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Objectives: This study aimed to identify attributes of resilience among nursing students., Design: The concept analysis method was used., Data Sources: Literature reviews from the past 10 years were searched in Science Direct, Cumulative Index to Nursing and Allied Health Literature, PubMed, and the Wiley online library. The literature search database and review period were determined after verification of validity by five experts (nursing professors). The inclusion criteria for the literature review were that the paper must be written in English, and the abstract or title of the paper should have included attributes of nursing students' resilience. Exclusion criteria were papers written in languages other than English, papers that did not include the attributes of resilience of nursing students, and duplicate papers. Seventeen studies were included in the analysis., Results: Resilience among nursing students comprised three attributes and 28 sub-attributes. The three attributes were individual, educational, and situational. Individual attributes included personal competency characteristics (e.g., self-confidence and self-efficacy) and consisted of 15 sub-attributes. Educational attributes included characteristics related to academic and clinical practicum (e.g., coping with academic work pressure) and consisted of seven sub-attributes. Situational attributes comprised characteristics that changed according to circumstances (e.g., coping with increased levels of patient acuity during the crisis), such as the COVID-19 pandemic and social support from significant others, and consisted of six sub-attributes., Conclusions: This study identified resilience attributes reflecting the characteristics of nursing students and recent situational changes. Consequently, tools to assess resilience should be developed based on study findings and utilized in various studies aimed at enhancing the resilience of nursing students., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: This review aimed to evaluate the effects of gamification on academic motivation and confidence among undergraduate nursing students and identify the game design elements contributing to these effects., Design: Systematic review and meta-analysis., Data Sources: Comprehensive systematic searches were conducted to retrieve randomized controlled trials (RCTs) and quasi-experimental studies (QES) with control groups published in English and Korean from inception to January 31, 2024, using PubMed, Embase, CINAHL Plus, ERIC, ProQuest Central, Cochrane Library, and RISS., Review Methods: Eligible studies, including grey literature, were selected. The quality of the selected studies was evaluated using the Joanna Briggs Institute Critical Tool. Meta-analyses based on a random-effects model were conducted to estimate the standardized pooled effects (SMD). Subgroup analyses were conducted to identify the effect size moderators and game design elements that contributed to the effect size. The grading of recommendations, assessment, development, and evaluation approach (GRADE) was used to evaluate the certainty of evidence., Results: A total of 22 studies were selected for the systematic review, and 18 studies were included in the meta-analysis. The SMD for academic motivation (SMD of RCTs = 0.86, 95 % CI [0.27, 1.45]; SMD of QES = 1.22, 95 % CI [0.17, 2.26]) and confidence (SMD of RCTs = 1.11, 95 % CI [0.54, 1.68]; SMD of QES = 0.79, 95 % CI [0.40, 1.19]) revealed moderate-to-large effects. The subgroup analysis revealed significant differences in effect sizes across academic years, measurement scales, study areas, study quality, game duration, and game design elements. GRADE assessments for academic motivation and confidence were rated as moderate and low, respectively., Conclusion: This review provides convincing evidence for the positive effects of gamification interventions on academic motivation and confidence among undergraduate nursing students. However, the limited number of RCTs and moderate-to-low certainty of the evidence underscore the need for additional research., Competing Interests: Declaration of competing interest Authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Understanding the link between plantar force, pressure, and foot discomfort is important for nursing students' well-being, given the prevalence of foot and ankle musculoskeletal disorders among nurses. Assessing these factors can inform tailored self-care interventions, supporting holistic nursing education., Purpose: To assess the plantar force and pressure distribution of third-year nursing students at baseline and after 5 months of exposure to a clinical setting., Methods: A prospective cohort study in a Portuguese nursing school measured changes in podiatric profile at 5 months, including peak pressure, maximum force, and contact area., Results: Elevated mean peak pressure in the heel correlated positively with maximum force and contact area. Negative correlations were found between the contact area and edema. Peak pressure correlated positively with thigh pain, indicating pressure transfer to metatarsal heads., Conclusions: The findings underscore the importance of integrating ergonomic education into nursing curricula and raising awareness of self-care interventions., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Reflection is a core competency in geriatric nursing, and reflective learning is an effective approach in nursing education and pracice. An internship program is a transition course that enhances the knowledge, skills, and attitudes of aspiring nursing students in real clinical work. In geriatric clinical setting, nursing internship students require a broad understanding of professional competency that integrates reflective learning with clinical practice to deal with geriatric patient problems and equip them with the knowledge, attitudes, and skills needed to provide quality of care. However, there is a lack of studies examining the effect of holistic reflective learning on professional competency development among nursing internship students in geriatric settings., Aim: This study aimed to investigate the effect of professional holistic reflective learning on professional competency development among nursing internship students caring for hospitalized older adults in medical-surgica wards., Design: This study employed a quasi-experimental pretest-posttest design, where 160 participants were grouped into control and intervention groups. This study was conducted at two nursing schools under the Mashhad University of Medical Sciences in Iran in 2020. Baseline information was collected from both groups, followed by a pretest and follow-up assessment. The intervention group received a Blended Professional Holistic Reflective learning program, while the control group received conventional learning(undertaking professional clinical practice as a usual treatment and submitted reflective logbooks),, which included standard lectures and group discussions., Methods: Participants were selected based on specific inclusion and exclusion criteria. The selection process was non-randomized and unblinded. The participants were equally divided, with 80 in the control group and 80 in the intervention group. Baseline data, including demographic characteristics, were collected. Pretest data were collected for both groups using the Geriatric Nursing-Specific Mini-CEX (GN-Specific Mini-Clinical Evaluation Exercise), an instrument designed to assess nursing students' professional competency in geriatric nursing practice. The intervention was delivered through a combination of in-person and online sessions over four mounts. Posttest data and follow-up, were collected similarly to the pretest. Data were analyzed using SPSS version 22, and potential confounding variables were controlled for in the analysis., Results: The study included a total of 160 nursing internship students, with no exclusions. At baseline, no significant differences were observed between the intervention and control groups in terms of professional competency (PC) and its dimensions, except for age, which was adjusted as a covariate in the analyses. The intervention group showed a significant improvement in PC and its various domains (communication skills, physical examination, clinical judgment, health education, professionalism, and organizational efficacy) over time. The Generalized Estimating Equation (GEE) analysis confirmed significant interaction effects between time and group for all PC dimensions (p < 0.05). Post-test comparisons revealed that the intervention group scored 2.4 points higher than the control group in overall PC (p < 0.001), with sustained improvements in the follow-up phase. Significant within-group improvements were also found across all PC dimensions for both groups from pre-test to follow-up (p < 0.05)., Conclusions: The study found that the professional holistic reflective learning program was effective in developing professional competency among nursing internship students. The blended teaching-learning approach (face-to-face and online) during workshops and geriatric clinical practice is a practical, cost-effective, and time-efficient learning program during students' clinical practice in geriatric settings. Nurse educators are recommended to implement holistic reflective learning during clinical education., (© 2024. The Author(s).)

Background:  The Nursing Education Programme was affected during the coronavirus disease 2019 (COVID-19) pandemic, resulting in nursing students being unable to participate in the clinical experiential learning required by the South African Nursing Council., Objectives:  The study seeks to explore and describe nursing students' experiences of clinical experiential learning during the COVID-19 pandemic., Method:  A qualitative, explorative and descriptive, research design was used in the study. A non-probability purposive sampling method was used, and 55 nursing students participated in the study. Data were collected through six focus group discussions, consisting of 8-12 nursing students in each group. Data were analysed following Tesch's open coding method., Results:  Three themes emerged from the study's findings: The impact of COVID-19 on the clinical experiential learning of nursing students, the effects of COVID-19 on the mental well-being of nursing students, and nursing students' experiences of support during the COVID-19 pandemic. Notably, 11 sub-themes emerged., Conclusion:  The findings of this study reveal that the COVID-19 pandemic severely disrupted the Nursing Education Programme, highlighting the challenges of inadequate clinical hours, restricted clinical access and the significant psychological impact on students.Contribution: This study adds to the literature on students' experiences during clinical experiential learning in South Africa during the COVID-19 pandemic.

