A cognitive task analysis of final year nursing students' situation awareness in simulated deteriorating patient events: A mixed methods study.

AIM: The aim of this study was to: (1) use cognitive task analysis to describe final year nursing students situation awareness in recognising, responding and escalating care of deteriorating patients in ward settings; and (2) make recommendations for training and practice. DESIGN: A mixed methods cognitive task analysis with a convergent triangulation design. METHOD: Data collection involved observations of 33 final year nursing students in simulated deteriorating patient scenarios and retrospective cognitive interviews. A process tracing technique was applied to identify the cues to deterioration participants perceived; how cue perception altered as situational demands increased; the extent that participants made connections between perceived cues and reached a situational understanding; and the factors that influenced and constrained participants situation awareness. Qualitative and quantitative findings are woven together and presented using descriptive statistics, illustrative quotations and timeline extractions. RESULTS: The median cue perception was 65.4% and 57.6% in the medical and surgical scenarios, respectively. Perception was negatively influenced by incomplete vital sign monitoring as situations escalated; limited physical assessments; passive scanning behaviours; poor task automaticity; and excessive cognitive demands. Incomplete perception, poor cue integration and underdeveloped mental models influenced situational understanding. Escalation calls did not always accurately reflect situations and a reporting mindset was evident. Clinical exposure to deteriorating patients was described as variable and opportunistic. REPORTING METHOD: The study is reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) checklist. PATIENT OR PUBLIC CONTRIBUTION: Patients and public were not involved in this research.

"This is how I'm going to do it, but this is not how you're going to do it": the expectation gap between student paramedics and mentors in East and Central Scotland.

BACKGROUND: The role of paramedics has expanded significantly over the past two decades, requiring advanced skills and education to meet the demands of diverse healthcare settings. In 2021, the academic requirements for paramedics were raised to a bachelor's degree to align with other registered professions. The limited evidence on effective paramedic practice education necessitates a novel or new examination of unique learning methods, emphasising the need to establish effective learning relationships between mentors and learners to enhance professional respect and support achieving learning outcomes. This study aimed to investigate expectations between student paramedics and their mentors, focusing on the learning dynamics within paramedic education. METHODS: This qualitative study used purposive sampling to recruit participants from two distinct cohorts: student paramedics from the University of Stirling and Practice Educator Mentors from the Scottish Ambulance Service. Focus groups were conducted to illuminate comprehensive insights into participants' expectations regarding practice education and their respective roles in the learning process. Codebook thematic analysis was used to assess the alignment of these expectations. RESULTS: Findings illustrate important challenges within practice placement across learning paradigms and highlight the attitudes surrounding the integration of higher education and expectations of practice placements. These challenges encompass systemic barriers, including the support provided to mentors as they assume increased responsibilities and barriers that deter qualified staff from initially undertaking this role. CONCLUSION: The study aimed to assess expectations between practice educators and students within the paramedic profession in Scotland. The methodology effectively identified key themes from comprehensive data, marking the first primary research in this field. There are disparities in learning styles, expectation measurement, and attitudes toward higher education during practice placements, which could significantly impact the teaching and assessment processes. The findings suggest increased support for practice educators, educational programs addressing challenges of mentorship, and stronger links between higher education institutes and the Scottish Ambulance Service. Further research is needed to understand the extent of the expectation gap, how expectations evolve, and to develop strategies to address disparities.

Final-year nursing students' perceptions of humanistic education in nursing: a cross-sectional descriptive study.

BACKGROUND: Humanistic education is an important part of nursing education. Final-year nursing students' perceptions of nursing humanistic education are under-investigated. This study aimed to examined final-year nursing students' perceptions of nursing humanistic education in both school and hospital. METHODS: This was a cross-sectional descriptive study conducted from May to June 2022 among 107 final-year nursing students with a self-designed questionnaire. RESULTS: Final-year nursing students recognized the importance of humanistic education, scoring above 4.0 on a 1-5 scale, while their initiative to enhance humanistic qualities was relatively low. Students' satisfaction with the number of humanities courses offered was only 3.7 ± 0.862. Moreover, 62.6% of students believed there was a need to enhance humanistic environmental development including corridor culture. The "monotonous teaching format" (63.6%) and "teaching methods" (64.5%) have emerged as focal points that students identified as needing attention and improvement. CONCLUSIONS: In the future, nursing humanistic education can be enhanced by increasing the proportion of humanities, improving teaching methods, stimulating students' learning motivation, and strengthening the construction of humanistic environment.

