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Background: Moral Distress (MD) is a unique form of distress that occurs when people believe they know the ethically correct action to take but are constrained from doing so. Limited clinical experience and insufficient ethical knowledge contribute to nursing students' MD, which can potentially cause negative outcomes. The aims of this study are: (1) to describe the MD intensity of nursing students, and (2) to analyze differences and associations between MD intensity and socio-demographic and academic variables., Methods: A cross-sectional study design with a convenience sample of the second, third, and delayed graduation students was included; only students willing to participate and who had attended their scheduled internships in the last six months were eligible for inclusion. To measure the level of MD, we used the It-ESMEE. We collected socio-demographic and academic variables. The data collection occurred from January 2024 to March 2024., Results: The students who adhered to the collection were N = 344. The findings reveal that the students perceived a high level of MD in situations related to clinical internship and class. They perceived higher levels of MD when nursing was not their first career choice, were separated or divorced, did not have children, and were not an employed student. The overall MD score is statistically significantly lower among students who had nursing as their first career choice (β = -0.267, p < 0.05), have children (β = -0.470, p < 0.01), and are employed (β = -0.417, p < 0.01). In contrast, being separated or divorced (β = 0.274, p < 0.01) was associated with a higher MD score., Conclusions: This study has some limitations: data reflect a local context, and the findings may not be generalizable to other regions or educational environments. Additionally, students' recollections of their experiences could be influenced by the passage of time, and there may be a selection bias since only students willing to participate were included. The findings suggest that nursing education programs should incorporate more robust training in ethical decision-making and stress management to better prepare students for the moral challenges in their professional practice.

Introduction: The healthcare systems in Europe are changing rapidly due to the increased complexity of healthcare needs, specifically for the ageing population with chronic diseases. Nurses play a key role in providing care for patients with chronic diseases, encouraging patients to take care of their own health improving their Health Literacy (HL) too. Previous works have highlighted the paucity of HL content in nursing curricula, and the need to prioritise the development of HL skills in academic teaching and assessment methods. The aim of this study is to analyse HL skills nursing literature to further develop scientific knowledge in this area of research., Methods and Analysis: This scoping review will be conducted following Arksey and O'Malley's framework. This study is based on the Joanna Briggs Institute manual. A systematic search will be performed by four researchers using the electronic databases of MEDLINE (via PubMed), the Education Resources Information Centre, the Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science and Google Scholar. We will include any paper that focuses on HL skills and undergraduate nursing students. We will select every primary study (quantitative, qualitative and mixed method design) published in peer-reviewed journals up until February 2023, in both Italian and English language, without any time limit., Ethics and Dissemination: This scoping review is part of a large project of the University of Catania which aims at developing higher educational standards for nursing student. This project will not involve patients/public and does not require ethical committee approval. This scoping review will be submitted to international peer-reviewed journals., Registration Details: The protocol was registered with the Open Science Framework on 20 April 2023 (https://osf.io/cn8d7)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: This research aims to explore the perceptions of nursing students and directors of bachelor of nursing degree courses regarding reasons for attrition amongst nursing students., Methods: A qualitative descriptive study was conducted using inductive thematic analysis. The study included a purposeful sample of 12 students and 4 directors of bachelor of nursing degree courses., Results: As reasons for attrition, the directors highlighted a lack of preparation for nursing studies and students' limited awareness of possibilities for support and learning. The students emphasized insufficient support from academic staff and poor course organization. Economic and family issues and a misunderstanding of the professional role of a nurse were cited as reasons by both directors and students., Conclusions: The findings provide important insight into attrition in the nursing programme. Further research is warranted, particularly in other contexts. Addressing student attrition requires a comprehensive approach that includes the provision of adequate support systems, mentorship, and resources for students., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

. Investing in healthcare professionals. The motivation for enrollment in bachelor nursing courses: results from a pilot study., Introduction: Understanding the reasons for enrolling in a Bachelor of Science in Nursing (BSc Nursing) is crucial for devising strategies to stimulate enrollment and counteract the current decline in applications. A multi-center longitudinal study was initiated to explore motivations for enrollment and dropout rates. The results of the pilot study focusing on enrollment motives are presented., Objective: To identify the reasons for enrolling in BSc Nursing programs at five Italian universities., Methods: First-year BSc Nursing students enrolled in the academic year 2022-2023 completed an online questionnaire exploring socio-demographic and personal information, priority criteria for their choice, information sources, and the following reasons for enrolling (Likert scale 1-5): altruistic motivations, personal interests, preferences, past experiences, job security, advice, fallback options, and the social image of nursing., Results: 759 questionnaires were analyzed (78% of those involved). 64.7% of the students indicated nursing as their first choice, while one-third enrolled as a fallback option, by chance, or because they were uncertain. Altruism was the primary motivation for enrollment (91.8%), but 74.2% of students enrolled to secure a good job or to pursue a career (52.3%), or due to curriculum counseling sessions (13.7%). Some differences were observed between geographical areas., Conclusions: Students primarily enroll in BSc Nursing programs due to altruism, personal experience, and job prospect. These findings may be valuable for guiding and tailoring information campaigns, and for enhancing the appeal of nursing courses.

Aim: To test the mediating role of burnout in the relationship between self-efficacy and academic success in nursing students., Design: This was a cross-sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students., Methods: We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018-2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self-Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed., Results: The participants (n = 556) had a median age of 20 years (IQR 19-22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self-efficacy on academic success and also a significant indirect effect of this relationship via burnout., Conclusion: The mechanism by which self-efficacy influences academic performance in nursing students is more complex than a simple direct relationship. Universities should consider screening students for variables affecting academic success to decrease academic costs and increase ranking systems classification., Impact: Nurses' professors should be engaged in strategies to promote self-efficacy. The area of intervention should be structured both during classes and internships, in tandem with the mentor and the clinical nurse., (© 2022 John Wiley & Sons Ltd.)

