Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

Assessing the Levels of Clinical Reasoning Skills Using Self-Assessment of Clinical Reflection and Reasoning in Undergraduate Nursing Students: A Descriptive Comparative Study

Background: Clinical reasoning is a critical cognitive skill that enables undergraduate nursing students to make clinically sound decisions. A lapse in clinical reasoning can result in unintended harm to patients. The aim of the study was to assess and compare the levels of clinical reasoning skills between third year and fourth year undergraduate nursing students. Methods: The study utilized a descriptive comparative research design, based on the positivism paradigm. 410 undergraduate nursing students were systematically sampled and recruited into the study. The researchers used the Self-Assessment of Clinical Reflection and Reasoning questionnaire to collect data on clinical reasoning skills from third- and fourth-year nursing students while adhering to ethical principles of human dignity. Descriptive statistics were done to analyse the level of clinical reasoning and an independent sample t-test was performed to compare the clinical reasoning skills of the student. A p value of 0.05 was accepted. Results: The results of the study revealed that the mean clinical reasoning scores of the undergraduate nursing students were knowledge/theory application (M = 3.84;SD = 1.04);decision-making based on experience and evidence (M = 4.09;SD = 1.01);dealing with uncertainty (M = 3.93;SD = 0.87);reflection and reasoning (M = 3.77;SD = 3.88). The mean difference in clinical reasoning skills between third- and fourth-year undergraduate nursing students was not significantly different from an independent sample t-test scores (t = −1.08;p = 0.28);(t = −0.29;p = 0.73);(t = 1.19;p = 0.24);(t = −0.57;p = 0.57). Since the p-value is >0.05, the null hypothesis (H0) “there is no significantno significant difference in clinical reasoning between third year and fourth year undergraduate nursing students”, was accepted. Conclusion: This study has shown that the level of clinical reasoning skills of the undergraduate nursing students was moderate to low. This meant that the teaching methods have not been effective to improve the students clinical reasoning skills. Therefore, the training institutions should revise their curriculum by incorporating new teaching methods like simulation to enhance students’ clinical reasoning skills. In conclusion, evaluating clinical reasoning skills is crucial for addressing healthcare issues, validating teaching methods, and fostering continuous improvement in nursing education.

Association of spiritual well-being with quality of life among undergraduate nursing students

Objective:The study was conducted with the aim of determining the spiritual well-being(SWB)of nursing students and its association with quality of life(QOL).Materials and Methods:A cross-sectional analytical study was conducted with a sample size of 504 nursing students collected from January 2023 to March 2023 in the nursing institutes of Khyber Pakhtunkhwa,Pakistan,using convenient sampling techniques.A Spiritual Health and Life-Orientation Measure(SHALOM)questionnaire for SWB and K-27 QOL(K-27 QOL)instrument were used for data collection that contains three parts.Results:The number of female participants was in the majority(50.4%)compared to male nurses(49.6%).The overall mean score of SWB of the students was 3.79±0.48,while the mean K-27 QOL score was 3.73±0.57.There were significant differences between the groups of gender(P=0.001),while no significant difference within the groups of semester(P=0.061)and college status(0.285).In QOL,there were significant differences within the groups of semester(P=0.000)and college status(P=0.036)while no significant difference in gender category(P=0.480).SHALOM score is positively and moderately correlated with QOL score(r=0.597,P<0.05).Conclusion:Spiritual practices are one of the important factors that are associated positively with QOL,therefore to enhance the QOL,it will require spiritual practices.

