity of emotions in the care situation. The UNS can receive support from their colleagues during processing their emotions and creating an experience from their encounters with patients in end-of-life care.