Aims: To explore a) pre-registration students' self-perceptions of clinical leadership behaviours and b) differences in students' self-perceptions of leadership behaviours between two countries (UK and Israel)., Background: Effective leadership has been associated with high-quality and compassionate care provision in health and social care contexts. This has led to a common acceptance that teaching leadership in nursing education is essential if students are to develop competencies in this area. Worldwide, there is limited research on nursing students' perception of clinical leadership behaviours as well as on the development of leadership behaviours during the study years., Design and Methods: A cross-sectional survey design was used among two convenience samples of UK and Israeli pre-registration nursing students. Closed questionnaires were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the virtual learning platforms in the two participating universities. In total 656 students were invited to participate and the response rates were 28.1 % (Israel) and 17.9 % (England)., Results: Overall, 140 students completed the questionnaires. Significant differences were found between the two sites in the leadership dimensions "Emotional Intelligence" and "Impact and Influence" (p < .05), with UK students scoring higher than Israeli students. Among the Israeli sample, significant differences were found in leadership dimensions according to years of study, with higher scores reported in the 3rd and 4th year students compared with the 1st and 2nd Year students in the referred dimensions (p < .05)., Conclusions: Differences in students' clinical leadership perception exist between the two cohorts examined. Nurse educators should expand international research on this subject to identify possible antecedents in developing clinical leadership behaviours. At the same time, there is a need to continue efforts to enhance the development of clinical leadership behaviours during all study years through curriculum updating to prepare future nurses better to provide quality, safe and person-centered care., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Collaborative and innovative educational approaches are essential to building nurses' competencies in responding to healthcare challenges and to enhance high-quality nursing practice. Nurses are increasingly learning in various contexts, and thus, the understanding and organising of collaborative learning needs further exploration., Aim: To describe collaborative learning in nursing practice and education from the point of view of nurses, involved as students and teachers in master's education in nursing., Design and Methods: Qualitative study using semi-structured focus groups involving 33 nurses as master's students and teachers from Estonia and Norway. The data were analysed using inductive content analysis., Findings: The essence of collaborative learning in the context of nursing practice and education was identified as the aggregation of diverse learners' skills and reflections while working towards shared aims. This fostered the development of workplace competencies, professional attitudes, and personal growth. Organising collaborative learning requires careful planning and synchronisation between clinical and educational organisations., Conclusions: Collaborative learning is an inclusive method, aiding nurses at different phases of their career to gain knowledge and enhance their soft skills, and potentially reducing professional hierarchies. Further research is needed to develop methods for evaluating the outcomes of collaborative learning., Competing Interests: Declaration of competing interest The authors have no competing interests to declare., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Empathy is significant in nursing, and showing empathy toward a patient positively impacts a patient's health. Learning empathy through immersive simulations is effective. Immersion is an essential factor in virtual reality. This study aimed to describe nursing students' experiences of empathy in a virtual reality simulation game. Data were collected from nursing students (n = 20) from May 2021 to January 2022. Data collection included individual semistructured interviews; before the interviews, the virtual reality gaming procedure was conducted. Inductive content analysis was used. Nursing students experienced compassion and a feeling of concern in the virtual reality simulation game. Students were willing to help the virtual patient, and they recognized the virtual patient's emotions using methods such as listening and imagining. Students felt the need to improve the patient's condition, and they responded to the virtual patient's emotions with the help of nonverbal and verbal communication and helping methods. Empathy is possible to experience by playing virtual reality simulation games, but it demands technique practicing before entering the virtual reality simulation game., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Aims: To explore the differences, if any, in the competences perceived by newly graduated nurses who attended their education before and during the COrona VIrus Disease 19 (COVID-19) restrictions., Background: Nursing education has undergone significant changes because of the COVID-19 restrictions. However, to date the perceived competences at the point of graduation have not been investigated over the restrictions years compared with the pre-restrictions era., Design: A repeated cross-sectional study followed by a pseudo-panel analysis. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. Data on individual, nursing programme and perceived competences with Nurse Competence Scale (NCS) were collected and analysed by also using a pseudo-panel approach., Methods: Two universities were involved. Those eligible were nursing students who graduated: (1) in 2020 (=323) as the first post-COVID-19 group, who were studying in the 3rd year at the onset of the restrictions; (2) in 2021 (=250) as the second post-COVID-19 graduated group, who were in the 2nd year at the restrictions onset; and (3) in 2022 (=247) as the third post-COVID-19 group, attending the 1st year of nursing education at the onset of the restrictions. Data were compared with those who graduated in 2019 (=336, pre-COVID-19 group)., Results: The overall NCS score was higher in the pre-COVID-19 group (68 out of 100, 95 % Confidence of Interval [IC] 66.4-69.5), lower in the first post-COVID-19 graduates (62.9, 95 % CI 60-65.8), higher in the second (66.6, 95 % CI 63.6-69.4) and lower again in the third post-COVID-19 group (63.8, 95 % CI 60.9-66.5). A sinusoidal pattern also emerged for the frequency of use of the competences from the pre-COVID-19 (2.3 out of 3) and the first group (2.1) and increased between the second and the third group (from 2.1 to 2.3) (p< 0.001). These sinusoidal trends are also evident in the pseudo-panel analysis., Conclusions: A different degree of perceived competences at the point of graduation emerged, with higher competences in the pre-restrictions group, lower in the first post-COVID-19 generation, higher again in the second and third group. However, all scores were over 60 points out of 100, thus indicating sufficient competences. The frequency of use of such competences slightly changed over the years with limited practical relevance. The findings may inform reflections regarding innovations in the clinical placements pathways as well as in the strategies supporting newly graduates nurses in their transition from education to health-care settings., Competing Interests: Declaration of Competing Interest None, (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: The aim of this integrative review is to identify, describe, and synthesise evidence regarding students' perceptions of online degree programmes in nurse education, their academic performance, and the factors associated with their academic performance., Design: Integrative review., Data Sources: Four databases, CINAHL, ERIC (Ebsco), PubMed/MEDLINE, and Web of Science were searched. The reference lists of included studies were reviewed to identify other relevant studies., Review Methods: Whittemore and Knafl's method was used as a guideline for the integrative review. Peer-reviewed studies describing students' perceptions of-or academic performance in-online degree programmes in nurse education were included in the review without time limitations. The quality of the selected article was assessed using the Mixed Method Appraisal Tool., Results: Nursing students' perceptions of online degree programmes were categorised into enabling career development, content delivered online, and community belonging. Factors related to student's academic performance were associated with individual students and the characteristics of online learning environments. Factors associated with students' academic performance were individual self-direction, formal communication skills, and working and educational backgrounds. Factors associated with academic performance in an online learning environment were categorised into regular feedback and methods for learning., Conclusions: Online degree programmes in nurse education contribute to developing pedagogy through a satisfactory work-life balance, students' experiences of community and support, pleasant digital content, and various teaching methods by faculties. The study findings of this review have implications for educators to develop and adopt strategies for advancing digital environments with the pedagogy that supports community building to meet the needs of individual students., Competing Interests: Declaration of competing interest The authors state there is no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The desire to work in the nursing profession has recently been identified as an important aspect to consider in the selection process of nursing students but very little is known about nursing applicants' or students' desire to work in nursing., Aims: The study aimed to describe and explain the desire of undergraduate nursing applicants to work in nursing., Design: A cross-sectional study design., Methods: The Desire to Work in Nursing Instrument was used to collect the data. All nursing applicants ( N  = 974) who took part in an entrance examination organised in six Universities in October 2018 were eligible to participate. Eight Hundred and Forty-one applicants (response rate 86%, 102 males) participated in the study. Statistical analysis included the use of descriptive statistics and linear regression was used to assess if dependent variables explained the observed outcomes., Results: A strong desire to work in nursing was demonstrated in all the four areas. The most common reason to desire this work was suitability to nursing and the nature of work, and the least common was the career opportunities. Gender, previous education, and a realistic image best explain the desire., Conclusions: The assessment of desire to work in nursing may assist career choice of nursing applicants, and may enhance recruitment and retention in nursing education. Applicants need to be more aware of the career development possibilities. Further studies are needed to investigate if the desire to work in nursing is different to men than to women to inform recruitment strategies.

