Experiencia vivida del primer contacto con muerte en prácticas clínicas de estudiantes de enfermería

Introduction: Death is a complex phenomenon, nurses in training may face the process of dying and death of people, which can generate diverse situations that represent their lived experiences. Objective: To understand the lived experience of the first contact with death during clinical practicum of nursing students at a public university.Methodology: Qualitative study with phenomenological approach. It was conducted from October 2020 to February 2021. Selection of participants by intentional sampling with information saturation with seven participants. Data collection through phenomenological interview; participants gave informed consent. The analysis was carried out through the three phases of Max Van Manen's hermeneutic phenomenological method (description, interpretation, description plus interpretation). Results: The students refer to having been faced with the phenomenon in a state of helplessness, blockage, uncertainty, and fear; as well as facing death in a professional and reflective manner in order to provide quality care. Discussion: Death is a natural process; however, the first experiences are diverse and can produce in the students a set of emotions that condition their capacity to act, the way of adapting and observing the needs that arise during this experience. Conclusion: The experiences of nursing students show that they have difficulties in facing death, but it was not an impediment to provide the necessary care; it is considered that a deeper preparation on the process of dying can be favorable for their performance as professionals. Introducción: La muerte es un fenómeno complejo, las enfermeras en formación pueden enfrentarse al proceso de morir y muerte de personas, lo que puede generar diversas situaciones que representan sus experiencias vividas. Objetivo: Comprender la experiencia vivida ante el primer contacto con la muerte durante prácticas clínicas de estudiantes de enfermería de una universidad pública.Metodología: Estudio cualitativo con enfoque fenomenológico. Se llevó a cabo de octubre del 2020 a febrero del 2021. Selección de participantes por muestreo intencional con saturación de información con siete participantes. Recolección de datos a través de entrevista fenomenológica; los participantes emitieron su consentimiento informado. El análisis se llevó a cabo por las tres fases del método fenomenológico hermenéutico de Max Van Manen (descripción, interpretación, descripción más interpretación). Resultados: Los estudiantes refieren haber estado frente al fenómeno en un estado de impotencia, bloqueo, incertidumbre y miedo; así como afrontaron la muerte de manera profesional y reflexiva para brindar cuidado de calidad. Discusión: La muerte es un proceso natural, sin embargo, las primeras experiencias son diversas y pueden producir en los estudiantes un conjunto de emociones que condicionan su capacidad de actuar, el modo de adaptarse y observar las necesidades surgidas durante esta experiencia. Conclusión: Las experiencias de los estudiantes de enfermería demuestran que tienen dificultades para afrontar la muerte, pero no fue un impedimento para brindar los cuidados necesarios; se considera que una preparación más profunda sobre el proceso de morir puede ser favorable para su actuar como profesional.

Nursing students’ confidence in clinical competency and job readiness during the COVID-19 pandemic era

Purpose: This study explored nursing students’ experiences of attending clinical practicum courses in 2020 during the COVID-19 pandemic era, focusing on their confidence in clinical competency and job readiness.Methods: The data for this study were collected using online questionnaires that were uploaded to a free online survey website and distributed via a link to the survey to 334 nursing students attending four-year nursing colleges at four national universities. Data analysis was done with descriptive statistics, independent t-tests, and ANOVA.Results: The participants were mostly female (83.2%) college seniors (78.1%). About 60% of the participants practiced between 40% to 100% of their clinical practicum hours in alternative ways. Almost a third of the participants reported that they were not ready for a job (30.2%). However, participants’ confidence in clinical competency and job readiness was not related to the rate of alternative practice, but rather to both achievement of educational outcomes and satisfaction in the nursing practicum.Conclusion: Due to COVID-19, it is evident that effective and efficient materials and ways of delivering clinical courses are constantly to be sought and developed. In particular, recently graduated nurses who experienced abrupt and considerable alterations in their clinical practicum courses due to COVID-19 are in need of attention while they strive to make clinical adaptations.

A pilot randomized controlled trial of a stress management and resilience training (SMART) programme to student nurses: A mixed-methods design (Preprint)