Student academic satisfaction is one of the most important factors affecting the success and quality of a higher education institute and is an indicator about teaching and learning. This study aims to summarize and critically evaluate the instruments assessing academic satisfaction in nursing education. A systematic review was undertaken, PRISMA were used for the screening of studies. MEDLINE, Cochrane, Scopus and CINAHL were searched using MeSH terms; seven eligible articles were identified referring to five assessment tools. COSMIN was used for evaluation of the methodological of the instruments. The systematic review identified five satisfaction measurement tools used in nursing education. The analysis of the instruments rarely considered a confirmative validity structure, measurement error or criterion validity. The best available instrument was the Nursing Students Satisfaction Scale (NSSS) for validation methodology; however, it needs further validation studies that consider CFA, reliability, criteria validity, hypothesis testing and measurement error., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Academic failure can negatively impact on the student, the university and the nursing workforce in the short term. The aim of this study is to analyze the characteristics and predictors of academic success in two cohorts of students of a Nursing Bachelor's Degree program., Methods: This longitudinal study enrolled students who attended the Nursing Bachelor's Degree program. The Tor Vergata University includes 21 Nursing Bachelor's Degree programs at several Sanitary Institutions of the Rome area, with a mean annual recruitment of 800 students. We considered two cohorts of students beginning the program in the 2011-2012 and 2012-2013 academic years, respectively. The follow-up of these two cohorts ended in the 2017-2018 academic year. We considered socio-demographic and academic variables in the nursing field (pre-admission test grade, training exam grade in the first, second and third year and professional license exam grade). The outcome variable is academic success defined as gradua-tion on time; academic failure is defined as changing degree, delay in completion of the course, attrition and dismissal (failure to complete the studies). Data were collected at baseline (T0), at the end of the first year (T1), at the end of the second year (T2) and at the end of the third year (T3) of the course. A logistic regression was performed to identify predictors of academic success., Results: 2,041 students were enrolled, with an average age of 22.0 years (± 4.6, 18-50); 67.4% were female. Regarding academic success, 30.6% of students graduated on time and so achieved academic success, while 69.4% failed to complete the course within the established time: 5.4% (110/2,041) changed the course, the attrition rate was 7.3%, 0.3% (6/2,041) overdue from the course for expiring of the terms, 18.0% (368/2,041) is attending the course and 38.4% (784/2,041) graduated after more than three years. Pre-admission test grade (OR: 10.0, 95% CI: 10.020-10.054) and training exam grade at the second and third years (OR: 10.0 95% CI: 10.027-10.139; OR: 10.2 95% CI: 10.171-10.294) predicted academic success., Discussion and Conclusions: Some nursing students changed course during the last year of the program, while the training exam grade of the second and third years had predicted academic success; this is a brand new information derived from this study. In addition, we confirmed the association of age, gender, secondary school type and grade and preadmission test with academic success. For these reasons, clinical training should be improved and the quality of internship wards, as learning environments, should be monitored. Italian universities should undertake establishing the ideal cut-off in pre-admission tests to determine which students have a high probability of academic success.

Background: Moral distress, defined as moral suffering or a psychological imbalance, can affect nursing students. However, many new instruments or adaptations of other scales that are typically used to measure moral distress have not been used for nursing students., Aim: This study aimed to translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Moral Distress Scale for Nursing Students (It-ESMEE) for use with delayed nursing students (students who could not graduate on time or failed the exams necessary to progress to the next level)., Research Design: The study used a cross-sectional research design., Participants and Research Context: Incidental sampling resulted in a sample of 282 delayed nursing students (mean age = 26.73 ± 4.43 years, 73% female) enrolled between May and August 2020 in a University of central Italy., Ethical Considerations: The research protocol was approved by the internal review board of the university, and all participants provided their written informed consent., Results: The study confirmed a multidimensional second-order factorial structure for the It-ESMEE with five dimensions: improper institutional conditions to teach user care, authoritarian teaching practices, disrespect for the ethical dimension of vocational training, lack of competence of the teacher and commitment of ethical dimension of user care. The internal consistency was high (0.753-0.990 across the factors), and the standard error of measurement and smallest detectable change were adequate., Discussion: The It-ESMEE is able to assess moral distress in delayed nursing students with good validity and reliability. It can be used in research and to determine moral distress levels, helping teachers to monitor the condition in nursing students., Conclusion: This instrument can help in comprehending moral distress, enabling students to develop coping and intervention strategies to maintain their well-being, and to ensure the quality of nurse education.

Objectives: To develop a self-report scale to measure academic motivation among nursing students and to test its psychometric properties., Methods: a cross-sectional validation study with a convenience sample of nursing students (n=1,635) was performed. The Motivation Nursing Students Scale was developed; content, face, construct validity, hypothesis testing and reliability were evaluated., Results: The validity structure revealed a four-factor solution and the model reached a satisfactory fit (χ 2 =622.835 df=160, p<0.01, CFI=0.90, TLT=0.83, RMSEA=0.060 (90% [CI] 0.055-0.064, p=0.001, SRMR=0.067). The hypothesis testing was confirmed with a positive correlation of the academic self-efficacy with Introjected, Intrinsic motivation and a negative correlation with Amotivation., Conclusions: We verified a link between academic self-efficacy and motivation. Both motivation and self-efficacy may increase academic achievement and the possibility for HEIs to degrees a number of students in line with demands., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Higher education students, especially nursing students, have drawn more attention as a group that is vulnerable to the risk of developing burnout syndrome., Purpose: To test the psychometric properties of the Oldenburg Burnout Inventory in Nursing (OLBI-N)., Methods: The OLBI-N validity and reliability was tested in a sample of 476 nursing students. The validity was assessed with explorative and confirmative factor analyses. For hypothesis testing, we evaluated the correlation between burnout and academic self-efficacy., Results: Two factors (exhaustion and disengagement) were identified, and the confirmative factor analysis of the OLBI-N yielded a good fit. The OLBI-N was significantly correlated with academic self-efficacy ( r = .29, -.37, p < .01)., Conclusions: The OLBI-N is a valid, reliable questionnaire for measuring burnout among nursing students., (© Copyright 2021 Springer Publishing Company, LLC.)

