Nursing students’ attitudes and experiences with mental illness: A cross-sectional study

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.     

Nursing students’ perceptions and experiences of reflective practice: A qualitative meta-synthesis

Reflective practice is a vital component of nursing education. It allows for the integration of core theoretical knowledge and the clinical experience. Despite a small and growing body of literature exploring the nursing students’ perceptions and experiences of this process, a review of the qualitative literature has not been published. The purpose of this meta-synthesis is to examine the qualitative data of nursing students’ perceptions and experiences of reflective practice. This meta-synthesis provides a model that suggests quality reflection results in an improvement in practice. Students perceive that quality reflection occurs when all facets of this model have been met. This encompasses an understanding of knowledge including, learning and the barriers and enablers to knowledge, as well as self-discovery including, facing emotions and personal growth. Understanding these experiences and perceptions will permit further understanding of the motivations and factors that influence the quality of reflective practice.     

Nursing students’ experiences with patient death and palliative and end-of-life care: A systematic review and meta-synthesis

AimTo synthesise the experiences of nursing students encountering patient death and caring for patients under palliative care or at end-of-life and their families in clinical settingsBackgroundNurses are pivotal in caring for dying patients and families. It has been reported that nursing students feel unprepared in caring for dying patients and handling patient death. Understanding their experiences would better inform how palliative care education can be improved and how students can be better supported in clinical settings.DesignA qualitative systematic review and meta-synthesisMethodsPubMed, Embase, CINAHL, PsycINFO, ProQuest and Google Scholar were searched for peer-reviewed articles and theses/dissertations published between 1 January 2012–25 Feb 2023. Qualitative studies of any design reporting nursing students’ experiences of patient death, caring for patients under palliative care, at end-of-life, or with time-limiting diseases in clinical settings in English were included. Study quality was evaluated using the Critical Appraisal Skills Programme tool. Data were synthesised using Sandelowski and Barroso’s 2-step framework through a meta-summary using thematic analysis, which were then integrated into meta-syntheses using an event timeline.ResultsThe review included 71 studies from 26 countries (n = 1586 nursing students). The meta-summary contained 8 themes and 23 subthemes: (1) Communication experience with patients and families, (2) Satisfaction with care provided to patients and families, (3) Impact of the COVID-19 pandemic on death and dying, (4) Perceptions of death and dying, (5) Impact of death, (6) Nursing education on palliative end-of-life care, (7) Support systems and coping methods, (8) Learning outcomes. The meta-synthesis depicted nursing students' experiences before, during and after encountering dying patients, families and patient death. Suggestions for nursing faculty and clinical staff on how they could equip students with necessary skills and knowledge and support them in clinical settings were also provided.ConclusionsWhile caring for dying patients and families was beneficial to nursing students' learning and professional development, they encountered many challenges. Governments, clinical and academic nursing leaders must prioritise the integration of palliative care content into the curricula across nursing schools in face of increasing palliative and end-of-life care needs in patients. Nursing schools should ensure that students are adequately prepared by designing culturally and socioeconomically relevant curricula, integrating theoretical and experiential learning and offering students a thorough understanding of palliative and end-of-life care. Clinical staff and nursing instructors should support students emotionally and guide them in patient care.     

Prehospital Emergency Nursing students’ experiences of learning during prehospital clinical placements

Clinical placements play an important role in learning a new profession, but students report about poor placement experiences. Standards have been laid down for improvements within clinical training in Prehospital Emergency Nursing programmes in Sweden, but no studies have been carried out in this field in a Swedish context. The purpose of this study was thus to describe the experiences of Prehospital Emergency Nursing (PEN) students of their clinical placement and the effect on their learning process. Data were collected in 28 individual interviews and analyzed in accordance with Flanagan’s Critical Incident Technique. Three main areas emerged: the professional clinical supervisor, the clinical placement setting and the learning strategy. All these areas played a significant role in the PEN students’ learning progress and development into a new professional role. The choice of clinical supervisor (CS) and clinical placement is important if PEN students’ learning is to be an effective and positive experience. The prehospital environment is unique and can have positive and negative effects on student learning depending on the support and structure given during their clinical placement. A learning strategy based on reflective dialogue, CS continuity and a learning structure based on the prehospital environment is presented.     