Background: The COVID-19 pandemic caused several higher educational institutions to switch from traditional face-to-face to virtual learning medium. This abrupt shift came with new expectations, experiences and challenges to nursing/ midwifery students, particularly new users, and even more so when preparation, orientation, and support were lacking or ineffective. The present study therefore aimed at exploring the expectations, experiences and challenges of nursing students using the virtual learning medium during the COVID-19 pandemic., Methods: This was a descriptive phenomenological design using 12 purposively sampled nursing and midwifery students from a public university in Ghana. With the aid of a semi-structured guide, individual face-to-face interviews were audiotaped, transcribed verbatim at a later time and deductively analyzed into themes using the customer experience execution model., Results: Participants were aged 22-36 years and involved equal number of males and females (n = 6), with majority being Christians (n = 11). Six themes were generated from the study: (1) "Initial thoughts and emotions" described participants initial reactions to the virtual educational medium during the pandemic; (2) "Expectations with the virtual medium" referred to the participants' anticipations regarding the convenience offered by the virtual medium; (3) "Experiences with the virtual medium" depicted the participants' recognition of both positive and negative encounters while using the virtual learning platform; (4) "Evaluation and recommendation" described participants' reports of meeting expectations and recommendations they made to enhance virtual learning; (5) "Challenges and limitations of the virtual medium" typically represented the obstacles encountered by nursing/ midwifery students when they embraced the virtual medium; (6) "Prospects of the virtual medium" referred to participants' views on the future of the virtual medium., Conclusion: The study has brought to light that the virtual education environment comes with its own expectations, experiences and challenges to students. Provision of adequate support such as orientation and simulation laboratories by higher education institutions to satisfy students' needs is necessary to enhance nursing education., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gracious et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: In today's complex healthcare organisations there is an increasing recognition of the need to enhance care quality and patient safety. Nurses' competence in demonstrating caring behaviour during patient encounters affects how patients experience and participate in their care. Nurse educators are faced with the challenge of balancing the demand for increasingly complex knowledge and skills with facilitating students' abilities essential to becoming compassionate and caring nurses., Aim: The aim was to describe undergraduate nursing students' development of caring behaviour while participating in a caring behaviour course., Method: This pilot study used a quantitative observational design. At a university in Sweden, video-recorded observational data from twenty-five students were collected in the first and last weeks of a full-time five-week Caring Behaviour Course (the CBC). In total, 56-min video-recorded simulation interactions between a student and a standardised patient were coded by a credentialed coder using a timed-event sequential continuous coding method based on the Caring Behaviour Coding Scheme (the CBCS). The CBCS maps the five conceptual domains described in Swanson's Theory of Caring with related sub-domains that align with Swanson's qualities of the Compassionate Healer and the Competent Practitioner. The CBCS contains seventeen verbal and eight non-verbal behavioural codes, categorised as caring or non-caring., Results: Between the two simulations, most verbal caring behaviours increased, and most non-verbal caring behaviours decreased. Statistically significant differences between the simulations occurred in the sub-domains Avoiding assumptions and Performing competently/skilfully in the quality of the Competent Practitioner. Most observed caring behaviours aligned with the Compassionate Healer., Conclusion: Generally, the students' development of caring behaviours increased while participating in the CBC. Using a structured observational behavioural coding scheme can assist educators in assessing caring behaviour both in education and in practice, supporting caring as the universal foundation of nursing and a key to patient safety., (© 2023 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.)

Background: Doctor of Philosophy (PhD)-prepared nurses are expected to exercise leadership in their various roles. Therefore, European nurse scholars developed a cross-national web-based Nursing Leadership and Mentoring Educational (Nurse-Lead) program., Purpose: To evaluate changes in leadership practices, professional and research competencies as well as career development of PhD-prepared nurses and doctoral nursing students after participation in the Nurse-Lead program., Methods: A pre-post-test evaluation was conducted. Surveys addressed leadership, professional and research competencies, and career development. Quantitative data were analyzed with descriptive statistics and paired sample t-tests. Content analysis was used for qualitative data., Discussion: The 30 participants showed significant improvements in all leadership practices, professional competencies, and most research competencies. Participants reported increased confidence in decision-making, taking on new responsibilities, and becoming more visible within research teams., Conclusion: Web-based, international leadership and mentoring programs are promising tools for the leadership and professional development of PhD-prepared nurses and doctoral nursing students., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Stigma is one of the documented barriers to achieving universal access to human immunodeficiency virus (HIV) and tuberculosis (TB) prevention, treatment, care, and support programs. The lack of African social theories to emphasize these issues may be the cause of the continent's failure to reduce stigma. We can use Ubuntu, an African philosophy that emphasizes sociability and ethics, to deepen our understanding of how to reduce HIV- and TB-related stigma in South Africa. In many African regions, Ubuntu values and principles were found to assist in reducing problems related to HIV. Ubuntu is a comprehensive phrase used by Africans to signify the characteristics that incorporate the core human virtues of compassion and humanity. We explored the perceptions of nursing students regarding the use of Ubuntu in the fight against HIV and TB stigma. Qualitative participatory research was used to engage all first- and second-level nursing students enrolled for the 2023 academic year at the selected university in South Africa. Purposive sampling was used to recruit the participants. An interactive workshop was used to gather data. The data from the recordings and flip charts were analysed together. Throughout the study, trustworthiness and ethical principles were upheld. Two primary themes emerged as expressions of Ubuntu in relation to a reduction in HIV and TB stigma and recognition of Ubuntu as a tool to combat stigma associated with HIV and TB. This confirms that within Ubuntu, there are elements that might be applied to reduce stigma attached to HIV and TB.