Results of the virtual simulation teaching method on autonomous learning competencies of undergraduate nursing students

Background:With the continuous development of information technology,most universities use mobile teaching platforms for classroom teaching.With the help of the national virtual simulation experimental teaching project sharing platform,students can enhance self-directed learning through the virtual simulation operations of the project.Purpose:To explore the application of virtual simulation experiment in teaching the fundamentals of nursing practice based on the Platform of the National Virtual Simulation Experiment Teaching Project during the COVID-19 pandemic analyze the impact of this teaching method on the autonomous learning ability of undergraduate nursing students.Methods:Convenience sampling was used to select 121 nursing undergraduates from Y University’s School of Nursing;the online teaching of fundamentals of nursing practice was conducted to the students.After taking the course,questionnaires were distributed to the undergraduate nursing students to collect their perceptions regarding the use of the virtual simulation experiment platform and autonomous learning competencies.Results:Most students expressed their preference for the virtual simulation teaching platform,and their satisfaction with the project evaluation was high 83.05%.They hoped to promote the application in future experimental teaching.Undergraduate nursing students believed that the virtual simulation teaching platform was conducive to cultivating clinical thinking ability,could stimulate learning interest,enhanced autonomous learning competencies.Conclusion:During the pandemic,the virtual simulation teaching platform for a lecture on in nursing education has achieved good results in both the aspects of teaching and student learning.Teachers efficiently used their training time and reduced their teaching burden.Moreover,the laboratory cost was also reduced.For undergraduate nursing students,the system was conducive to cultivating clinical thinking ability,stimulating their interest in learning,enhancing their learning and comprehension abilities and learning initiative.

Attitudes of undergraduate nursing students toward Objective Structure Practical Examination: An Exploratory study

Background: Objective Structured Practical Examination (OSPE) is a method of assessment of clinical competence.The examination is conducted at multiple stations.Besides practical and problem-solving skills,theoretical knowledge is also tested.OSPE can be traced back more than 40 years.OSPE has been included more than two decades,as a part of assessment in the College of Nursing,All India Institute of Medical Sciences (AIIMS),New Delhi.Objectives: This study was carried out to determine nursing students' attitudes towards OSPE as an assessment tool.Participants: The responses of all the 252 Undergraduate nursing students studying at the College of Nursing,AIIMS were obtained for this study (77 from B.Sc.(H) Nursing first year,61 from the second year,69 from the third year and 45 from the fourth year).Methods: The students attitudes towards OSPE were assessed by using a validated questionnaire containing 28 item statements on Likert's 5-point scale (LS) and 11 bipolar adjectives on Osgood's 7-point Semantic'Differential Scale (OSDS).Result: Most of the students approved of OSPE and felt that it was fair,useful,good,effective,exciting,interesting,practical,skill oriented but also taxing.The study also revealed that amongst the second years' students there was a strong correlation between Overall Rank in the Class and Assessment of OSPE.Conclusion: The study supports the introduction of OSPE as one of the methods of assessment of B.Sc.(Hons.) Nursing students.

Mediating effect of undergraduate nursing students’ professional commitment on positive psychological capital and learning burnout

Objective:The objective of this study is to explore the mediating role of professional commitment of undergraduate nursing students between positive psychological capital(PsyCap)and learning burnout.Materials and Methods:A cluster sampling method was used to survey 442 students of a bachelor’s degree in freshman to the junior in a medical college in Shaanxi Province.Results:Professional commitment was positively related to positive PsyCap(=0.487,P<0.01),while positive PsyCap and professional commitment were negatively related to learning burnout(r=−0.456,r=−0.411,P all<0.01).There are certain mediating effects of professional commitment in the relationship between positive PsyCap and learning burnout.The mediating effect value of professional commitment is−0.065,accounting for 16.08%of the total effect.Conclusion:Nursing educators in medical colleges and universities should focus on developing and training the positive PsyCap of undergraduate nursing students,thereby enhancing and stabilizing their professional commitment level and reducing the risk of learning burnout.