Aims and Objectives: To describe the sociodemographic and academic characteristics of nursing students who report academic failure and to identify the determinants of academic failure (no degree on time) in a population of nursing students., Background: Although prior studies have shown that academic failure is influenced by multiple factors, the studies mentioned have mostly focused on specific single variables associated with academic failure, and they have reported inconsistent results., Design: A prospective follow-up study design was used in an Italian Baccalaureate Nursing Degree program. A total sample of 2,040 at baseline and a random subsample of 753 students were considered for academic failure determinants. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology)., Methods: We included in the model academic background, self-efficacy, sociodemographic variables and self-efficacy in psychomotor skills and motivation. We used the Academic Nurse Self-Efficacy Scale (ANSEs), the Nursing Self-Efficacy in Psychomotor Skill Scale (NSE-PS) and the Motivation Nursing Students' Scale (MNSS) which have been validated on nursing students. For the assessment of predictors of academic failure, a two-stage hierarchical logistic regression analysis was performed., Results: Students who had academic failure were 69.4% of the sample. Predictors of academic failure were the secondary school certification grade, the university pre-admission test score; the academic self-efficacy, self-efficacy in psychomotor skills and clinical training examination grades were additional predictors., Conclusions: The secondary school certification grade, the University pre-admission test score, low academic self-efficacy, low self-efficacy in psychomotor skills and low clinical training examination grades were predictors of academic failure in nursing students., Relevance to Clinical Practice: Our findings suggest that the universities could consider a cut-off in the pre-admission test score as a critical value for identifying students who are likely to fail. In addition, nursing faculty staff should consider strategies for developing self-efficacy and motivation., (© 2021 John Wiley & Sons Ltd.)

Background: Student satisfaction is one indicator of quality in higher education, allowing access to funding and coming with repercussions on student performance. This theme is considered complex and highly studied; however, in the nursing literature, there are no studies that summarize and combine the variables and predictors of satisfaction, as well as the existing conceptual models., Purpose: The purpose of this study is to define the following: 1) nursing students' academic satisfaction, 2) the existing theoretical models, 3) the academic satisfaction trend during the course, 4) the differences in academic satisfaction level between nursing student characteristics, and 5) the variables involved in the satisfaction process., Methods: An integrative review using Whittemore and Knafl's (2005) methodologies was conducted. The electronic databases CINAHL, PubMed, Cochrane, and Scopus were used. Two reviewers independently conducted the quality appraisal of the selected studies using the checklist proposed by Edwards (2015) and the Joanna Briggs Institute (JBI) tool., Findings: Nineteen papers were included. The articles were published between 1990 and 2018., Conclusions: The review highlights the lack of a shared conceptual framework to guide the empirical research in the nursing degree field. Four dimensions that predict satisfaction with the curriculum have been identified: faculty, curriculum, social, and development., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Aim: To analyse any changes seen in the academic self-efficacy of nursing students during the three years of their academic education as well as the associated predictive factors., Design: A longitudinal study design was applied., Methods: The sample included 220 students who attended a large university in central Italy. The students' academic self-efficacy was measured using the Academic Nurses' Self-Efficacy Scale. Data were collected annually from 2014/2015 to 2017/2018 at the beginning of the first year (T0), at the end of the first year (T1), at the end of the second year (T2) and at the end of the third year (T3). A repeated measure univariate analysis of variance (ANOVA) was conducted to detect any possible changes in the students' academic self-efficacy scores over the four measurement points. To identify the factors that are predictive of academic self-efficacy, a linear regression model was used., Results: Overall, the students' academic self-efficacy did not change significantly over the three-year period of their education. Both sex (female) and age (24-50 years) during T0-T2 significantly predicted changes in the students' academic self-efficacy over time. Moreover female students started with lower academic self-efficacy scores than male students, although their academic self-efficacy increased over time, while the male students' academic self-efficacy actually decreased over time. In addition, students with a scientific background reported higher academic self-efficacy than other students., Conclusions: Although the students' academic self-efficacy did not change over time, from a theoretical perspective, academic self-efficacy can be developed using a number of strategies such as a well-organised tutorial during the clinical learning phase and feedback or encouragement., Impact: Academic staff should monitor nursing students' academic self-efficacy over time, particularly in the case of male and younger students, students with a partner and students with a humanities background during the first 2 years of the course., (© 2021 John Wiley & Sons Ltd.)

Introduction: Future nurses should possess the knowledge and competences necessary to ensure patient safety. However, little evidence is available on the way in which students learn patient safety-related principles over time. This study explored the progress of a cohort of Italian undergraduate nursing students as they acquired patient safety knowledge and competences from time of enrolment to graduation., Methods: A longitudinal study carried out between 2015 and 2018 enrolled a cohort of 90 nursing students from two Italian Bachelor of Nursing Science Degree Courses at the Udine University, Italy. The students were followed-up on an annual basis and data collection was performed three times: at the end of the 1st, 2nd and 3rd years. The validated Italian version of the Professional Education in Patient Safety Survey tool was used to collect data., Results: At the end of the 1st year, students reported an average 4.19 out of 5 patient safety knowledge acquired in classrooms (CI 95%, 4.11-4.28), which was stable at the end of the 2nd (4.16; CI 95%, 4.06-4.26) and 3rd years (4.26; CI 95%, 4.16-4.32) and no statistical differences emerged over the years. With regard to the competences acquired in clinical settings, at the end of the 1st year the students reported an average 4.28 out of 5 (CI 95%, 4.20-4.37), which decreased significantly at the end of the 2nd year (4.15; CI 95%, 4.07-4.23; p=0.02) and increased at the end of the 3rd year (4.37; CI 95%, 4.27-4.47; p<0.01)., Conclusions: Nursing students' competences in patient safety issues increases over time, while their knowledge remains stable. Students are more vulnerable at the end of the 1st year, when they seem to be overconfident about patient-safety issues., Competing Interests: Conflicts of interest The authors declare that no conflicts of interest exist with regard to this study., (© 2021 Valentina Bressan, Giulia Causero, Simone Stevanin, Lucia Cadorin, Antonietta Zanini, Giampiera Bulfone, Alvisa Palese, published by Sciendo.)

Aims and Objectives: To examine nursing students' health habits. More specifically, the objectives were to determine whether there were any changes in their health habits during their course of study, and to understand whether the students' perceptions about good health conditions cohered with their health-related behaviour., Background: The transition from high school to university has an undesirable effect on students' health habits, and nursing students' unhealthy behaviours may prevent them from helping patients improve their poor health habits., Design: A longitudinal design was used. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology)., Methods: All students were recruited from a nursing science degree course in an Italian university. The sample consisted of 351 nursing students. Data were collected at the baseline during their entrance into the university (T0) and at the end of their third year of coursework (T3). We developed the Nursing Student Health Habits Scale, which was administered by a trained researcher. The McNemar test and the Wilcoxon signed-rank test to evaluate the differences in health habits between T0 and T3, and a logistics model to assess the factors influencing students' good health perceptions were used., Results: From T0 to T3, there were decreases in the number of students who requested physician consultations (p = .01) and increases in those who exercised daily (p = .003). There was also a change in the nutrition model (p = .018). In the multivariate model, physician consultations for medical problems and performing physical exercise were factors influencing good health perceptions., Conclusions: Future research is needed to illuminate other aspects of students' health habits., Relevance to Clinical Practice: Universities are advised to address these problems by reflecting on undergraduate and postgraduate curriculum content concerning health management and disease prevention., (© 2020 John Wiley & Sons Ltd.)