Review: typically-developing students’ views and experiences of inclusive education

Abstract

Purpose: The present review aimed to summarize and critique existing qualitative studies that have examined typically-developing students’ views of inclusive education (i.e. the policy of teaching students with special educational needs in mainstream settings). Methods: Guidelines from the Centre for Reviews and Dissemination were followed, outlining the criteria by which journal articles were identified and critically appraised. Narrative Synthesis was used to summarize findings across studies. Results: Fourteen studies met the review’s inclusion criteria and were subjected to quality assessment. Analysis revealed that studies were of variable quality: three were of “good” methodological quality, seven of “medium” quality, and four of “poor” quality. With respect to findings, three overarching themes emerged: students expressed mostly negative attitudes towards peers with disabilities; were confused by the principles and practices of inclusive education; and made a number of recommendations for improving its future provision. Conclusions: A vital determinant of the success of inclusive education is the extent to which it is embraced by typically-developing students. Of concern, this review highlights that students tend not to understand inclusive education, and that this can breed hostility towards it. More qualitative research of high methodological quality is needed in this area.

• Implications for Rehabilitation

• Typically-developing students are key to the successful implementation of inclusive education.

• This review shows that most tend not to understand it, and can react by engaging in avoidance and/or targeted bullying of peers who receive additional support.

• Schools urgently need to provide teaching about inclusive education, and increase opportunities for contact between students who do and do not receive support (e.g. cooperative learning).

     

Physiotherapy students’ self-reported assessment of professional behaviours and skills while working with young people with disability

Abstract

Purpose: To quantify self-reported changes in student professional behaviours and skills after a 10-week community-based experience. Method: Twenty-eight physiotherapy students (22 women, 6 men; mean age 21.9 years, SD 2.9) were each matched with a young person with Down syndrome, who was randomly allocated to an intervention or control group. The intervention group completed a 10-week, twice a week progressive resistance training (PRT) programme. The control group completed a 10-week, once a week social programme. Before and after the experience, the students completed a self-reported assessment of their skills in prescribing and supervising PRT, professional behaviours, confidence and the likelihood they would work with people with intellectual disability in the future. Between-group differences were analysed using analysis of covariance with baseline measures as covariate. Results: There were between-group differences for 7 items rating skills implementing PRT, in favour of the intervention group, but not for any other outcome. Across both groups, students self-reported positive changes in their professional behaviours, confidence and the likelihood they would work with people with intellectual disability after the programme. Conclusions: A 10-week community-based experience produced changes in physiotherapy student professional behaviours. Students who completed the exercise programme self-reported an improvement in their professional skills relating to PRT.

• Implications for Rehabilitation

• Community-based experiences working with young people with disability offer physiotherapy students the opportunity to development their professional behaviours, skills and confidence.

• Students who completed a 10-week experience working with a young person with Down syndrome reported they were more likely to work with people with intellectual disability in the future.

• Improvements in the students’ skills in delivering progressive resistance training were only found for the students who completed an experience that included an exercise intervention.

     

Midwives’ perspectives of the challenges in mentoring students: A qualitative survey

ProblemNational professional standards dictate that all practitioners should provide mentorship to students, however students often report a lack of interest from many mentors while on placement.BackgroundIt is important that academic researchers investigate issues that can inform us of how the student/mentor relationship is facilitated and supported.AimThe aim of the project was to explore the perspectives of midwifery mentors who had experienced challenges with mentoring students, to determine what the challenges are, and what support they need, as mentors.MethodsAn online anonymous survey containing qualitative questions was used to identify the challenges faced by mentors, and asked them to provide recommendations for improving their delivery of mentorship. Three themes emerged; challenges of providing mentorship – student related; challenges of providing mentorship – work related; and what needed to be done to improve mentoring.DiscussionMentors shared their experiences of mentoring students and the issues they had faced.ConclusionsRecommendations are made that acknowledges the important role of midwifery mentorship and suggest the introduction of preparation for mentorship training for midwives working with students.     