Do the Application of Problem-Based Learning on Undergraduate Nursing Students’ Is Effective? A Case Study Review

Objectives: The study’s aims to determine and assess the application of problem-based learning to undergraduate nursing students. Background: Nursing students are the upcoming health care delivery system;according to their standard of learning, it will affect their clinical training. Method: The study design is a case study review, the data was collected using many articles related to problem-based learning collected from E-books and E-journals websites like CINAHEL, Google Scholar, etc. After that, the data was analyzed and evaluated related to the application of problem-based learning on undergraduate nursing students. Result: The result appeared that most of the research proved and supported that the application of problem-based learning is effective for undergraduate nursing students, and students can solve patients’ problems in a better way. Conclusion: In conclusion, problem-based learning is an essential part of the nursing diagnosis process that will increase knowledge, and performance, and merge it with the nursing concepts.

The effects of Professional Commitment and Patient Safety knowledge-attitude-practice on Undergraduate nursing students’ Humanistic Care Ability in clinical practice

Objective:To describe the status quo of humanistic care ability,the knowledge-attitude-practice of Patient Safety and professional commitment among Undergraduate Nursing Students in clinical practice,and to determine the effects of professional commitment and patient safety knowledge-attitude-practice on humanistic care ability.Methods:Two hundred and thirty-two undergraduate nursing students in clinical practice were investigated with the general questionnaire,Caring Ability Inventory(CAI),Patients Safety knowledge-attitude-practice(KAP)Questionnaire and the Nursing Professional Commitment Scale.Results:The score of humanistic care ability of nursing undergraduates was 185.19±20.95,patients safety KAP score was 106.94±11.62,professional commitment score was 74.93±10.44.Undergraduate nursing students’humanistic care ability were positively correlated with professional commitment and patients safety KAP(P<0.05).Multiple Linear regression analysis showed that professional commitment,patient safety KAP entered the humane care equation(F=24.051,P<0.001),and explained 39.1%of the total variation in humane care.Intermediate effect analysis shows that patient safety played a partial mediating role in professional commitment and humane care.Conclusion:The professional commitment and patient safety KAP of undergraduate nursing students were positively related to their humanistic care ability.Improving the professional commitment and knowledge and patients safety KAP of nursing students can strengthen their humanistic care ability to provide high-quality nursing for patients.

Analysis on the status and influencing factors of undergraduate nursing students’ online learning engagement in the context of the pandemic

Objective:This project has mainly studied the online learning engagement of undergraduate nursing students and analyzes influencing factors of online learning and teaching mode during the Novel Coronavirus(COVID-19).This research has significant references for improving the efficiency and quality of the online learning mode of students.Methods:In this study,212 undergraduate nursing students were selected from a comprehensive university in Jilin Province by combining convenience sampling and cluster sampling methods.And these students were conducted with a general information questionnaire,Online Academic Emotion Scale,and Online Learning Engagement Scale.The influencing factors of this teaching mode were analyzed by multiple linear stepwise regression.Results:The total score of online learning engagement of undergraduate students was 53.85±7.38,which positively correlated with positive high arousal emotion and negative high arousal emotion,but weakly negatively correlated with negative low arousal emotion(r=0.661,0.246,-0.187,P<0.001).Grade,type of online class,online learning time,and positively high arousal emotion were mainly affected the online learning engagement of undergraduate nursing students,which explained 78.5%of the total variation(P<0.001).Conclusion:The online learning engagement of undergraduate nursing students was above the middle level under the background of the COVID-19 pandemic.Lectures and professors who teach undergraduate nursing students,should integrate the individuation characters of nursing students,and motivate their positively high arousal emotion to improve online learning engagement of students to ensure the quality of online teaching mode.

Are parental rearing patterns and learning burnout correlated with empathy amongst undergraduate nursing students?

Objective:Empathy can help establish harmonious nurse-patient relationships.We aimed to assess the status of empathy,and explore the relationship between learning burnout,parental rearing patterns and empathy amongst nursing students.Method:A questionnaire survey that employed the Learning Burnout Scale,the Short-Form Egna Minnenav Barndoms Uppfostran(s-EMBU)and the Jefferson Scale of Empathy was conducted amongst 562 nursing students.The data were analysed on the basis of descriptive statistic and correlation analysis was used.Results:Empathy is negatively correlated with learning burnout,parental rejection and overprotection and showed no positive correlation with parental emotional warmth.Conclusions:Educators should pay attention to nursing students'feelings and learning burnout status and take positive measures to improve the empathy level of the students.Positive parental rearing patterns also help cultivate empathy.