Background: University time is considered to be a period of vulnerability among nursing students for substance abuse, which can create an unsafe clinical practice. The aim of this study was to investigate the substance abuse of nursing students in the form of alcohol, drugs and tobacco use during the course of studies. In addition, another study aim was to describe a typical socio-demographic profile for substance-abusing students., Methods: A longitudinal study design based on a sample of 254 nursing students was used. Data from the same cohort of students at the baseline level (T0), at the end of the first year (T1), at the end of the second year (T2) and at the end of the third year (T3) were analysed., Results: A decrease in the number of nursing students who smoke regularly, an increase in the number of those who use drugs to lose control and of those who drink weekly were found., Conclusion: The early recognition of substance-abusing students can be fundamental to their health, academic background and safe clinical practice.

Background: Cancer is recognized as a family illness as many head and neck cancer (HNC) patients after treatment require assistance from a family caregiver throughout the rest of their life. The purpose of this study was to explore the lived experience of primary family caregivers of HNC patients dealing with laryngectomy regarding their complex supportive role., Methods: Phenomenological study based on individual interviews of twelve primary caregivers of HNC patients, recruited by purposeful sampling. Interview contents were analyzed in depth, in accordance with Colaizzi's descriptive analysis framework, to explore and identify significant themes and subthemes., Results: Analysis evidenced three main topics and subthemes embracing various aspects of the caregiver's lived experiences: (1) experiencing disease and the pathway of care, (2) handling changes to everyday life, and (3) support received by others., Conclusion: Given the essential role the caregiver has in the patient's post-treatment recovery, future planning of HNC patient care must consider the caregivers' needs. In order to guarantee an appropriate and effective health professional care, it is important to consider caregivers' issues and needs as part of HNC patient care planning from the diagnosis to the follow-up.

Background: Self-employment represents a new work opportunity for new nursing graduates; however, little is known about nursing students' Intention to meet this new demand from the labour market., Aims: To develop a theory-driven questionnaire to assess students' Intentions for self-employment and psychometrically test this scale., Method: A cross-sectional study was conducted investigating 344 nursing students in their final year in an Italian university. The content, face, construct, convergent and discriminant validity, and reliability were evaluated. We also tested the theory of planned behaviour., Results: The Planned Self-Employment Scale demonstrated satisfactory validity and good reliability. A moderate Intention to be self-employed emerged among nurses (3.6 ± 1.5 out of 7). This level of Intention was predicted by the Attitudes and Perceived Behaviour Control dimensions., Conclusion: The Planned Self-Employment Scale exhibited good validity and reliability and can thus be used with nursing students., Implications for Nursing Management: Educators need to design a curriculum to improve students' decision-making and autonomy. At the central level, there is a need to produce guidelines that offer guidance to both nurses and patients, as well as the system as a whole with regard to this new form of nursing service., (© 2020 John Wiley & Sons Ltd.)

Objective: To summarize the evidence in the literature about rehabilitative treatments that reduce low anterior resection syndrome (LARS) symptoms in patients who underwent surgery for colorectal cancer., Methods: We have search in PubMed, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health and Scopus databases. Studies selected were limited to those including only patient undergone low rectal resection with sphincter preservation and with pre-post assessment with a LARS score. Five articles fit the criteria., Results: The percutaneous tibial nerve stimulation demonstrated moderate results and sacral nerve stimulation was found to be the best treatment with greater symptom improvement. Only one study considered sexual and urinary problems in the outcomes assessment., Conclusions: In clinical practice patients should evaluate with the LARS and other score for evaluation of urinary and sexual problems. Future research must be implemented with higher quality studies to identify the least invasive and most effective treatment/s.

Aims: An available strategy to counteract academic failure is the development and implementation of student academic self-efficacy; however, to date, there are no instruments measuring it. The aim of this study was to develop and psychometrically test an academic nurse self-efficacy scale., Design: A longitudinal study design was used in accordance with Consensus-based Standards for the Selection of health status Measurement Instruments guidelines., Methods: A convenience sample of 1,129 nursing students attending the first year of the course were involved. The data collection began in 2014 and went on for 3 years. Data were collected at the beginning of the first (T0), at the end of the first (T1), at the end of the second (T2), and at the end of the third (T3) year. The academic nurse self-efficacy scale was evaluated for content and face validity, for construct validity with explorative, confirmative factor analysis and hypothesis testing and for reliability. The standard error and the smallest detectable difference were also evaluated., Results: Scree plot analysis suggested a four-factor solution and confirmative factor analysis model reached a good fit. We verified the first hypothesis, partially the second and not the third. The dimensions show a Cronbach's α 0.72-0.83. The smallest detectable difference was 26%., Conclusions: The academic nurse self-efficacy scale had good validity and reliability and should be considered for nursing students., Impact: These findings may have an impact on universities, mainly in nursing degree programmes because nurse educators can identify nursing students with low academic self-efficacy and help them in their academic duties. Indirectly, academic self-efficacy monitoring can be used for evaluating the effect of different teaching strategies or mentorship support over time., (© 2019 John Wiley & Sons Ltd.)

The aim was to conduct a systematic review and a meta-synthesis of primary qualitative studies exploring experiences of head and neck cancer patients (HNC) undergoing radio and/or chemotherapy, in order to provide a better understanding of this phenomenon and supply new directions for care and clinical practice. Six databases were systematically searched, and 13 studies were included. The meta-synthesis methodology was adopted to conceptualise the way in which patients lived their cancer journey and the impact of treatments on their daily life. Four themes embracing various aspects of HNC patients' experiences were identified: (a) self-body image and perceived quality of life; (b) experiences and treatment of symptoms; (c) cancer journey; and (d) the relationship with health professionals. The finding demonstrates the importance of acknowledging that treatment sequelae and patients' daily issues do not appear, develop and affect people's lives in isolation and should be considered and analysed as a whole within the social and cultural context of patients' lives. Further research is needed to explore the treatment experience of HNC patients throughout their cancer journey with a more holistic approach that involves health professionals, caregivers and other family members and peers in the community., (© 2018 John Wiley & Sons Ltd.)