A ‘rite of passage?’: Bullying experiences of nursing students in Australia

Background

Bullying in nursing remains an unacceptable international phenomenon and one that is widely reported in the literature. Recently, reports of bullying and harassment of nursing students have been increasing.

Austrian medical students’ attitudes towards male and female homosexuality: A comparative survey

BACKGROUND: The attitudes of health-care professionals and medical students towards male and female homosexuality are of practical relevance and have increasingly become a topic of scientific research. Comparative investigations between medical students and other student groups have not yet been conducted. OBJECTIVES: To assess the attitudes of Austrian medical students towards homosexuality and to compare these with the attitudes of students of politics and veterinary medicine. METHODS: Students of medicine (122), politics (145), and veterinary medicine (153) completed a questionnaire consisting of validated instruments assessing anti-homosexual attitudes, items assessing knowledge on homosexual issues, and basic demographic information. RESULTS: Participants' attitudes were predominantly positive. For all instruments, two-way analyses of covariance revealed significant influences of participants' sex and study major: students of medicine and veterinary medicine held more negative attitudes than students of politics, and males were more prejudiced than females. Overall, attitudes towards male and female homosexuality were balanced, but male students of politics and veterinary medicine were more prejudiced towards male than female homosexuality. A significant influence of participants' sex (favoring females) was observed in knowledge of homosexual issues. CONCLUSIONS: Although neutrality and empathy are considered vital in the doctor-patient relationship, medical students revealed more negative attitudes than students of politics did, the latter's attitudes being similar to those of students of veterinary medicine. These findings suggest that educational and correcting interventions are required in medical training.     

“Nursing students’ experiences with concept cartoons as an active learning strategy for developing conceptual understanding in anatomy and physiology: A mixed-method study”

AimThe aim of this study was to explore bachelor-level nursing students’ experiences with concept cartoons as an active learning strategy and formative assessment to develop conceptual understanding in anatomy and physiology (A&P).BackgroundMany first-year nursing students struggle to understand central concepts in A&P. Concept cartoons–cartoon characters proposing scientifically acceptable statements and misconceptions combined with an illustration–might facilitate active learning in lectures, overcome misconceptions and promote deep learning. Voting on the most precise statement using a student response system gives formative information about the students’ conceptual understanding.DesignParallel mixed methods design with an emphasis on a qualitative approach.MethodsNine concept cartoons were developed based on former students’ written answers to exam items and applied in lectures at three universities/university colleges. Qualitative data of students’ experiences were collected in three focus group interviews during November 2019, one focus group at each of the three universities/university colleges (n = 5, 8 and 8). A short questionnaire was also applied (n = 343) to all students at the three universities/university colleges. Qualitative data were analysed using qualitative content analyses, whereas frequency analysis and Chi-square statistics were applied for the quantitative data. The study was approved by the Norwegian Centre for Research Data, ref. 779586.ResultsQualitative data analysis indicated that the use of concept cartoons addresses different learning styles and could promote deep learning and enhance the environment for learning. The concept cartoons were also seen as valuable for examination preparation. Regarding potential improvements, more information about concept cartoons, how they were developed and how they were supposed to be used would be beneficial, and the cartoons could be used in a more time-efficient manner during lectures. Quantitative data indicated that most of the students thought that concept cartoons were useful and inspiring in learning A&P, and they would recommend further use to increase their understanding of central concepts. There were no significant differences across sex, age, or entrance qualifications when it comes to the benefits of using concept cartoons in learning A&P. Compared to students born in Scandinavia, a larger proportion of students born outside Scandinavia found the use of concept cartoons inspiring for their learning in A&P.ConclusionsThe use of concept cartoons was appreciated by the students to develop a conceptual understanding in A&P. Most students recommended future use.Registration number: At point of submission put this on title pageTweetable abstract: Concept cartoons are appreciated as an active learning strategy and formative assessment in developing nursing students’ conceptual understanding of anatomy and physiology.     