BACKGROUND Resilience is an ‘ability which involves behaviours, thoughts and actions which can be learned and developed in anyone’. The principal investigator of this study found that the institute counsellor conducted 65 counselling sessions for the student nurses in the academic year from 2018/2019 to 2020/2021. Forty-five percent of them were related to clinical issues, and some of the student nurses had even quit the programme due to serious mental problems. Such phenomenon can be explained by the fact that this programme was their first exposure to a complex workplace after completing their secondary education; they needed extra support to overcome the adversities and adapt to the clinical environment. Currently, in the first clinical practicum, student nurses are normally supervised and supported in groups by their schoolteachers and groupmates every minute. In the subsequent clinical practicums, they need to work independently in the ward and are supervised by the ward nurses when necessary. The schoolteachers are their resource persons, and the former visits the latter approximately once bi-weekly. Therefore, this study aims to implement a pilot study on introducing a structured and scientifically proven method, namely, Stress Management and Resilience Training (SMART), to the student nurses before their second clinical practicum, evaluate its effectiveness and explore students’ experience in using it. OBJECTIVE • To employ a structured and evidence-based programme, namely, Stress Management and Resilience Training (SMART), to student nurses before their clinical practicum which aims to boost their resilience. • To evaluate the effectiveness of SMART by measuring the changes in nursing students’ resilience and stress levels at three time points by using two self-report questionnaires. They are Connor-Davidson Resilience Scale-10 (CD-RISC-10) and Perceived Stress Scale-10 (PSS-10). • To explore students’ experience in using SMART during their clinical practicum by conducting two semi-structured focus group interviews. METHODS This research is a mixed-method study using a pilot randomised controlled trial (RCT) and focus group interviews. The RCT will be conducted in accordance with the Consolidated Standards of Reporting Trials statement. A total of 100 student nurses will be randomly assigned into control and test groups. A group of experienced professionals will employ Sood’s framework to devise a nursing-based and 8-week SMART programme and will intervene it to 50 student nurses in the intervention group. No intervention will be implemented to the 50 student nurses in the control group. Connor-Davidson Resilience Scale-10 and Perceived Stress Scale-10 will be used to measure students’ resilience and stress levels at three different time points. After the student completed the second clinical practicum, semi-structured focus group interviews will be conducted to collect students’ experience of using SMART. The demographic data will be summarised by descriptive statistics of frequency count, mean and standard deviation. Chi-squared test and Fisher's exact test will be applied to analyse the differences between demographic variables. Given that the outcome measures of both assessment tools are continuous data, dependent t-test will be used to compare the means between time points. Multilevel modelling analysis will be used to investigate the changes in the outcome measures on each time interval with respect to its baseline and assess the effectiveness of the intervention. A two-level model can be built with repeated time points at level 1 and participants at level 2. The significantly different demographic variables between groups and other possible confounders will be adjusted by including them in the main effect model. A pairwise comparison and other hypotheses on the intervention effects can be tested using a generalised Wald test with an adequate degree of freedom from the modelling analysis. RESULTS The recruitment for this study will begin in March 2022 and the results are expected to be ready by February 2023. CONCLUSIONS This protocol outlines a pilot study on introducing a SMART programme to the student nurses and the methods of evaluating its impact. CLINICALTRIAL Nil

Speech-Language Pathology Graduate Student Experiences of Incivility, Bullying, and Intimidation in the Clinical Practicum Setting: An Exploratory Study

Purpose The purpose of this phenomenological study was to describe and interpret the experiences of graduate students in communication sciences and disorders who experienced forms of incivility in the clinical practicum setting. There is precedent for identifying and handling incivility, such as bullying, harassment, and intimidation, in the nursing education, psychology education, medical education, and physical therapy literature. A literature search for incivilities such as bullying, harassment, and intimidation in graduate student education in communication sciences and disorders did not yield any systematic studies. Method Nineteen participants who were interested in participating contacted the researcher; of those, nine participants were ultimately interviewed. A thematic analysis of videotaped semistructured interviews was used to measure outcomes based on the five questions posed to the participants. The participants responded to the five questions designed to understand the lived experience of incivility for graduate students in speech-language pathology practicum settings. Conclusions This study fills a gap in the clinical education literature in speech-language pathology. It was a qualitative study using a phenomenological approach that described and interpreted speech-language pathology graduate students' experiences of bullying, harassment, and/or intimidation during clinical practicums across practice settings. Data analysis yielded five themes based on the participants' responses during the interview. The themes were communication, physical and/or psychological effects, interpersonal dynamics, clinical instruction, and lingering physical and psychological effects of the experience. The authors make recommendations to reduce the probability that incivility, bullying, and/or intimidation will occur during a student's clinical practicum experience.

Structural Equation Model for Developing Person-Centered Care Competency among Senior Nursing Students

Recent health care developments have emphasized person-centered care, which highlights individualized treatments rather than focusing solely on the nature of a given disease. Thus, we aim to identify the factors and construct a structural equation model for developing person-centered care competency among senior nursing students based on the social cognitive career theory and a subsequent literature review. We use a hypothetical model to examine the factors influencing person-centered care competency, and using a structured questionnaire, and we collect data on self-awareness, the clinical learning environment, clinical practicum adaptation, nursing professionalism, empathy, and person-centered care competency. The participants include 383 third- and fourth-year senior nursing students who had undergone at least one semester of clinical practice in South Korea. SPSS/WIN 26.0 is used to analyze all obtained data, while AMOS 25.0 is used for structural equation modeling. The final model is confirmed to be suitable for explaining and predicting person-centered care competency among participants. Nursing professionalism, empathy, clinical practicum adaptation, self-awareness, and the clinical learning environment explained 38.8% of the total variance among participants. Strategies and interventions designed to enhance person-centered care competency for senior nursing students should particularly focus on nursing professionalism, empathy, clinical practicum adaptation, self-awareness, and the clinical learning environment.