Correlation between self-differentiation and professional adaptability among undergraduate nursing students in China

Purpose:This study aimed to investigate the current status of self-differentiation and professional adaptability among undergraduate nursing students,to analyze the relationship between these two variables,and to provide recommendations for nursing educators.Methods:A total of 341 nursing undergraduate students at the University of South China were investigated using the Differentiation of Self Inventory and the Professional Adaptability Scale for college students.Results:The mean scores of self-differentiation and professional adaptability were 3.70±0.60 and 2.87±0.37,respectively,and the two variables were positively correlated(P<0.01).Conclusion:The level of self-differentiation of undergraduate nursing studentsaffects their professional adaptability.Nursing educators should consider the characteristics of self-differentiation of undergraduate nursing students in developing measures to improve their professional adaptability.

Electroconvulsive Therapy in the Eyes of Undergraduate Nursing Students

Despite the fact that electroconvulsive therapy (ECT) is an established safe and effective procedure, its use has continued to attract controversy with considerable stigma associated with it. This often overshadows the established effectiveness. Poor knowledge, negative attitude and bias towards ECT by the nurses may translate to poor education and support to patients from whom they are expected to obtain informed consent before an ECT procedure. This study assessed the perception of undergraduate nursing students of a Nigerian university about ECT. A total of 81 students who had completed all relevant lectures and practical/clinical exposures in psychiatry as prescribed in their academic curricular participated in the study. All the consenting students were administered the socio-demographic questionnaire and modified questionnaire on attitude and knowledge of electroconvulsive therapy (QuAKE). Majority of the students responded appropriately to the principal uses of ECT. Few believed that ECT was an out-moded form of treatment, that the procedure was cruel and barbaric, that psychiatrists who still administered ECT were wicked and not responsible physicians, and that it caused permanent brain damage. The total mean score of the students was 7.53 ± 2.65. Fifty eight (71.6%) students observed an ECT procedure and followed up the patients during the posting. They scored 7.17 ± 2.55 while 23 (28.4%) students who had not observed the procedure scored 6.98 ± 1.92 on the QuAKE (t =?-0.36, p = 0.72). Thirty one (38.3%) students who would accept the procedure if indicated scored 7.14 ± 2.21 while 50 (61.7%) of them who would not allow ECT carried out on them scored 6.88 ± 1.96 (t = 0.56, p = 0.58). The mean score of 29 (35.8%) students who might pursue psychiatry as a career was 8.10 ± 1.90 while 52 (64.2%) of them who would not specialise in psychiatry scored 6.05 ± 1.79 (t = 5.00, p < 0.001). The total mean score on the QuAKE was low among the student nurses. Therefore, there is a need to improve undergraduate nursing education on ECT.

Impact of self-directed learning readiness and learning attitude on problem-solving ability among Chinese undergraduate nursing students

Objective: To explore the effects of self-directed learning readiness and learning attitude on problem-solving ability among Chinese undergraduate nursing students. Methods: A convenience sampling of 460 undergraduate nursing students was surveyed in Tianjin, China. Students who participated in the study completed a questionnaire that included social demographic questionnaire, Self-directed Learning Readiness Scale, Attitude to Learning Scale, and Social Problem-Solving Inventory. Pearson’s correlation analysis was performed to test the correlations among problem-solving ability, self-directed learning readiness, and learning attitude. Hierarchical linear regression analyses were performed to explore the mediating role of learning attitude. Results: The results showed that learning attitude (r=0.338, P<0.01) and self-directed learning readiness (r=0.493, P<0.01) were positively correlated with problem-solving ability. Learning attitude played a partial intermediary role between self-directed learning readiness and problem-solving ability (F=74.227, P<0.01). Conclusions: It is concluded that nursing educators should pay attention on students’ individual differences and take proper actions to inspire students’ self-directed learning readiness and learning attitude.