Aim: To map the research methods, frameworks, structures, processes and outcomes investigated to date when implementing nursing bedside shift reports (BSRs)., Background: BSRs have become an area of increased interest among nurse managers (NMs) with several projects aiming at implementing bedside reports also as a strategy to increase nursing surveillance and reduce adverse events. However, to date, no summary of the available evidence has been provided with regard to research methods, theoretical frameworks underpinning BSR implementation and outcomes aiming at supporting NM decision-making in this field., Evaluation: A scoping review including quantitative studies written in English and retrieved from five databases was performed in 2018., Key Issues: Twenty-two studies originating from USA, Australia, Finland and Sweden, largely monocentric in nature and involving mainly medical/surgery units, have been performed to date. BSR implementation has been conducted mainly under organisational change theories, patient safety and nursing conceptual models. The BSR outcomes have been measured at the patient, nurse and organisational levels and reported positive trends., Conclusion: Professional reports-describing success transitions from traditional methods of handover to BSRs, and scientific studies aimed at improving evidence in the field, have been conducted to date, in order to document BSR implementation processes and outcomes., Implications for Nursing Management: BSRs should be designed and conducted under a theory of organisational change; moreover, clinical nurses should be trained and supported in the transition from the traditional shift report to the BSR; while implementing this transition, outcomes should be set at the patient, nurses and organisational levels with the aim of tracing the comprehensive effects of the change., (© 2019 John Wiley & Sons Ltd.)

No evidence from any longitudinal study design has been reported to date with regard to patient safety (PS) incidents witnessed by nursing students during their training. Therefore, with the aim of closing this gap in available knowledge, a longitudinal study was performed from 2012 to 2015 by involving all nursing students (n = 145) enrolled in two Italian nursing programs. At the end of each academic year, students were invited to report in writing all PS incidents witnessed during their clinical learning experience; the number of days each student spent in their clinical setting was also collected from administrative records. Ninety students were included and 94 incidents were reported: 17 (18.1%) by first year students, 27 (28.7%) by second year students, and 50 (53.2%) by third year students. One third of students did not report any PS incident at the end of each academic year, while only a few reported more than one. The incidence density was 3.8/1000 days of clinical training without statistical differences across academic years. Supporting nursing students by encouraging them to share, discuss, and reflect on their clinical learning experience might increase their confidence in reporting safety incidents., (© 2018 John Wiley & Sons Australia, Ltd.)

Objective: To conduct a systematic review to investigate risk factors, incidence, and preventive strategies for perioperative pressure injuries (PIs)., Methods: The authors reviewed four databases for literature published from January 2001 to December 2017. Selected articles included primary quantitative studies with prospective, descriptive, and longitudinal design or randomized controlled trials that evaluated risk factors, incidence, and preventive strategies for perioperative PIs. The studies included were evaluated for methodological quality using the Edwards Method Score. The authors used a standardized extraction form to extract inclusion and exclusion criteria, participant demographics, methodology, PI risk instrument and classification systems, type of surgery and anesthesia, PI risk factors, incidence, preventive strategies, and outcomes evaluation., Main Results: Of the 115 publications identified, 11 met the inclusion criteria. The risk assessment and PI classification instruments used differed in every study. Incidence of PI varied throughout the studies and was reduced by warming therapy and by a skin care intervention program., Conclusions: Further studies are necessary to develop a standard risk assessment instrument and preventive strategies and to clarify some contradictions evident in the literature.

Background: Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom., Aims: To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession., Research Design: A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project., Findings: In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses., Discussion: Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed., Conclusion: The call for investing in nurses and nurses' care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

Student perceptions of self-efficacy (SE) prevent stress and burnout and improve engagement in nursing education, thus increasing learning outcomes. The study aims were to (1) validate a scale measuring nursing SE in psychomotor skills (NSE-PS), (2) describe changes in NSE-PS over time, and (3) explore NSE-PS correlations with burnout and engagement. A total of 1117 nursing students participated. A significant increase in the NSE-PS scores over the years has emerged; in addition, all NSE-PS dimensions were correlated negatively with burnout and positively with engagement.

The study sought to validate the Italian version of the Health Professional Education in Patient Safety Survey (H-PEPSS), an instrument used to assess the perceptions of health professionals regarding patient safety competence. The H-PEPSS was administered to a sample of 574 bachelor degree nursing students in two north-eastern Italian universities. Its factor structure, validity and reliability were examined using explorative factor analysis. The internal consistency of the Italian version of H-PEPSS (H-PEPSSIta) measured with Cronbach's alpha (α) was higher for both classroom (.938) and clinical training (.942) dimensions. The six factors that emerged from the analysis were composed of three to five items loading ≥.55 and explaining 69.344% of the classroom total variance and 70.425% of the clinical training total variance of the H-PEPSSIta. The H-PEPSSIta is a valid tool capable of evaluating the self-perception of nursing students regarding patient safety knowledge and competence. Therefore, the instrument could be adopted in educational settings as a periodic nursing student report. This may help students reflect on PS related-issues, and evaluate gaps in knowledge and competences; furthermore, data emerging from periodic self-reports may offer the opportunity to tailor educational strategies to fill the gaps in PS knowledge and competences that emerge., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Ensuring safety in health-care settings is provoking improvements both in education and clinical practice. However, the studies available have not offered to date information regarding knowledge and competence on patient safety (PS) developed by nursing students over their academic career. There is no documentation of the amount of close calls and/or adverse events that students may have witnessed and the degree of safety perceived in the attended clinical settings., Objectives: To describe the perception of nursing students regarding their own knowledge and competence on PS and describe differences, if any, among students attending the first, second and third academic year., Design: A cross-sectional study design was undertaken in 2013., Participants and Setting: A convenience sample of 621 nursing students of two bachelors nursing degrees located in two Italian universities, was the population target of the study. Students attending the first, second and third academic year, obtaining admission to the annual clinical competence examination, were eligible., Methods: The Italian version of the Health Professional Education in Patient Safety Survey (H-PEPSSIta) and open-ended questions was administered to the students after having obtained their informed written consent., Results: A total of 573 students (response rate 92.4%) participated. Around a quarter (28.8%) of students reported having experienced an adverse event or close call during their clinical experience. The settings where they learn were perceived as unsafe by 46.9% of students. PS knowledge and competence as perceived by students, was high (Median=4) in all factors and dimensions of the H-PEPSSIta tool. High PS knowledge and competence was reported by first-year students, moderate by second-year students and higher at the end of the third-year., Conclusions: Faculties and health-care institutions offering clinical placements have to share the responsibility of well-prepared future nurses, working together to improve PS through dialogue when issues are identified by students., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This study was carried out in the framework of a regional surveillance program of surgical site infections, to assess the feasibility of performing a longitudinal study to evaluate possible correlations between perioperative blood glucose levels and surgical site infections in patients undergoing colorectal cancer surgery. A convenience sample of patients aged 18 years and above, admitted to the University Hospital of Udine (Friuli Venezia Giulia region, Italy) from 1 January to 31 March 2011, were invited to participate in the study. Patients admitted for recanalization surgery for obstructing carcinomas were excluded. Twenty-five patients participated in the study, 20% (n=5) of whom had a surgical site infection. No correlation was found between blood glucose levels and surgical site infections. The costs of performing a study of this kind would be mainly related to the number of persons involved in data collection and the estimated time required is 12 to 18 months. For the future conduct of the study, it is hoped that simpler operational methods may be agreed upon within the healthcare facility.