Numeracy Teaching for Undergraduate Nursing Students: A Scoping Review.

BACKGROUND: Education providers teach numeracy to undergraduate nursing students using a diverse range of approaches. Proficiency in numeracy skills is critical for patient safety; however, alarmingly, the accuracy rate of calculations by both undergraduate nurses and RNs is reported to be low. METHOD: The literature search yielded 1,180 articles published between 1994 and 2022. The assessment of the studies was reported using the PRIMSA extension for Scoping Reviews. RESULTS: Thirty-nine articles were included in the review. A diverse range of approaches were used to teach numeracy including learning theory, methods of calculation, learning environment, and examination aids. CONCLUSION: This review highlights the plethora of approaches for teaching numeracy within undergraduate nursing education. Internationally, there were limited studies on the most effective teaching approaches; therefore, developing a robust evidence-based numeracy framework would be beneficial to guide non-nursing instructors in teaching undergraduate nurses. [J Nurs Educ. 2024;63(4):218-227.].

Lebanese nursing students' perceptions of barriers to the implementation of person-centered care in clinical settings: A qualitative study.

AIM: This study aims to investigate how Lebanese nursing students perceive the challenges of implementing person-centered care in clinical settings. DESIGN: A qualitative descriptive design was adopted for this study. METHODS: At one of Lebanon's top universities, a qualitative descriptive study design was used with 18 nursing students from various academic levels. Content analysis was used to generate the results after three focus group discussions. The Consolidated Criteria for Reporting Qualitative Research were used to report this study. RESULTS: The content analysis gave rise to four main themes, namely, "overload", "challenges with education", "unawareness", "establishing connection", and "lack of initiatives related to policy". The results showed a number of obstacles that Lebanese nursing students believed were in the path of providing person-centered care. These obstacles included organisational issues like time restraints and an intense workload, as well as interaction difficulties with patients and healthcare teams, and educational issues like insufficient instruction in person-centered care concepts during nursing programs.

The effect of case-based teaching method on professional competence and clinical decision-making levels of public health nursing students: A sequential explanatory mixed-methods study.

OBJECTIVES: To evaluate the effect of case-based teaching method applied to fourth year nursing students on their professional competence and clinical decision-making levels. DESIGN: A quasi-experimental design study with a sequential-exploratory mixed-method approach. SAMPLE: 64 nursing students enrolled in the Public Health Nursing course. METHODS: A case-based teaching program was applied to the students that cover the topics of the Public Health Nursing course. Quantitative phase data were collected with the Clinical Decision Making in Nursing Scale and Nursing Students' Competence Scale. For the qualitative part, focus group interviews were conducted with a Structured Interview Form. RESULTS: It was determined that the total and subscale posttest scores of the students increased significantly compared to their pretest scores (p < .001). A moderate positive correlation was found between the total scores received from the scale and a significant positive correlation was found between researching information and adopting new information impartially and all sub-dimensions except care (p < .05). Three main themes emerged from the focus group interviews conducted after the case-based teaching method experience: usefulness, limitations, and improvement. CONCLUSIONS: Case-based teaching method is effective on students' professional competence and clinical decision-making scores. Students' professional competence levels positively affect their clinical decision-making levels.

Creating a Dual Degree: Nursing Education Goes Global.

A global health human resource crisis has intensified the need for innovative education programs to maximize the supply of nurses worldwide. In response to the current and anticipated shortage of nurses globally, a novel collaborative undergraduate nursing program was developed at the University of New Brunswick in Fredericton, NB, and Manipal Academy of Higher Education in Karnataka, India. The resulting dual degree model is shaped by the contexts of the participating countries and current activities related to the international recruitment and migration of registered nurses. This partnership will increase program capacity and the potential number of graduates and will ease the immigration of internationally educated nurses.

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.

Nursing students' experience of moral distress in clinical settings: A phenomenological study.