Objectives: To analyze methodological approaches (theoretical frameworks, study designs, methods) and competence areas of nursing students in research on virtual reality simulations (VRS) with a high level of immersion., Methods: A scoping review was performed. A systematic search of the literature was conducted on MEDLINE, CINAHL and ERIC databases on 30/11/22. In addition, a manual search was utilized. The extracted data relating to the research questions was descriptively analyzed and results were narratively summarized., Results: In total 23 studies were included in the review. Selected studies employed a wide range of theoretical frameworks and research designs. The studies aimed to develop competences both through complex interventions where team-based skills are required in acute situations, and they described basic nursing interventions where individual skills are required in non-acute nursing care., Conclusions: A significant amount of the selected studies did not utilize a learning theory or an instructional design framework as a basis for their research. More knowledge was found on training specific skills compared to facilitating the attitudes and values of the participants. Therefore, there is a need for further research on whether nursing students' attitudes and values can be supported through VRS with a high level of immersion., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study aimed to analyze the concept of social support in nursing students., Design: A concept analysis method was used., Data Sources: Articles on concept analysis, published from 2000 to 2022, were examined. Science Direct, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar were searched to identify international articles, and Research Information Sharing Service, Korean Studies Information Service System, and Database periodical information academic were searched to identify Korean articles. In total, 27 articles were examined., Results: The following attributes of social support were found: 1) structural (social integration and social support network); 2) educational (academic support and support of a role model); 3) psychosocial (emotional, positive appraisal, and self-esteem supports); and 4) instrumental (informational and material supports). Furthermore, social support was found to have the following antecedents: 1) stress and crisis, 2) personal need, 3) social network, and 4) social climate. The consequences of social support were as follows: 1) improved mental health and 2) quality of life., Conclusions: Social support among nursing students includes both structural and functional attributes. Structural attributes are social integration and support networks, and functional attributes are educational, psychosocial, and instrumental. Based on the results, we recommend developing a tool to measure social support for nursing students in the future., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Perceptions of the nursing profession influence career choices in nursing. An unrealistic perception might lead students to drop out of nursing education programmes. Objective measurement of the nursing applicants' perceptions at the student selection stage could enhance their career choices in nursing., Aim: To develop and psychometrically evaluate the Perception of Nursing Profession Instrument (PNPI)., Design: Mixed method design., Method: Two versions of the PNPI were developed during the years 2016-2022. The first version was based on documents describing the nursing profession and the second version was based on an integrative literature review, a focus groups study and a document analysis of descriptions of the nursing profession. The meta-ethnographic approach was used to synthesize the results and form a theoretical framework for developing the PNPI (60 items). Item content validity was evaluated by an expert panel of nurses (n = 7). The psychometric properties of the instrument were analysed using the item response theory approach., Results: The development process resulted in the 40-item PNPI with the following subscales: the content of nursing work, the career in nursing, the nature of nursing work and the characteristics of a nurse. The psychometric analysis revealed unidimensionality and goodness of fit to the partial credit model; however, the item difficulty was not well matched with the participants' abilities., Conclusion: The PNPI is a novel instrument for objectively measuring perceptions of the nursing profession. For further development, item difficulty must be enhanced to improve the measurement accuracy of the nursing applicants' perceptions of the nursing profession., Impact: Perceptions of the nursing profession influence career choices, but there is a lack of objective assessment instruments that can be used in nursing student selection setting to measure the perception. The results of this study offer an instrument to measure perception, while also suggesting ideas for further development., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: to explore experiences of being mentored and the contribution of the mentoring to leadership and professional development of doctorally prepared nurses and doctoral nursing students participating in the Nurse-Lead programme., Background: Mentoring is considered important for career development of academic nurses. Doctorally prepared nurses need a wide range of professional competences to develop sustainable careers. Therefore, they may benefit from a larger network of mentors, outside their own organization, to support their professional development. Therefore, a web-based leadership and mentoring programme was developed - the Nurse Lead programme., Design: A descriptive study with semi-structured focus groups., Method: Three focus groups were conducted during an on-site programme meeting in 2019 with twenty-one doctorally prepared nurses and doctoral nursing students. The interview guide included questions about mentoring relationships and meaning of mentoring for leadership and professional development. The interviews were thematically analysed., Results: Five themes were identified: "Preferred characteristics of mentors", "Developing trusting relationships", "Engagement of the mentors", "Becoming a proficient researcher and team leader" and "Becoming an empowered and confident professional"., Conclusion: Mentoring supported the leadership and professional development of doctorally prepared nurses and doctoral nursing students. Participants were engaged in rewarding mentoring trajectories. The results indicate that a similar approach could be followed when developing mentoring programmes in the future., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and control. This study aimed to explore the barriers to learning HAI prevention and control experienced by nursing students during their clinical practicum. A qualitative study was performed using focus group interviews. A total of 12 nursing students from South Korea, consisting of six third-year students and six fourth-year students, were enrolled. Both groups had taken clinical practicum courses. Data were collected using semi-structured questions and analyzed with conventional content analysis. Barriers experienced by the participants when learning HAI prevention and control were limited learning opportunities, inadequate infection control-related knowledge, inadequate practicum experience, and passive learning attitudes. Addressing the identified barriers would allow nursing students to effectively acquire infection control competencies during their clinical practicum.

Aim: To examine the overall level of self-assessed competence of final-year nursing 'bachelors' degree students in the Czech Republic. In addition, the study aimed at the factors associated with the students' level of competence., Design: A cross-sectional observational study., Methods: Data were collected with the Czech version of the Nurse Competence Scale from 274 final-year nursing students of the bachelor's nursing program. Data were analysed using descriptive statistics and multiple regression analyses., Results: Majority of the students (80.3%) assessed their level of competence as good or very good. The highest level of competence was assessed in the category of 'managing situations' (VAS mean 67.8) and 'work role' (VAS mean 67.2). Previous work experience in healthcare and successful supervisory experience had a positive association with self-assessed competence. Students who completed clinical placement during the COVID-19 pandemic assessed their level of competence as lower than students before the pandemic. No Patient or Public Contribution., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Nursing preceptors play a vital role in providing skills-oriented opportunities for students in the clinical environment. This study assessed the perceptions of nursing students regarding the clinical learning experience provided by preceptors, and the perceptions of nursing preceptors regarding their roles in ensuring beneficial clinical accompaniment in the three nursing institutions in Ekiti State, Southwestern Nigeria. A concurrent mixed-methods design consisting of a survey and semi-structured interviews were used. A multistage (consecutive, purposive, and convenience) sampling technique was used to obtain quantitative data from 120 nursing students and qualitative data from 20 preceptors. Data were analyzed using descriptive and thematic content analysis. Findings showed that overall students' perceptions of the clinical learning experience were good (92%), 91.7% of the students wanted direct supervision and inadequate support was reported due to the low preceptor-to-student ratio. Preceptors acknowledged that clinical accompaniment is one of their roles, challenges mentioned include few number of preceptors, lack of policy requirements to guide their duties, and limited equipment. We conclude that there is a need to provide adequate preceptors in clinical settings, as they are vital to the training of nurses. A unified policy and standardized procedure manual will improve the quality of the delivery of preceptorships in training institutions.

Background: Understanding the paths that influence professional commitment among nursing students is important for helping students continue the nursing profession after graduation. The paths between the teaching behaviours of clinical teachers (TBCT) and professional commitment were unknown., Objectives: This study aimed to examine whether psychological well-being mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Moreover, we investigated whether the mediating effects of psychological well-being were moderated by optimism., Design: A cross-sectional design was conducted., Setting and Participants: A total of 318 students from 24 hospitals in 13 cities in northern, north-eastern, and eastern China were included in the study., Methods: The instruments used in this study included the scale of teaching behaviours of clinical teachers, a brief inventory of thriving (measuring psychological well-being), a life orientation test (measuring optimism), and a professional commitment scale. The PROCESS macro for SPSS was used to perform mediation analysis and moderated mediation analyses., Results: Psychological well-being of nursing students partially mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Also, optimism moderated the indirect effect of this mediation model. The indirect effect of clinical teachers' teaching behaviours was stronger for nursing students with low levels of optimism., Conclusion: The findings suggest that the teaching behaviours of clinical teachers and psychological well-being promote professional commitment. In addition, the mediation of psychological well-being between the teaching behaviours of clinical teachers and professional commitment was conditional on different levels of optimism. Clinical teachers should pay special attention to students with low levels of optimism because teaching behaviours of clinical teachers exert more influence on those students' professional commitment., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Abstract: Nurse educators are uniquely positioned to equip students with the knowledge, skills, and attitudes to provide LGBTQ+ persons with culturally congruent inclusive care. Using Quality and Safety Education for Nurses' patient-centered care competency as a framework, this study used a qualitative exploratory-descriptive design to investigate nine undergraduate nurse educators' perceptions of teaching LGBTQ+ gender-affirming care. Three themes emerged from the interviews denoting challenges: importance of patient-centered care, limited knowledge, and barriers to curricular integration. Incorporating LGBTQ+ topics across the undergraduate nursing curriculum is necessary to support the delivery of person-centered care., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2022 National League for Nursing.)