Background: The incidence of postoperative surgical site infections (SSIs) in breast surgery is 3.1%. The risk to develop SSIs seems correlated to the level of glycemia., Materials and Methods: The aim is to test a correlation between glycemic values and SSIs in breast surgery with a longitudinal perspective study. The data were collected in a Surgical Department of a University Hospital of north-east Italy; the study is in the context of the Regional Surveillance Program of Health Agency., Results: We have observed 100 patients. The incidence of the SSIs has been 5.7%. The patients that have developed the SSIs were in ordinary recovery, with a glycemic value taller then the patients without SSIs both in preoperative (92.6 vses 88.5) that in postoperative period (104 vses 91.8 and 108.3 vses 94)., Conclusions:  We cannot test a correlation between SSIs and glycemic value nevertheless for the clinical practice we have important guideline.

Rationale and Objectives: In 2004, Johansson and colleagues, in their systematic review covering the years 1990-2003, documented education interventions and their effectiveness in the treatment of surgical patients. While they provide a review of the state of knowledge until 2003, recent trends in preoperative education and its effects on postoperative patients' outcomes have not been documented in a systematic review. The aim of this study was to describe preoperative educational interventions (including content and delivery time) and postoperative outcomes as considered in studies evaluating the effectiveness for patients undergoing major surgery published from 2004 to 2010., Methods: A systematic review of preoperative education and its effects on postoperative patient outcomes was undertaken. A search was conducted of the PubMed, CINAHL and EBMR databases, including the Cochrane Central Register of Controlled Trials. Randomised controlled trials, or at least clinical trials including pre-/post-test evaluations, with educational interventions performed by nurses preoperatively and outcomes evaluated postoperatively, and written in English, were included., Results: A total of 19 studies involving 3944 patients were retrieved. Of these, 12 were randomised controlled trials. Interventions were based on verbal education, on written/visual education, or both. The content of interventions varied widely. Frequent outcomes evaluated were anxiety, knowledge, pain and length of stay. Objective knowledge (what a patient retains from education) was the only positive outcome influenced by education., Conclusions: Current trends in preoperative education are: scheduling education early; increased frequency of message exposure through several interventions and/or reinforcements; content frequently addressing postoperative management; the measurement of outcomes such as patients' cognitive, experiential and biophysiological aspects. Both the clinical and research implications that emerged from the findings are discussed., (© 2012 The Authors. International Journal of Evidence-Based Healthcare © 2012 The Joanna Briggs Institute.)

Potential nursing students and their families are faced with difficult decisions regarding the amount of time and money required to complete the nursing programme and the availability of funds to cover the costs and this seems to have received little no attention to date. With the aim of describing the costs incurred by Italian nursing students and/or their families per academic year and compare cost trends incurred from 2004-05 to 2010-11, a multi-centre qualitative/quantitative study design was adopted. Italian Nursing students attending the first, second and third academic years in 2004-05 and those attending the first, second and third academic years in 2010-11 were eligible. Five hundred and six students were involved: 215 (out of 300 eligible, 71.6%) attended the bachelor's degree in nursing in 2004-05 and 291 (out of 383 eligible, 75.9%) in 2010-11. On an annual basis, the average annual expenditures increased by 12% for nursing education from 2004-05 to 2010-11. Given that qualification as a nurse requires at least three years, and considering inflation, for a student who matriculated in 2005 an average of 2485.7€ per year (7457.0€ in total) was required. Data suggest that students have modified their spending behaviour (limiting lunches at public bars, buying books and photocopies) in order to handle the rise of non-discretionary costs, such as tuition fees and the costs of attending lectures and hospital/district trainings. Policies supporting nursing education in general and for those students who are motivated but unable to undertake the course for economic reasons are urgently needed., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Administration of medication in an environment such as operating rooms is extremely complex and considerably increases the possibility of errors . This study was performed to analyze how medication is stored, prescribed and administered in operating rooms. Eight operating rooms in a Northern Italy hospital were taken into consideration, analyszing the medication prescribed in 96 working days. The critical points that emerged from the study regarded tasks performed by nurses , but also other professionals. This pilot study was useful for acquiring basic data on the working processes that surround the administration of medication.