AIM: To explore nursing students' moral distress (MD) experiences in clinical settings. DESIGN: An interpretative phenomenological analysis (IPA) design was employed. METHODS: Purposive sampling was used. In-depth semi-structured face-to-face interviews were conducted from December 2020 to June 2021 with nursing students who were taking the internship course in clinical settings. Data analysis was conducted following Dickman et al.'s (1989) method. RESULTS: Ten nursing students participated in this study. Three main themes were identified, including (1) negative learning environments, (2) internal disgust and (3) threats to professional identity. CONCLUSION: Findings showed that value conflict, lack of knowledge of ethical standards and its application, and unprofessional approaches result in negative environmental learning perceptions from the nursing students. Therefore, due to being unable to change the situation, they start to feel guilt and shame and, as a result, decide to escape the problem instead of managing it. These feelings lead to internal disgust. This issue indicates the importance of improving the knowledge and perception of these situations. Thus, nursing students must be prepared for the real world, where their ideals are constantly challenged. MDs were experienced as threats to dignity, inequality, distrust, and change of mentality towards nursing, characterised as threats to professional identity. It is suggested to inquire about the process of nursing students' resiliency in morally disturbing situations to deduce the suitable approach for clinical education.

Does reading ability predict student success? A scoping review.

OBJECTIVES: Nursing students do not only have to understand the content they read, but they must also analyze, synthesize, and think critically as these skills are required for success in clinical practice. This review investigates if testing reading in students can predict outcomes of student success in nursing programs. DESIGN: A scoping review of the literature on reading assessments in nursing education. DATA SOURCES: Databases explored included CINAHL, ERIC, and MEDLINE and included English language papers published from January 2001 to November 2022. REVIEW METHODS: Joanna Briggs Institute scoping review methods informed this review. RESULTS: Data were extracted from 34 full text papers and dissertations. All papers examined reading as an independent predictor of outcomes such as NCLEX-RN success, program completion, or early program success. Various reading tests delivered at admission were more likely to predict proximal outcomes such as early program success rather than more distal outcomes such as NCLEX-RN failure or program completion. CONCLUSION: Reading assessments are effective predictors of a student's potential for academic success in nursing programs which has many implications for admission and progression policies. Many areas for future research are proposed including examining the developmental nature of reading improvement across nursing programs, development of reading interventions, and building faculty capacity for reading support. This body of literature said very little about the impact of race and racism on reading as they relate to academic outcomes which also must receive attention in future research.

A study of factors affecting pass rates of level 5 written assessments for undergraduate adult nursing students.

Nursing programmes were flexible during the COVID-19 pandemic, offering simulation to replace clinical hours and adjusting supervision and assessment. However, second-year students in two modules had lower results despite no changes to the material, team or delivery. OBJECTIVES: A retrospective cohort study was conducted, on second-year adult nursing students who submitted written assignments, to analyse recurring patterns that could explain the failure rate. METHOD: Data were analysed from 265 university students to identify patterns of association in demographics, module results and student engagement indicators. RESULTS: A positive correlation was found between age and assignment results, with older students achieving higher grades. Clustering identified three patterns of student engagement. Students demonstrating engagement with all aspects of the course (30.2%) performed significantly better than those in other clusters (P<0.001). Students with disabled student support recommendations performed notably worse than those without. All sizeable differences were resolved following the return to campus and the implementation of additional writing support. DISCUSSION: Age, cross-medium engagement and preparation were all shown to have an impact on marks. These findings can influence how higher education institutions drive and monitor engagement, as this study suggests that all parts of a blended learning approach are equally important.

[Excelling in the AI Era: Cultivating AI Literacy].

In light of the rapid advancements in artificial intelligence (AI), the future of the nursing profession is expected to be closely intertwined with AI applications. In response to this challenge, nursing educators must cultivate AI literacy in students to ensure their ability to communicate and collaborate effectively with their interdisciplinary peers. Nursing educators should comprehend the essence of AI literacy, integrate AI literacy into their curriculum designs, and regularly assess the effectiveness of AI literacy cultivation efforts among their students to ensure nursing graduates are able to effectively fulfill their roles in nursing and healthcare. The purpose of this paper is to explain the essence of AI literacy, approaches for cultivating AI literacy in students, and methods for assessing AI literacy with the aim of educating nursing students to become competent nurses for tomorrow.

Perspectives on self-directed learning in bioscience in nurse education - An integrative review.