Aim: To explore the experiences and perceptions of final-year nursing students in assessing and managing acute pesticide poisoning using a socio-environmental care approach in a primary health care simulation-based scenario., Design: A qualitative descriptive study was conducted using focus groups., Methods: Twelve focus groups were held, with 114 fourth-year nursing students. The study was carried out from September to November 2021. To grant an in-depth analysis of the collected data, a thematic analysis was used., Results: After our data analysis, three main themes emerged: (i) experiences of an acute pesticide poisoning case in a simulation-based scenario; (ii) environmental health nursing competencies for a culturally competent practice and (iii) social factors in prevention strategies., Conclusions: Using a socio-environmental care approach with a primary care simulation-based poisoning case can provide a realistic public health clinical experience for local problems and prepare the context for the development of global citizenship values, as well as offer numerous opportunities to facilitate transformative learning, including Sustainable Development Goals (SDGs) into local nursing clinical practice., Impact: Nurse managers, policymakers and educators must collaborate together to broaden their reach in teaching the role of the environment and social determinants of health through evidence-based care models, as well as actively contributing to the achievement of the SDGs to promote "glocal" competencies among nursing professionals., (© 2022 John Wiley & Sons Ltd.)

Aim: To describe nursing students' user experiences' (UX) regarding highly immersive virtual reality (VR) simulation with head mounted display used for learning., Design: Qualitative descriptive study., Methods: Graduating nursing students (n = 41). Individual interviews were held right after VR simulation. The usability was assessed using System Usability Scale (SUS)., Results: User experiences emphasized three themes about the highly immersive VR simulation: nursing care in the immersive VR simulation, technology in the immersive VR simulation, and learning nursing in the immersive VR simulation. Usability was evaluated as fair (SUS score 62.3 out of 100). Scores revealed that the VR simulation was easy to use. The support of a technical person was highlighted., Conclusions: This study supports strongly the use of highly immersive VR simulation for nursing education. VR simulations should replicate the most authentic nursing care. Technical assistance is crucial when adopting new technologies in education. The results highlighted the importance of UX in an education context., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Nursing applicants' desire to work in nursing has been identified as an important aspect to consider in nursing student selection, but relevant instruments are missing., To describe the development and psychometric testing of the Desire to Work in Nursing instrument., A mixed-methods design., The development phase included the collection and analysis of two types of data. First, three focus group interviews were organised with volunteer nursing applicants (n = 18) after the entrance exams of three universities of applied sciences (UAS) (in 2016). The interviews were analysed inductively. Second, scoping review data from four electronic databases were collected. Thirteen full-text articles (published between 2008 and 2019) were included in the review and analysed deductively based on the results of the focus group interviews. The items for the instrument were generated by synthesising the results of the focus group interviews and the scoping review. The testing phase included 841 nursing applicants who participated in the entrance exams of four UAS on 31 October 2018. The psychometric properties were analysed by examining internal consistency reliability and construct validity by principal component analysis (PCA)., The desire to work in nursing was classified into four categories: nature of the work, career opportunities, suitability for nursing and previous experiences. The internal consistency reliability of the four subscales was satisfactory. The PCA found only one factor with an eigenvalue over one, explaining 76% of the total variance., The instrument can be considered reliable and valid. Although theoretically the instrument contains four categories, a one-factor solution should be considered in the future., Evaluation of applicants' desire to work in nursing may provide a strategy to retain students., Individuals choose the nursing profession for variety of reasons. However, there is very little understanding of why nursing applicants desire to work in nursing. With the current challenges in the adequate staffing in the nursing workforce, it is important to understand any aspects that may be associated with student recruitment and retention. In this study, it was identified that nursing applicants desire to work in nursing because of the nature of the work, career opportunities, being suitable for nursing and of previous experiences. Instrument to measure this desire was developed and tested. The tests revealed that the instrument can be used reliably in this context. It is suggested that the developed instrument could be used as a pre-screening or self-assessment tool before applying to nursing education to provide further insights to applicants about their reasons for applying and an opportunity to reflect on their decision.

Background: This randomized controlled trial evaluated the outcomes of simulation- and video-based training for teaching nursing students Leopold's maneuver. Their self-efficacy and anxiety levels were also explored., Method: Data were collected among 121 participants [low-fidelity simulator group (LFSG) n = 43; video training group (VTG) n = 41; control group (CG) n = 37] using a Student Information Form, Leopold's Maneuver Skill Checklist, Spielberger State Anxiety Inventory, and General Self-Efficacy Scale. The primary outcome measure was the participants' performance; the secondary outcome measures were their anxiety and self-efficacy levels and grade point averages., Results: The LFSG and VTG participants performed Leopold's maneuvers better than the CG participants. A negative correlation between anxiety and self-efficacy in the LFSG and CGs was found, while there was a positive correlation between grade point average and self-efficacy in the VTG., Conclusions: Educational institutions with an insufficient number of instructors and laboratory infrastructure can use video-based training as an alternative to simulation-based education to reach more students., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Society for Simulation in Healthcare.)

Aim: The aim of the study was to test the psychometric properties of the Facilitative Student-Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries., Design: A multi-country, cross-sectional survey design was applied., Methods: A convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha., Results: Both validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two-factor construct explaining 47.7% of the total variance, identifying two sub-scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two-factor structure. The Cronbach alpha coefficients (0.8-0.9) indicated acceptable reliability of the scale., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: This study aimed to explore the barriers to implementing person-centred care based on nursing students' experiences during clinical practice., Design: This is a descriptive, qualitative study., Methods: Seventeen nursing students were recruited through purposeful sampling from two universities in South Korea. The semi-structured interviews consisting of open-ended questions were conducted. The collected data were analysed using an inductive content analysis method., Results: Five main categories were identified from nursing students' experiences: busyness, educational challenges, lack of awareness, lack of relationship building and lack of a policy approach., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Rationale: Undergraduate nursing students' learning opportunities to practice caring behaviours to assure compassionate and competent nursing practice with standardised patients are few. Earlier studies primarily focused on practicing communication skills in relation to mental health or developing psychomotor skills while caring for a patient with a specific diagnosis., Aim: The study aim was to describe undergraduate nursing students' experiences of practicing caring behaviours with a standardised patient., Method: A sample of forty-eight undergraduate nursing students in semester four at a school of nursing in southern Sweden, enrolled in a full-time, 5-week, on-campus elective caring behaviour course, were at the first and last week individually video-recorded during two caring behaviour simulations encountering a standardised patient. After observing each of their video-recordings, students completed written reflections focusing on their own compassionate and competent verbal and nonverbal caring behaviour. In total, 96 individual written reflections were analysed using qualitative content analysis to describe the experience., Results: One main theme emerged: The challenge of being mindfully present in patient encounters. Four themes further described the experience: A challenging but realistic learning experience, learning the impact of nonverbal behaviour, recognising the complexity of verbal behaviour, and learning to be with the patient instead of only doing for the patient., Conclusion: When caring is intertwined with visible and realistic nursing practice in simulations using standardised patients it facilitates undergraduate nursing students learning compassionate and competent caring behaviour. The learning experience opened the students' eyes to the impact of practicing caring, recognising that being with is not the same as doing for the patient, and thus, how challenging it is to be mindfully present in patient encounters. Designing caring behaviour simulations with standardised patients is a feasible and efficacious educational learning didactic to facilitate students' learning caring behaviour and enhancing patients' experiences., (© 2022 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.)