The OSCE (Objective Structured Clinical Examination) is considered the most valid and reliable method for assessing the clinical skills of students training for health professions, but its use is limited by the related high costs. We analyzed the cost retrospectively of using an OSCE designed for second-year students (2009) in our degree course, adopting the Reznick et al. guidelines (1993), which recommend assessing both high-end costs and low-end costs. The high-end costs adopting the OSCE amounted to € 145.23 per student, while the low-end costs were € 31.51 per student. Considering the economic crisis and the cost-containment measures applied also in nursing education, strategies for further reducing costs are discussed., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Unlabelled: Effective transfer of information and responsibilities with handover: a literature review., Introduction: The simultaneous and interactive transfer of information between health care workers, on patients' conditions is defined handover. The transfer of information implies also the transfer of responsibility and creates the conditions to guarantee patients' safety; however written or verbal handovers are often incomplete, inaccurate and may last longer than feasible for the organization., Aims: The aim of the review was to identify the strategies to guarantee an effective transmission of clinical information with the handover., Methods: The literature was searched in Medline and Cinahl including articles published in English and Italian (limits adults <19 years) up to 2011., Results: Over 153 articles retrieved, 44 were analyzed. With the manual search further 11 (articles, chapter of books) were obtained. Several methods for organizing handover and selecting the information to pass over were identified. The preferred method is the bedside handover, although its use influenced by the context. As expected, the choice of the model to be used must rely on a series of local factors, above all the organizational model. Conclusions. Further studies are needed to explore the optimal integration of written and verbal information, to avoid redundancies but guaranteeing, at the same time, the transmission of information essential for care planning and patient's safety.

To explore the incidence of intraoperative pressure sores, the associated risk factors and the preventive strategies adopted by nurses, we adopted a longitudinal study in a 900-bed teaching hospital with multiple operating theatres, located in the North of Italy. Patients who underwent major surgery were evaluated four times: at the moment of operating theatre admission, at operating theatre discharge, and on their third and sixth postoperative day. Of the patients included (n = 102) who had an average age of 62.3 years (range 20-87), 12.7% (13/102) developed a pressure ulcer in the operating theatre; 46.1% (6/13) of these ulcers were still present on the third postoperative day. Some health conditions (diabetes mellitus, cardiac diseases) and intra-operative factors (lying on the operating table for more than 6.15 hours, intraoperative hypothermia) are associated with the occurrence of pressure sores.

Low birth weight is one of the major health problems throughout the world. All such neonates can benefit from an effective and efficient human care model - Kangaroo Mother Care. A review of the literature was performed to compare the short and long-term outcome of Kangaroo Mother Care to those of conventional care (incubator). Short-term outcome considered heart and breathing frequency, percutaneous oxygen saturation , transcutaneous oxygen pressure , body temperature, sleep-wake cycles, stress and pain. Long-term outcome considered mortality, somatic, psycho-motor and cognitive development, the incidence of infections and duration of hospitalization. Studies including pre-term neonates were also included. 19 of the 80 studies corresponded to the study criteria and demonstrated that Kangaroo Mother Care is important because it reduces pain and infections, shortens hospitalization, favors breast-feeding: in comparison to neonates treated conventionally, this method results in an earlier and better cognitive and motor development . Concerning body temperature, there were no differences with respect to traditional care. The literature shows that the Kangaroo Mother Care method can be a useful "adjunctive" strategy although further studies are necessary to clarify aspects such as heart and breathing rate and oxygen saturation that appear contradictory.

Aims of the study was To define predictor factors of academic success of student in an Italian Nursing School. The recent introduction of the first level nursing education at university in Italy primed many changes processes and required to think new methods and contents. The study was descriptive and retrospective. The setting is an Italian School of Nursing. It was considered a sample constituted by 2 three years. Academic success was defined such as the capability of the student to finish formative pathway in three years with a final mark &gt;90/110. An half of sample (53.7%, 66/123) finished the studies in three years. Variables that more influenced academic success were age, nationality, admission mark, evaluations obtained in professionals and tutorship formative activity. To know factors influenced academic success provides some indications that should be useful to define "at risk" students for which to plan formative pathways and specific supports.

Aims of the study was to compare perception of both clinical preceptors and nursing students in relation to clinical nursing practice in Italy. The recent introduction of primary level nursing education to Italian University primed many changes in processes and required to think new methods and contents. Special attention was adopted on revaluation of clinical practice. The study was part of a large investigation conducted from 2005 until 2006 as prevalence survey throughout two questionnaire addressed to nurses student and to clinical guides. Participants were all students (tot. 172) from one School of Nursing and their clinical guides (tot.120) working in a high specialization hospital located in a large urban area in Northern Italy. Students' and nurses' perceptions differed in these fields: knowledge of students' learning objectives, explanation of students' competences and objectives already reached, prevalence execution of assistance activity, organization of briefing/debriefing meetings, planning of a learning programme with students at the beginning of tutorship, choosing occasions related to nursing subjects discussed in classroom, filling an intermediate evaluation of the student tutorship in addiction to the final. The perceptions of the students and preceptors were opposite on several factors. This means that students and clinical guides approach the clinical experience from individualized viewpoints.

The "workload" is defined as the whole of the activities completed by a group of professionals in a period of time. The different conceptualization of nursing workload has determined different methods and tools of evaluation. The aim of this study is to evaluate the nursing workload in a Day Surgery Unit with a quantitative (time in activities) and qualitative approach (perceived complexity). We want analyze also every correlation with the time in the activities. The study design is observational. We have analyzed 147 patients admitted to the Day Surgery Unit of a University Hospital in Italy. The nurses have dedicated the average of 164,8 minutes in care. The nursing care time is correlated to anesthesiological risk class and to the general surgery procedure. The patients in specialistic surgery are considered more complexes from the nurses then the general surgery patients. Another indicator associated to the high perceived complexity is the "comorbidity management". This study will help to manage nursing resources and the admission of the patients.

This study examines the socio-demographic characteristics of first-year students on first degree healthcare courses at Udine University (Italy). The survey tried to elicit useful information in a field where literature is scarce. Every student starting healthcare courses in the 2007/08 academic year was contacted and asked to fill in a questionnaire. Two hundred and sixty students were identified, belonging to six different courses: Nursing Sciences, Obstetric Sciences, Physiotherapy, Radiography, Neurophysiopathology Techniques, Biomedical Laboratory Techniques. Each questionnaire included 26 items (25 closed and one open) and had four sections: personal data, family data, training background, criteria affecting the decision to attend a healthcare course. The overall response rate was 87% (226 out of 260). Major findings were: women prevail on men (77% vs. 23%), many students chose these courses because some family member worked in the healthcare field (22.1%), 19.9% of students are older than 26 and 7.1% of them are postgraduates, 12% come from foreign countries, and job opportunities and former work experience influenced the choice of course. This database provides an important benchmark for comparing future trends among students in the healthcare profession in terms of socio-demographic characteristics and personal attitudes.