OBJECTIVES: There is a lack of synthesized knowledge on nursing students self-directed learning in bioscience and how to best support students' learning in this subject. The purpose of this integrative review is to synthesize current literature on perspectives on self-directed learning among nursing students studying bioscience to guide further research aiming to support students' learning more effectively. METHODS: An integrative review in line with Whittemore & Knafl's modified framework containing five stages: problem identification, literature search, data evaluation, data analysis and presentation. A structured literature search was undertaken in the Web of Science, ERIC, Medline and CINAHL databases from November 2022 to January 2023. The inclusion criteria were nursing students enrolled in a bachelor programme, research addressing activities intended for learning bioscience, in addition to formal taught lectures and perspectives on self-directed learning in natural science subjects within nurse education such as views, actions, activities, habits and attitudes. Exclusion criteria were students in other education programs, research in formal learning contexts, and self-directed learning in other subjects than natural science subjects. Rigour of each included source was assessed using Whittemore & Knafl's suggested 2-point scale (high or low). A constant comparison method was used to synthesize results. RESULTS: Of the initial 1143 sources, 12 articles were included after abstract and full-text screening: one pilot study for randomized controlled trial, one qualitative study, two mixed methods studies and eight quantitative studies. The sample size was from 23 to 563 participants. DISCUSSION: This review identifies self-directed learning in bioscience understood as a continuum of teacher-directedness and self-directedness rather than as distinguished orientations. There seem to be no consistent definition of self-directed learning in bioscience, yet descriptions commonly imply metacognitive learning approaches. Nursing students value digital learning resources, yet technology might be secondary to the skill of self-directed learning.

The effect of seven-step educational strategy on knowledge of diabetic foot ulcer prevention, critical thinking and self-efficacy of nursing students: A randomized controlled trial.

BACKGROUND: Diabetic foot ulcer is a significant complication of diabetes that carries a high mortality risk and is associated with substantial financial costs. Choosing a suitable educational model for nursing students as future nurses is necessary to improve knowledge and manage issues related to caring for diabetic patients. OBJECTIVES: To determine the effect of education based on the 7E learning cycle model on the knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy in nursing students. DESIGN: A single-blind, randomized controlled trial with a parallel group. SETTINGS: This study was conducted in a nursing school and hospitals covered by it in Iran. PARTICIPANTS: 98 students studying in the fourth semester of the Bachelor of Nursing course. METHODS: Students were divided into two distinct groups at random: an experimental group (class A, with 51 participants), and a control group (class B, with 47 participants). The participants of the experimental group were provided with an education based on the 7E learning cycle model, while the control group received conventional teaching method. Data collection methods included pre- and post-tests using research instruments (demographic questionnaire, Kaya Diabetic Foot Prevention Knowledge Questionnaire, Ricketts' Critical Thinking Disposition Questionnaire, and General Self-Efficacy Scale). The data were analyzed using descriptive statistics, non-parametric Mann-Whitney and Wilcoxon tests, parametric independent sample t-tests, ANCOVA, and paired sample t-tests. RESULTS: The difference in mean scores of diabetic foot ulcer prevention knowledge (Z = -6.232, p < 0.001), critical thinking (t (50) = -4.382, p < 0.001), and self-efficacy (Z = -4.427, p < 0.001) in the experimental group were statistically significant between the time interval before the intervention and one month after its completion. CONCLUSIONS: Compared to conventional method of teaching, education based on the 7E learning cycle model is a more effective method to improve nursing students' knowledge of diabetic foot ulcer prevention, critical thinking, and self-efficacy.

Enhancing nursing education for Indigenous students: Indigenous nursing students' insights and strategies.