Background: Professional self-concept is one of the important outcomes of nursing professionalism. There is a lack of adequately planned curriculum may limit nursing students' practical knowledge, skills and professional self-concept in providing comprehensive geriatric-adult care and promoting nursing professionalism. Professional portfolio learning strategy has allowed nursing students to continue professional development and enhance nursing professionalism in professional clinical practice. However, there is little empirical evidence in nursing education to support the use of professional portfolios in blended learning modality among internship nursing students. Therefore, this study aims to examine the effect of the blended professional portfolio learning on professional self-concept among undergraduate nursing students during Geriatric-Adult internship., Methods: A quasi-experimental study two-group pre-test post-test design. A total of 153 eligible senior undergraduate students completed the study (76 in the intervention group and 77 in the control group). They were recruited from two Bachelor of Sciences in Nursing (BSN) cohorts from nursing schools at Mashhad University of Medical Sciences (MUMS), in Iran, in January 2020. Randomization was undertaken at the level of school via a simple lottery method. The intervention group received the professional portfolio learning program as a holistic blended learning modality, though the control group received conventional learning during professional clinical practice. A demographic questionnaire and the Nurse Professional Self-concept questionnaire were used for data collection., Results: The findings imply the effectiveness of the blended PPL program. Results of Generalized Estimating Equation (GEE) analysis was indicated significantly improved professional self-concept development and its dimensions (self-esteem, caring, staff relation, communication, knowledge, leadership) with high effect size. The results of the between-group comparison for professional self-concept and its dimensions at different time points (pre, post and follow up test) showed a significant difference between groups at post-test and follow up test (p < 0.05),while at pre-test there was no important dissimilarity between two groups (p > 0.05).The results of within-group comparison for both control and intervention showed that there were significant differences in professional self-concept and for all its dimensions across the time from pre-test to post-test and follow-up (p < 0.05), and also from post-test to follow-up it was significant (p < 0.05) for both groups., Conclusion: This professional portfolio learning program demonstrates as an innovative and holistic blended teaching-learning approach to improve professional self-concept during professional clinical practice among undergraduate nursing students. It appears that the use of a blended designed of professional portfolio can promote a link between theory and the advancement of geriatric adult nursing internship practice. The data obtained from the present study can be useful for nursing education to evaluate and redesign a curriculum for development of nursing professionalism as a quality improvement process and groundwork to develop new models of teaching-learning and assessment., (© 2023. The Author(s).)

Nursing students, who need to reflect on self, secure their identity, and be prepared as would-be nurses, can make a good use of post-traumatic growth (PTG) that can function as a catalyst for positive change even amidst this COVID-19 crisis. Emotional regulation strategies in traumatic events are key factors for successful growth, resilience is positively associated with PTG, and distress disclosure is an important factor for stress reduction. In this context, this study is a descriptive research study to identify factors influencing the PTG of nursing students, using emotional regulation, resilience, and distress disclosure as the main variables. Data were collected from 231 junior and senior students of the nursing departments of two universities, and the collected data were analyzed using the t-test, the Mann-Whitney U test, ANOVA, the Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression in SPSS/WIN 26.0. Analysis of the PTG scores of the nursing students by general characteristics revealed significant differences in PTG according to the transfer status, perceived health status, and levels of satisfaction with major, hybrid-learning class, interpersonal relationship satisfaction, and clinical practice. Factors influencing PTG were identified to be resilience, reappraisal among emotional regulation strategies, satisfaction with clinical practice, and transfer, with the overall explanatory power calculated at 44%. Based on the results of this study, it is necessary to consider resilience and reappraisal, which is a sub-variable of emotional regulation strategies, in order to develop programs designed to promote PTG of nursing students in the future.

Aim: To conduct a Chinese translation and validation of the Friedman Life Balance Scale (FLBS)., Background: Prevalence of mental disorders is high among nursing students. Life balance is important for nursing students, which may help them increase efficiency in their studies and develop physical and psychological health. Yet, little is known about life balance in nursing students. Therefore, it is crucial to evaluate the status of life balance of the students to lay the foundation for exploring its associated factors., Design: A multi-centre cross-sectional design., Method: The study was comprised of 420 nursing students from 15 hospitals and two educational institutes in East, North and Northeast China from July 2021 to January 2022. The Chinese version of the FLBS was translated and adapted based on published, standardized, international guidelines. Psychometric evaluation included floor and ceiling effects, factorial validity, convergent validity, discriminant validity, internal consistency, test-retest reliability, diagnosis accuracy and calibration. The tests used for validity included floor and ceiling effects, confirmatory factor analysis, average extracted variance (AVE) value, composite reliability, correlations with life satisfaction and subjective well-being. The tests used for reliability incudes Cronbach's alpha and intraclass correlation coefficients. Diagnosis accuracy was tested by the area under the curve and calibration was tested by Hosmer-Lemeshow goodness-of-fit test., Results: The Chinese version of the Friedman life balance scale did not demonstrate floor or ceiling effect, showing content validity is not limited. Confirmatory factor analysis showed acceptable model fit after it was modified. Convergent validity and discriminant validity of the Friedman life balance scale were supported, except subscales two and three were not discriminated well by AVE technique. The internal consistency was acceptable and the test-retest reliability was good with 0.858. The area under the curve was 0.762 and the optimal cut-off point for depressive symptoms was 44. Hosmer-Lemeshow goodness-of-fit test showed the calibration to be acceptable. Life balance is moderate among Chinese nursing students. The subscale "self-forgive, compassion, love" had the highest correlations with well-being and life satisfaction., Conclusions: The Chinese version of the Friedman life balance scale is a suitable instrument for assessing life balance in Chinese-speaking contexts. It also may have potential utility in identifying nursing students with or without depressive symptoms that may need further examination. Future work should examine additional samples of Chinese nursing students, as well as, perhaps other student populations to determine the extent to which the psychometric properties of the FLBS generalize to other students and contexts., Competing Interests: Conflicts of interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Purpose: This study aimed to determine how undergraduate nursing students' knowledge and health beliefs affected their COVID-19-related infection-prevention behaviors., Methods: This study used a descriptive survey. A total of 188 undergraduate nursing students from two universities in South Korea participated in this study. The data were collected from June 2020 to August 2020. Factors influencing infection-prevention behaviors were identified using multiple regression analysis., Results: The participants' mean knowledge level regarding COVID-19 was 84.05 ± 11.78 out of 100. The average health belief score was 2.80 ± 0.32 points out of 5. COVID-19-related preventive health behaviors were correlated with experiences of searching for COVID-19 information (r = .22, p < .01), perceived severity (r = .24, p < .01), perceived benefits (r = .29, p < .01), cues to action (r = .30, p < .01), knowledge (r = .27, p < .01), and perceived barriers (r = -.19, p < .05). Factors that significantly affected COVID-19-related preventive health behaviors were the participants' years of study, experiences regarding COVID-19 prevention education, perceived severity, perceived barriers, and cues to action., Conclusion: COVID-19-related preventive health behaviors are promoted by increasing awareness about the disease and promoting COVID-19 education in nursing curriculums., Competing Interests: The authors declared that no conflict of interest., (© 2022 Korean Society of Nursing Science.)