The focus of this article is an examination of the clinical guides' views and their role in student nurses' learning. The descriptive survey was conducted in July-September 2006. The sample was composed of 120 clinical guides who answered a questionnaire regarding the last student nurses' clinical practice experience during 2006. Clinical guides are nurses working in the wards who are available to supervise the clinical practice of nursing students, similar to preceptors in the United States. Clinical guides used different teaching strategies to stimulate students in various activities. The study revealed that the role of clinical guide is very important for the students as they develop into professional nurses.

The clinical teaching in nursing has the aim to help the student to acquire technical ability, to develop his professional responsibility and to pass from a depended and supervised practice to an independent one. Literature describes many strategies to facilitate students' learning, like "peer teaching". In the Nursing School of Udine peer teaching is characterized by a role of "guide" in apprenticeship assumed by the student of the third year towards a student of the first year. The objective of the study is to analyze the students and the clinical tutors perception of this model. The study is observational; the sample is composed by third year (40) and first year students (150) and by clinical tutors (40) that took part in this tutorial model in the academic year 2002/03 and 2003/04. The instrument is a questionnaire. A positive impact of peer teaching emerges. Nevertheless there are some difficulties faced by the clinical tutor in his role of supervisor and by the "guide" student struggling with a responsibility that put in discussion his theoretical, clinical and pedagogical preparation. It is therefore necessary to prepare the guide student for an important role in nursing education.

Supporting student nurses whilst undertaking clinical training is an important activity for both educators and students, yet there is little consensus in the literature as to what constitutes support. Also, it is difficult to find a robust instrument that provides a valid measure of the quality of the clinical learning environment in different contexts. The aim of this study was to identify factors that influence student nurses' perception of their clinical tutors. A two-part questionnaire was administered to students of a Nursing School in a large city in northern Italy; 143 students participated in the study. In replying to the questions, student nurses were asked to refer to their last one-month training period of the year 2004. Analysis of study results showed that students' perceived satisfaction with their clinical guide was greater in cases where tutors used the critical thinking method. A one-to-one relation between tutor and student was not found to be essential in assuring a satisfactory clinical experience for nursing students.

In literature, about Italy, there are only few studies regarding final thesis and the choices of the nursing student of first level degree. The scope of this study is to analyze the theses of the nursing students of University of Udine to the aim to characterize the fields and and the modalities used from the students in order to write this work. This work analysed 162 theses discussed in three years academics. The triennial experience of Udine's University demonstrates that the nursing students invest more time to elaborate this theses especially in clinical area and intrahospital context. The structuring of a multicentric study that involved other university could give surer information.

The process nurses adopt to solve the patients' problems is known as "Problem Solving" in the literature. Problem Solving Abilities include Diagnostic Reasoning, Prognostic Judgment and Decision Making. Nursing students apply the Problem Solving to the Nursing Process that is the mental and operative approach that nurses use to plan the nursing care. The purpose of the present study is to examine if there is a positive relationship between the number of Educational Tutorial Strategies (Briefing, Debriefing and Discussion according to the Objective Structured Clinical Examination Methodology) used for nursing students and their learning of Problem Solving Abilities (Diagnostic Reasoning, Prognostic Judgment and Decision Making). The study design was retrospective, descriptive and comparative. The Problem Solving Instrument, specifically developed for this study and proved for its reliability and validity, was used to collect the data from a sample of 106 nursing care plans elaborated by the second-year students of the Bachelor Degree in Nursing of the University of Udine. Nursing care plans were elaborated during three times consecutively, after students had participated in different Educational Tutorial Strategies. Results showed that the more the students took part in a higher number of Educational Tutorial Strategies the more they significantly increased their Problem Solving Abilities. The results demonstrate that it is important to use Educational Tutorial Strategies in the nursing education to teach skills.

Objective: This study aims to describe how undergraduate nursing students learn clinical skills., Materials and Methods: This study is part of a larger study and was performed in January-March 2005 as a prevalence survey. A semi-structured questionnaire was administered to all nursing students (n.172) enrolled in the undergraduate nursing program at the University of Udine (Italy)., Results: The response rate was 83.1% (143/172). Relevant results of the study include the following: in 61% of cases (87/143) tutors asked each student, at the beginning of training, to make clear which skills and objectives had already been achieved; during training, students who had problems with writing out nursing records asked their tutor for help in 64.3% of cases (92/143); according to 17.5% (24/143) of students, the tutor's role should include encouraging students to be autonomous, teaching them to reason about problems and how to link theory with practice., Conclusions: While keeping in mind that this study evaluates students' perceptions about their clinical training experience, we can state that tutoring methods were found to be sufficiently homogeneous and can be improved to become more efficient and meaningful.

Unlabelled: The problems and discrepancies occurring in the final evaluation of nursing students brought about the introduction of the OSCE method (Objective Structured Clinical Examination) in the University Course for nurses., Aim: of the article is to describe our experience and first results., Methods: Sixty-seven Ist year students were assessed with the OSCE and asked to perform 3 tests to assess theoretical knowledge; practical skills and diagnostic reasoning., Results: 82% passed the three tests. The best results were achieved for the diagnositc reasoning (87%) and the higher number of failures in the practical skills test (57%). The students who had previously passed the exams of the nursing courses had a lower number of failures (3% vs 29%)., Conclusions: exposure to the skills assessed and to the differences between what is thaugh in the classroom and what the students observe in practice. A close collaboration is needed with ward nurses to reduce the gap between theory and practice and the variability of assessment criteria.

A surgical and oncological patient feel anguish, anxiety and fear when he know his health problems. Information is a very important factor for reducing anxiety level of patient and, at the same time, affects his perceived satisfaction. The aim of this study was to evaluate the impact of informations giving by one or more physicians on anxiety and satisfaction of patient. We have used the State Trait Anxiety Inventory (S.T.A.I.) and the Perceived Physician Communication Style Scale for evaluating anxiety and patient perceived satisfaction in medical encounter. We have involved 36 oncological and surgical patients admitted in General Surgery Department of University Hospital of Udine. The findings showed that patients post-consultation and post-information encounter anxiety level became lower when there were only one physician giving informations; instead there were no significant differences between perceived satisfaction inside groups of patients. Nevertheless case group patients perceived more disposition in listening of physician.