Effects of attribution retraining on the perceived career barriers of undergraduate nursing students

Background/purpose:To evaluate the effects of attribution retraining on the perceived career barriers of undergraduate nursing students and to foster positive attributional styles.Methods:Ninety-four undergraduate nursing students were recruited and randomly divided into two groups:the attribution retraining group and the control group.All students were assessed by the perceived career barriers inventory before and after the eight-week study.Results:Attribution retraining significantly influenced the students'perceived career barriers.The mean scores of vocational knowledge,professional knowledge,and social ability of the experimental group were significantly reduced compared to the control group(p<0.05).Conclusion:Attribution retraining provides opportunities for improving the undergraduate nursing students'vocational knowledge,professional knowledge,and social ability.Attribution retraining should be encouraged in undergraduate nursing programs in order to reduce the nursing shortage in China's Mainland.

Analysis of licensure examination anxiety and its influencing factors among undergraduate nursing students

Background:Examination anxiety is a concern for educational policymakers because of the impact it can have on the overall outcome of the performance of the candidates who partake in such examinations.Aim:The aim of this study is to determine the examination anxiety level of students of Nursing and Midwifery College,Agogo,and Presbyterian University College and to evaluate the factors affecting them.Materials and Methods:A total of 160 undergraduate nursing students comprising 80 degree and 80 diploma students were conveniently sampled for the study.The study was conducted in September 2019 using a descriptive cross-sectional design.The Westside Test Anxiety Scale was used to measure examination anxiety among the participants.A researcher-designed questionnaire in which participants responded to a three-point Likert scale was used to assess factors influencing examination anxiety.Results:The findings of the study showed that test anxiety was higher among the diploma candidates(M=3.60)than the degree candidates(M=2.95)and the difference was statistically significant(P=0.024).Demographic characteristics such as age(P=0.009),sex(P=0.003),study hours per day(P=0.001)were found to be significantly associated with test anxiety.The factors found to influence examination anxiety among students were volume of materials to study(P=0.044),level of preparation(P=0.005)perceived difficulty of the questions(P=0.033)and myth about examinations(P=0.000).The perceived importance of the examination(P=0.057)and schedule of the exams(P=0.68)did not influence examination anxiety.Conclusion:Candidates for the licensure examination organized by the Nursing and Midwifery Council of Ghana should be assessed for test anxiety and offered the necessary psychological support where necessary.

Association between social media addiction and sleep quality among undergraduate nursing students:a cross-sectional study

Objectives:To examine the association between social media addiction and sleep quality among undergraduate nursing students.Methods:This research is an analytical observational study with a cross-sectional approach.The sampling technique was purposive sampling of 150 nursing students at a private university in Malang,Indonesia.Respondents filled out a questionnaire about self-identity,a sleep quality questionnaire from the Pittsburgh Sleep Quality Index(PSQI),and social media addiction from Social Media Addiction Scale(SMAS).This was a bivariate analysis which was conducted using the Pearson Product Moment Correlation test.Results:The results of this study reported that most nursing students were addicted to social media(76%).As for the parameter of the quality variable,most respondents had poor sleep quality,which were about 106 people(70.3%).The result of the Pearson Product Moment Correlation test obtained a P value of 0.000.The Pearson correlation coefficient was 0.358.Social media addiction(adjusted odds ratio[OR]4.80,95%confidence interval[CI]=2.08-11.02),gender(adjusted OR 3.79,95%CI=1.58-9.12),and using social media for a long time(adjusted OR 4.21,95%CI=1.97-10.48)were associated with sleep quality.Conclusions:We found that there is an association between social media addiction and sleep quality among nursing students.Furthermore,we might be educating nursing students to manage their time to improve their quality of sleep to avoid any health problems.