Background: The COVID-19 restrictions and quarantines had led to increased dependence and usage of digital devices for various human activities and internet gaming to the extent of risking vulnerable individuals to develop addiction towards it. Little is known on such risks among populations of nursing students and its impact on their empathy skills or trait., Objective: Determining the impact of digital use and internet gaming on empathy of nursing students undergoing remote learning during closure of learning institutions nationwide., Design: Cross-sectional online survey was conducted from October to December 2020., Settings: Two established public institutions located in Malaysia., Participants: A total of 345 nursing students pursuing diploma and bachelor nursing programs., Methods: Toronto Empathy Questionnaire (TEQ), Digital Addiction Scale (DAS) and Internet Gaming Disorder Scale-Short form (IGDS9-SF) were self-administered via Google Form™. Following principal component analysis of TEQ using IBM-SPSS™ (V-27), path analyses was performed using SmartPLS™ (V-3)., Results: Despite the increased time spent on digital devices (∆ 2.8 h/day) and internet gaming (∆ 1 h/week) before and during the pandemic, the proportion of high digital users (1.4 %) and gamers (20.9 %) were low; and sizable ≈75 % had higher-than-normal empathy. Digital-related emotions and overuse of them were associated with lower empathy (β = -0.111, -0.192; p values < 0.05) and higher callousness (β = 0.181, 0.131; p values < 0.05); internet gaming addiction predicted callousness (β = 0.265, p < 0.001) but digital dependence correlated with higher empathy (β = 0.172, p = 0.009)., Conclusions: Digital and internet gaming addiction potentially impact empathy. The negative impact of digital dependence can be attenuated by "digital empathy" - an emerging phenomenon becoming increasingly vital in digital health and communication., Competing Interests: Declaration of competing interest No conflict of interest declared by all authors and this study did not receive funding from any agency., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Professional socialization is an essential process of the nursing profession to internalize the values into behavior, resulting in professional identity. However, research into students' experience of professional socialization in clinical nursing education remains limited., Aim: To explore Bachelor nursing students' (NS) experience of professional socialization in clinical education in Indonesia., Design: This study used a descriptive phenomenology qualitative approach. Four sessions of focus group discussions (FGD) were conducted with ten final-year NS from five teaching hospitals using the purposive sampling technique. Data were analyzed using Colaizzi methods and NVivo 12 Plus., Results: The analysis identified two themes and four-subthemes in this study. The first theme is the facilitators of the socialization experience, consisting of "being a professional nurse" and "Islamic culture". The second theme hinders the socialization experience, including "inadequacy of socialization" and "nurses' unprofessional behavior.", Conclusion: Bachelor NS experience is challenging in Indonesia in both a positive and negative way, which facilitates or hinders professional socialization. Thus, the role of a nurse educator in establishing a comprehensive professional socialization program for new NS to assist their transition from the academic setting into clinical education needs to be reassessed., Competing Interests: Declaration of competing interest There is no conflict of interest to declare. The author(s) have no financial relationships relevant to this study to declare., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Aim: to explore nursing students' experiences with the use of RCA technique in patient safety-related incidents during clinical placements. A secondary descriptive qualitative content analysis BACKGROUND: Patient safety education for nursing students is an international priority. While early detection and intervention strategies, such as the root cause analysis technique, have been found to be effective for near misses and errors, little is known about how these strategies facilitate nursing students understand how patient safety incidents happen., Design: A secondary qualitative content analysis was conducted as part of a larger patient safety research project., Methods: Data were collected from nursing students at [Hidden for blinding purposes]. This study included 108 third-year undergraduate nursing students enroled in the Care Management in the Socio-Health Care Settings for the academic years 2017-2018 and 2018-2019. During hospital clinical placements, nursing students were asked to do a coursework describing a patient safety incident and using the root cause analysis technique for its analysis. A content analysis was used to provide an in-depth analysis of the collected data., Results: Two main themes were identified after the data analysis process: (i) patient safety incident as learning events: highlights how these incidents were turned into learning opportunities and how the root cause analysis guided them in identifying and addressing critical incidents to prevent similar situations in the future; and (ii) strategies for improving patient safety culture: depicts how nursing students realised that following protocols and evidence-based practice reduces incidents related to patient safety and the value of reporting errors in avoiding and minimising the recurrence of similar mistakes., Conclusions: The root cause analysis technique is a versatile and flexible learning resource for nursing students that can help them understand complex patient safety incidents while also fostering critical and problem-solving thinking, teamwork and systematic communication., Competing Interests: Conflicts of interest none., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Aim: The aim of this study is to explore the experiences and perceptions of final-year nursing students on the acceptability and feasibility of using a chatbot for clinical decision-making and patient safety., Background: The effective and inclusive use of new technologies such as conversational agents or chatbots could support nurses in increasing evidence-based care and decreasing low-quality services., Methods: A descriptive qualitative study was used through focus group interviews. The data analysis was conducted using a thematic analysis., Results: This study included 114 participants. After our data analysis, two main themes emerged: (i) experiences in the use of a chatbot service for clinical decision-making and and (ii) integrating conversational agents into the organizational safety culture., Conclusions: The findings of our study provide preliminary support for the acceptability and feasibility of adopting SafeBot, a chatbot for clinical decision-making and patient safety. Our results revealed substantial recommendations for refining navigation, layout and content, as well as useful insights to support its acceptance in real nursing practice., Implications for Nursing Management: Leaders and managers may well see artificial intelligence-based conversational agents like SafeBot as a potential solution in modern nursing practice for effective problem-solving resolution, innovative staffing and nursing care delivery models at the bedside and criteria for measuring and ensure quality and patient safety., (© 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.)

This study aimed to understand the experiences of nursing students who experienced clinical practice before the outbreak of COVID-19 on clinical field practice and alternative clinical practice adopted during the COVID-19 pandemic. A phenomenological study was conducted on 14 graduates who experienced clinical field practice and alternative clinical practice during a pandemic. Data were collected using individual in-depth interviews that were semi-structured. Data were analyzed according to Colaizzi's procedure. As a result of data analysis, five themes and 17 sub-themes were selected. The five themes were: alienation during the process of clinical practice change, regret caused by alternative clinical practice, alternative clinical practice as a supplementary measure, difficulties due to COVID-19, non-replaceable clinical field practice. It is necessary to consider using alternative clinical practices to complement the clinical setting and improve the quality of clinical practice in the post-corona era. To this end, it is necessary to supplement the disadvantages of alternative clinical practice, such as reduced concentration and lack of sense of presence, by applying integrated education using Edutech.