Nurse educators’ experiences of fostering undergraduate students’ ability to manage stress and demanding situations: A phenomenological inquiry

AimTo understand the lived experience of nurse educators when mitigating nursing students’ stress and fostering their ability to manage demanding situations.BackgroundSupporting and advocating for nursing students during their stressful and challenging times is one of the core competencies of nurse educators. Much of the research has focused on understanding nursing students' views and experiences of managing their stress. No research could be found to have explored the role and contribution of nurse educators in managing student well-being and supporting them during demanding situations.DesignA hermeneutic phenomenology was conducted in Pakistan. The COREQ guidelines were followed for reporting.MethodsSemi-structured interviews were conducted from February to May 2021 with a purposive sample of 13 nurse educators with atleast a bachelor's degree in nursing or a three-year diploma with one-year specialization and at least three months of teaching experience in educational or clinical settings. Data were analyzed using Ricoeur’s interpretation theory. The three steps included: (a) explanation, (b) naïve understanding and (c) in-depth understanding.ResultsSix themes captured educators’ experience: Sharing personal experiences, developing a trustworthy relationship, creating a stress-sharing culture, demonstrating stress management, encouraging to speak up and confront and prompting management to address student issues. Policymakers and management should collaborate with educators to strengthen existing mechanisms and revisit the policies directed toward supporting students in managing their clinical and academic stress.ConclusionsNurse educators should continue to play their part by creating a stress-sharing culture, sharing personal experiences and enhancing student stress management abilities by teaching through demonstration and building their courage to speak up for their issues. Nursing institutions should develop policies to expand nurse educators’ role in supporting student stress management. Institutions also need to collaborate with educators to establish mechanisms and resources to mitigate student stress.     

Nursing students’ perceived stress and clinical learning experience

BackgroundStressors among nursing students arise from both academic activities and clinical placement. Understanding how nursing students perceive academic and clinical stressors and the clinical learning environment could help develop useful approaches to reducing levels of stress and contribute to the maintenance of a good learning environment. There is a paucity of studies that investigated associations between the clinical learning environment and the stress of nursing students.ObjectivesTo investigate the relationship between the perception of the clinical learning environment and stress in nursing students; to compare the perception of the clinical learning environment and stress in terms of the year and terms of the organization of supervision.DesignCross-sectional correlation studySettingsUniversityParticipantsThe sample consisted of 155 nursing students in the bachelor's degree program. During the four academic years, students of individual years of the bachelor's study program were included in the study after completing all clinical placements in a given academic year.MethodsThe following instruments were used for the data collection: Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Perceived Stress Scale; Physio-Psycho-Social Response Scale and Coping Behaviour Inventory. Correlation analysis and multiple linear regression analysis using stepwise methods were used to determine the relationships between the variables.ResultsThe clinical learning environment is a strong predictor of students' perceptions of stress related to teachers and nursing staff. Types and degrees of stressful events during clinical practice varied between years of study. The experience with supervision was related to the overall perception of the clinical learning environment, but not to the students' physio-psychosocial status, types of stressful events during clinical practice and coping behaviors. Also, the differences in the students' physio-psychosocial status were not significant in terms of individual years of study and method of supervision.ConclusionsThere is a significant relationship between the clinical learning environment and the perception of academic stress. The attitude of the teacher and the medical staff can thus be important in influencing the level of stress in nursing students.     

A qualitative descriptive enquiry of nursing students’ perceptions of international clinical placement experiences

International mobility for nursing students is still a relatively new phenomenon. While educators and students are both excited by the opportunity that mobility presents, there are often many challenges inherent within third level organisations and practice organisations. These obstacles not only serve to make international mobility arrangements complex to manage but also mean that these opportunities are only available to very small numbers of students. Furthermore the benefits of undergraduate international exchanges remain largely anecdotal and the elements that facilitate success are not entirely clear. To address these issues, a qualitative study was conducted to identify the elements that characterize a nursing student's successful learning during international clinical placement. Semi-structured interviews were carried out with six students who had completed their international clinical placements experiences in Portugal, Spain, and Italy. Three common themes emerged from the data analysis: relationship with institutions and countries, student's thoughts and feelings and learning outcomes and the role of the nursing student's clinical supervisor. These themes contain seven sub-categories, representing the characterizing elements of the student's experience of mobility in the foreign country. These results are useful to nurse educators internationally to inform clinical learning experiences within exchange programmes.