BACKGROUND: Indigenous nursing students contended with far-reaching challenges during the pandemic that significantly altered their experiences of nursing education. These experiences are poorly understood by nursing educators and strategies for Indigenous nursing student success rarely involve the insights of current Indigenous nursing students. AIM: The aim of this article is to offer Indigenous-student derived recommendations regarding strategies for improving their experiences and success within nursing education during the pandemic and beyond. DESIGN AND METHODS: This qualitative study employed an Indigenous methodology including land-based learning, ceremony, and sharing circles. PARTICIPANTS AND SETTING: Indigenous nursing students (n = 17) from a Western Canadian school of nursing participated in one of three sharing circles. RESULTS: Indigenous nursing students recommended institutional and program adaptations along with increases to cultural safety for enhancing their experience in nursing education. Institutional and program strategies included: decreasing course loads and class sizes; an Indigenous-specific cohort; a transition program after course failure; increasing academic supports such as additional clinical skills and academic writing practice. Recommendations for increasing cultural safety included: mandatory and recurrent cultural safety training for faculty, staff and students; differential learning and evaluation strategies; and increased inclusion of Indigenous ceremonies and practices. CONCLUSION: The findings of this study provide insights that can help guide curriculum development, pedagogical approaches, and policy development to improve nursing education for Indigenous students.

Experiences of nursing students providing end of life care for children and young people: A focus group study.

BACKGROUND: End of life care for Children and Young People (CYP) is known to be an emotive area of practice. Previous studies involving qualified nurses have demonstrated that nurses feel they need more end-of-life care education, as well as a platform for sharing experiences and discussing them with others. Evidence relating to nursing students remains limited despite being widely acknowledged as a difficult aspect of nursing education. AIMS: This study aims to help improve understanding of the lived experiences of children's nursing students who have cared for a patient at, during, or immediately following end-of-life. The study describes the emotions experienced by children's nursing students and explores the student nurses' perceptions of education and support needs around caring for CYP during end-of-life care. METHODOLOGY: A qualitative inquiry methodology allowed for a pragmatic approach to design this focus group study. Nine undergraduate student children's nurses participated in two focus groups. Ethical approval was granted by the host university. Thematic data analysis using Braun and Clarke's (2019) thematic analysis was conducted. FINDINGS: Six themes emerged from the data; Emotional practice (1), the heart of the care (2), a lasting impact (3), hierarchy of grief (4), experience, knowledge and understanding (5), and the value of support (6). End of life care for children and young people is recognised by students as a sad but important part of the job role, which can have a lasting impact and which students required improved education and support for. IMPLICATIONS FOR PRACTICE: Improved education on end-of-life care is required. This should be introduced early, encompassing practical approaches to the varied nature of end-of-life care, normalising a range of emotions and delayed responses. Furthermore, improved support is required for both student nurses and qualified staff, who are supporting students caring for CYP at the end of life.

Effects of an unfolding case study on clinical reasoning, self-directed learning, and team collaboration of undergraduate nursing students: A mixed methods study.

BACKGROUND: Clinical reasoning is an essential nursing competency that students must develop to provide safe patient care. Developing and utilizing unfolding case studies, which present constantly changing patient conditions to improve students' clinical reasoning and to foster communication and self-reflection, can help to achieve that imperative. OBJECTIVES: To develop an unfolding case study and to test its effectiveness in improving clinical reasoning, team collaboration, and self-directed learning. DESIGN: A mixed methods design. SETTING: One university in Southern Taiwan. PARTICIPANTS: Forty nursing students. METHODS: An unfolding case study was developed based on the clinical reasoning model and unfolding cases model. The Nurses Clinical Reasoning Scale, Self-Directed Learning Instrument, and Questionnaire of Group Responsibility and Cooperation in Learning Teams were used. Forty nursing students completed questionnaires and nine of them participated in focus group discussions. Wilcoxon signed-rank, Spearman correlation, regression, and inductive content analysis were used to analyze data. RESULTS: Students' abilities in clinical reasoning, self-directed learning, and team collaboration were statistically significantly improved after implementation of the unfolding case study. Emergent themes included "patient-centered communication," "group inspiration and learning," "thinking critically and reflecting on oneself," and "applying theoretical knowledge in care to meet patients' changing needs." CONCLUSIONS: Unfolding case studies provide a safe environment in which nursing students may learn and apply knowledge to safe patient care.

Remediation in clinical practice for student nurses - A scoping review.