Background Recognition of prior learning broadens employees' access to higher education and career progress. In South Africa, the process provides previously disadvantaged nurses a fair and equitable opportunity to further their education. It is necessary to understand the support needs of these nurses., Objective: To describe the lived experiences of students who gained entry through recognition of prior learning to a three- or four-year nursing training programme at a nursing college in South Africa., Design: A qualitative descriptive phenomenological approach was used to explore and describe the meanings students attached to their educational experiences., Setting: A public nursing college in South Africa., Participants: Ten nursing students who gained entry through recognition of prior learning were purposefully selected., Methods: Data were collected over a period of three months, using in-depth individual interviews, and analysed using Giorgi's descriptive phenomenological method., Results: Nursing students who furthered their studies through recognition of prior learning experienced various academic, clinical practice and personal challenges that instilled in them a fear of failure and self-doubt. They used social support from various sources as a way of coping. Previously disadvantaged nursing students require institutional interventions and support to improve their chances of success., Conclusions: Nurses given the opportunity to advance their careers through recognition of prior learning should have access to person-centred support, academic orientation and resources to attain language and technological competency., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Research suggests that the interventions of practice education facilitators, who liaise between the higher education institution and the clinical placement sites, may strengthen the clinical learning environment for nursing students. However, there is a lack of evidence concerning the value of these roles in nursing education., Objective: The objective of this study was to explore how, under what circumstances and why the practice education facilitator role can strengthen the clinical learning environment for nursing students., Design: A realist review was conducted to understand the contextual factors and mechanisms that support or hinder the capacity of the practice education facilitator to strengthen the clinical learning environment for nursing students., Setting: The settings are clinical areas where nursing students are directly involved with patient care., Participants: The participants comprised academic and clinical staff involved in clinical nursing education., Methods: This realist review was conducted in three overlapping and iterative phases: (1) the development of an initial programme theory explaining how the practice education facilitator role is thought to strengthen the clinical learning environment; (2) structured searches, screening and data extraction; and (3) analysis and synthesis to develop and refine the programme theory., Results: The review included 27 research papers. Evidence from these studies led to the development of five context-mechanism-outcome configurations that explain how, under what circumstances and why practice education facilitators can (or can fail to) strengthen the clinical learning environment. Factors such as practice education facilitators' visibility and accessibility in the clinical area and their clinical credibility were found to influence whether clinical supervisors took the opportunity to seek support and guidance from them. Moreover, ward culture regarding student learning and opportunities to prepare for the role were found to influence clinical supervisors' motivation to carry out the functions of the role and develop professionally; this in turn further influenced whether they used the resources provided by the practice education facilitator., Conclusions: Theory-based explanations of how, under what circumstances and why the practice education facilitator role may strengthen the clinical learning environment of nursing students may support further development of this role in the future., Competing Interests: Declaration of Competing Interest All authors state that they have no conflicts of interest to declare in relation to this study., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Impact Statement: This review provides a comprehensive analysis of undergraduate nursing students' exit examinations and indicates that more clinical evaluation methods should be developed to ensure adequate competence.

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.)

Aim: To explore nursing students' perceptions of the identification and medical care of sex trafficking victims and how to improve the care provided based on the identified barriers., Background: Despite the fact that more than 87% of sex trafficking victims establish contact with health professionals, their lack of awareness and training hinders their ability to assist victims properly., Methods: A descriptive qualitative study was carried out using 11 focus groups of nursing students after a simulated case of sex trafficking victim. The analysis of results was conducted through content analysis., Results: A total of 110 fourth-year nursing students participated in this study. After performing the data analysis, three main categories emerged: (i) making a health issue visible, (ii) identifying sex trafficking victims: resources based on evidence-based practice, and (iii) educational resources on sex trafficking in nursing degree., Conclusions: Our results show that through clinical simulation, integrating content regarding the medical care of vulnerable groups can be useful for developing the skills necessary to provide effective care from a trauma-informed approach., Implications for Nursing Management: Health institutions, senior charge nurses, and other health service managers should be aware of the current need for sex trafficking training, structural-level changes, and updated evidence-based guidelines and protocols with other service providers and law enforcement to provide high-quality care., (© 2021 John Wiley & Sons Ltd.)

Background: The career maturity of nursing students has an influence on their individual career choices and their personal career development trajectory. Psychological resilience and a positive professional self-concept might help students adjust and adapt to their nursing careers. Therefore, there is a growing need to assess and develop these psychological concepts among nursing students., Purpose: This study aimed to determine the levels of career maturity, psychological resilience, and professional self-concept among Chinese senior nursing students as well as to examine the relationships between the variables., Methods: A cross-sectional survey was carried out across six undergraduate medical colleges in China from May to August 2021. A total of 1223 full-time final year undergraduate nursing students who fulfilled the study criteria were recruited using the universal sampling method. Self-administered questionnaires including the Career Maturity Scale (CMS), Connor-Davidson Resilience Scale-2 (CD-RISC2), and Professional Self-Concept of Nurses Instrument (PSCNI) were used for data collection. For results reporting, the study complied with the STROBE checklist., Results: The participants' career maturity, professional self-concept, and psychological resilience were found to be at moderate levels. Experience of being a class leader and actively choosing a nursing major were factors that had significant influence on students' career maturity, professional self-concept, and psychological resilience. Pearson's correlation analysis revealed career maturity to be closely related to professional self-concept and psychological resilience (p < 0.01). Results of structural equation modelling analyses revealed a good fit to the data based on various fit indices (χ 2 /df = 6.18, GFI = 0.926, CFI = 0.915, IFI = 0.957, RMSEA = 0.058). Nursing students with positive professional self-concepts demonstrated higher psychological resilience, which in turn influenced their career maturity., Conclusions: The results of this study provide the initial indications for an extended career maturity model. A positive professional self-concept and psychological resilience has the potential to improve the career maturity of nursing students. The study findings provide a basis for nursing educators to focus on improving the professional self-concept and psychological resilience of nursing students., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to investigate newly admitted nursing students' views on nursing education and their future profession., Background: Students' choice of education can be influenced by societal and familial values and among nursing students' altruistic motives are common. Students', conceptions, expectations and doubts combined with their orientations to learning affect their ability to successfully cope with studies in higher education., Design: A descriptive design using mixed method., Methods: This mixed-method study is based on 126 qualitative semi-structured interviews and 158 questionnaires with newly admitted nursing students. The data collection was conducted during their first six weeks of education. Collected data were analyzed using content analysis and descriptive statistics. This study was conducted and reported in accordance with the COREQ checklist., Results: The overarching theme: "Making a difference if managing to become a professional nurse", describing students' dichotomous emotions of expectations and doubts in relation to their conceptions, emerged from seven main categories. Students' ratings of emotions revealed high ambition and motivation. Fears and worries about uncertainty expressed in interviews correlated with ratings of negative emotions., Conclusion: Newly admitted nursing students think highly of the nursing profession and upcoming education. Students put faith in their own ability which is accompanied by doubts derived from uncertainty about forthcoming demands in academic, clinical and personal settings. Understanding of students' conceptions, expectations, doubts and their orientations to learning could be helpful in guiding them to acquire the nurse competencies necessary to become professional nurses that are able to handle complex situations., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Patient safety is a global concern. Learning to provide safe, high-quality care is core to nursing education., Problem: Students are exposed to diverse clinical practices, and experiences may vary between placements and across countries. Student experience is seldom used as an educational resource., Approach: An international, European Union-funded project, Sharing Learning from Practice for Patient Safety (SLIPPs), aimed to develop an innovative online educational package to assist patient safety learning. Based on student reported data and educational theory, multiple elements were iteratively developed by a multicountry, multidisciplinary group., Outcomes: The educational package is freely available on the SLIPPs Web site. Materials include a student reporting and reflection tool, virtual seminars, student reports data set, pedagogical game, high-fidelity simulation scenarios, scenario development and use guidelines, debriefing session model, and videos of simulations already performed., Conclusions: E-learning enables removal of physical barriers, allowing educators, professionals, and students from all over the world to collaborate, interact, and learn from each other., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students' clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher's cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries., Methods: A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher's pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018-2019. The data were analyzed using a Chi-Square test, Pearson's correlation coefficients, and linear models., Results: A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher's pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students' experiences of the nurse teacher's pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher's pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country., Conclusions: This study reveals that nurse teachers play an essential role in supporting and guiding nursing students' final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers' pedagogical cooperation role within the clinical learning environment., (© 2022. The Author(s).)