Campus Connectedness and Its Relationship to Stress, Anxiety and Depression among Nepalese Undergraduate Nursing Students

Background: Campus connectedness is a kind of social connectedness that determines the students’ perception of their belonging to the other populace of the campus that includes students, teachers, administrators, and other staff. Campus connectedness plays a significant role in determining stress, anxiety, and depression among students. The purpose of the study was to examine the relationship of campus connectedness to stress, anxiety, and depression among nursing students. Methods: This cross-sectional analytical study was conducted among 680 undergraduate nursing students from nine nursing colleges affiliated with a university in Kathmandu Valley. Data were collected from June 1, 2018, through July 10, 2018. Depression, Anxiety, Stress Scale and Campus Connectedness Scale were used to collect data. The data were analyzed using Statistical Package for Social Sciences version 23. A one-way multivariate analysis of variance (MANOVA) test was used to examine the relationship of campus connectedness to stress, anxiety, and depression. Discriminant analysis was done as a follow-up procedure to MANOVA. Results: Students had moderate to extremely severe levels of depression (51.7%), anxiety (72.9%) and stress (47%). High campus connectedness score was observed (M = 62.42;SD = 9.79). Statistically significant differences were found among the levels of campus connectedness on the outcome variables, Wilks’ lambda (λ) = 0.90, F(3, 676) = 24.56, p < 0.001. Depression demonstrated the strongest relationship with the discriminant function. Conclusions: There was a significant relationship of campus connectedness to stress, anxiety, and depression. Despite the high level of campus connectedness, students had moderate to severe levels of stress, anxiety, and depression. The campus adminstration must take measures and efforts to provide conducive environment and counseling services for the wellbeing of their students.

Undergraduate nursing students’experiences of online learning:gaining access in resource-limited circumstances

Background:In response to the need to mitigate the increase in Coronavirus Disease 2019(COVID-19)cases,nursing students undertake online learning in almost all nursing education institutions in Indonesia.These students face distinctive learning experiences,which have not yet been identified in the Indonesian context.This study aimed to explore students’experiences of online learning during the COVID-19 pandemic.Methods:We used a descriptive exploratory design.Eleven students from three nursing education institutions in Indonesia were interviewed through telephone calls or video conference applications.Results:One main theme,Gaining access in resource-limited circumstances,was developed to describe students’experience of online learning during the COVID-19 pandemic.This theme was supported by five subthemes:struggling for internet connection;becoming familiar with the applications;flexibility;supported by others;and dealing with limitations.Conclusions:This current study provides insights into what support should be provided for nursing students to manage limitations in the online learning process.

Real experience among undergraduate nursing students in learning the course of geriatric nursing : a qualitative study

Objective:To understand the real experience of nursing students majoring in geriatric nursing in learning the course of geriatric nursing,so as to provide reference for the design of this course.Methods:The semi-structured int erview was used to interview 27 sophomore nursing students in the department of geriatric nursing in a a Chinese medicine college to understand their experience of learning the course of"Geriatric Nursing",and to apply a seven-step phenomenological analy sis method for data analysis.Results:Refined 8 themes:Lack of cognition of physiological aging;focus on social issues and daily life care;adopting a blended teaching style to stimulate nursing students'interest in learning;understanding the life of the elderly from a professional point of view after class;reverence for life and realisation of life values;little attention is paid to the career of the elderly in China;Geriatric Nursing program expands the scope of employment;and fostering nursing s tudents'willingness to engage with the elderly.Conclusion:The nursing students can understand and experience to the elderly and their lives through learning the course of Geriatric Nursing,but lack the motivation to learn actively.Teachers should guid e nursing students to pre-study before class,enrich the course content,expand their knowledge outside of class,and adopt blended teaching to cultivate their perception of the elderly.

Analysis of ideological education status of male undergraduate nursing students

This article through the analysis of male nursing students after graduation employment status quo and the cause of low professional identity,to explore the status quo and countermeasures of male nursing student’s professional ideological education,to provide basis for male nursing students personalized training,to meet the needs of society and patient nursing diversification.