BACKGROUND: Clinical practice provides an opportunity for undergraduate nursing students to develop the professional attitudes, knowledge and skills required for the delivery of safe competent care. Some students, however, are challenged to consolidate learning in clinical practice and are therefore at risk of failing courses or programmes. Supporting these students requires remediation strategies specific to clinical practice. This is challenging, however, as remediation approaches frequently centre on supporting students in theoretical components of courses/programmes, rather than clinical practice. OBJECTIVES: A scoping review was conducted to explore and summarise literature in undergraduate nurse education related to remediation support for clinical practice. METHODS: The research question was developed using the Population/Concept/Context model. Following the identification of keywords, five databases (CINHAL Plus, MEDLINE, ProQuest, Scopus and Informit) were searched. Abstracts and full-text articles were independently screened by two authors. Data from included studies was extracted and then thematically analysed. RESULTS: Twenty papers met inclusion/exclusion criteria (five literature reviews, one concept analysis, six commentary papers and eight original research studies). Research studies used qualitative, quantitative, or mixed methods research designs. Populations included nurse academics, mentors/preceptors, health professional students (including nursing students) and nursing students exclusively. Three themes were identified: pre-placement remediation strategies; on-placement remediation strategies and post-placement remediation strategies. All authors highlighted the importance of remediation for at-risk students in clinical practice. CONCLUSIONS: This review identified several remediation strategies that may support undergraduate nursing students in clinical practice. Few, however, were well-defined or rigorously evaluated, highlighting the need for additional research on nursing student remediation in clinical practice. A partnership-based approach to remediation that engages students, educators, and healthcare providers and is underpinned by clear processes may be of further benefit to nursing students in clinical practice.

Nurses' self-regulated learning in clinical wards: Important insights for nurse educators from a multi-method research study.

Central in nurse education curricula stands the preparation of future nurses to work in quickly evolving, dynamic, clinical wards. Learning in the flow of work plays a pivotal role in initial nurse education, but also during continuous professional development. To drive their ongoing development, nurses need competency in self-regulation of learning (SRL). Despite the importance of SRL in the clinical workplace for all (future) healthcare professionals, research on self-regulated workplace learning (SRwpL) of nurses and future nurses in clinical wards is underdeveloped. This study aims to enhance the conceptual understanding of SRwpL strategies and practices in clinical nursing wards and to offer insights for designing effective educational interventions supporting the facilitation and development of (future) nurses' SRwpL in the clinical ward. A multi-actor, multi-method perspective was adopted to qualitatively investigate SRwpL strategies nurses engaged in. Nurses were observed and interviewed, but also professionals responsible for ongoing development in clinical wards (the ward's head nurses and learning counselors) were interviewed. The data collection took place before the COVID pandemic. Results reveal self-regulatory strategies conditional for SRwpL in addition to strategies initiating, progressing, and evaluating the learning process. Head nurses and learning counselors report a lack of these conditional strategies and little variation, and sporadic engagement in all other self-regulatory strategies. To enhance (future) nurses' SRwpL, we suggest that clinical supervisors from educational institutions could exert a lasting influence by not only educating student nurses, but also fostering further professional development of counselors and head nurses to scaffold the SRwpL processes of future nurses in clinical wards.

Test anxiety: Perceptions of Omani nursing students - A descriptive qualitative study.

BACKGROUND: Excessive anxiety may have a detrimental effect on nursing students' performance. Understanding students' experiences of test anxiety (TA) is crucial to improve their academic performance and help them lead a successful professional life. OBJECTIVES: To explore TA from the perspective of nursing students, identify the factors that affect TA and possible interventions to reduce it. METHOD: the setting is a nursing college from Oman. All regular undergraduate nursing students from years 2, 3, 4 and 5 and bridging students (those doing BSc nursing after a diploma in nursing) were invited through their cohort leaders. The interested participants from each cohort signed the consent to participate in the focus group. RESULTS: Thirty students from different academic years participated in five focus groups, each comprising 5-8 undergraduate students and lasted from 45 to 60 minutes. Approximately 80% of the students experienced moderate to severe TA. The causes were divided into students, courses and examiner-related factors. Other themes were signs and symptoms of TA, the impact of TA on different aspects of life, effective management techniques and suggestions for improvement. The findings indicate that TA improves with experience as students advance academically. Furthermore, bridging students face less TA in their clinical practice than regular students and TA impacts more aspects of their lives. CONCLUSION: This study highlights the TA experiences of nursing students at different levels and in different programs. the findings showed that most students experienced test anxiety, but the perception of TA improved when students advanced their academic lives. the distinct experiences of Omani nursing students highlight the importance of tailored interventions to mitigate its impact on academic performance and overall well-being.