Studies have revealed that nursing students experience greater amounts of stress and anxiety than the average college student. Nursing students attribute increased stress levels to the twin demands of their classroom and clinical workloads. Higher stress levels frequently result in students reporting symptoms of poor health and lack of psychological well-being. It is important to note that some nursing students are also actively working in clinical settings and contending with the added stress of the recent COVID-19 pandemic. Mindfulness meditation is a natural measure that can help alleviate the feelings of perceived stress and anxiety and improve levels of mindfulness and self-compassion. An experimental two group pretest-posttest randomized controlled design was used to evaluate the effect of a virtual mindfulness meditation intervention on levels of perceived stress, anxiety, self-compassion, and mindfulness of nursing students. Study participants were randomly assigned to either an intervention or control group and received recordings prepared by the study authors. The intervention group received a 10-minute mindfulness meditation recording each week and the control group simultaneously received five 10-minute separate recordings on nursing news and information. Both groups were instructed to listen to the recordings at least three days per week for four weeks. The instruments used in this study were the Perceived Stress Scale (PSS), the Generalized Anxiety Disorder subscale (GAD-7), the Self-Compassion Scale (SCS), and the Mindfulness Attention Awareness Scale (MAAS). These surveys were provided at baseline and at a 4-week follow-up. The study presented in this dissertation is part of a larger study that was a collaboration between this author, Debra Heinrich, and Shohini Holden. Other instruments in the original study that are not discussed here are the Depression, Anxiety, and Stress Scale (DASS) and the Five Factor Mindfulness Questionnaire (FFMQ). This dissertation consists of three articles. The first article provides an analysis of the effect of a mindfulness meditation intervention on the stress and anxiety levels of nursing students. A two-way mixed ANOVA revealed a significant interaction between group assignment and timing of test on participants’ stress levels and on their anxiety levels. Follow-up simple main effects tests involving independent-samples t tests revealed that the intervention group, receiving the online mindfulness meditation recordings, experienced lower levels of stress and anxiety on the posttest surveys than the control group. The second article reports on a study of the effect of the intervention on mindfulness and self-compassion levels. The findings of a two-way mixed ANOVA and independent t tests demonstrated that mindfulness meditation can increase levels of mindfulness and self-compassion in nursing students. The third article compares two instruments used to self-report feelings of anxiety, reports on the demographic variables related to anxiety among nursing students, and explores the correlation between levels of mindfulness and levels of anxiety in this study. There were no significant relationships found between any demographic variable and anxiety scores. The GAD-7 instrument was found to be more sensitive to mild and moderate anxiety then the DASS instrument, and it is, therefore, the recommended instrument for use in nursing programs. There was a significant inverse relationship between levels of mindfulness and anxiety for students in this study. The findings of this study demonstrate that mindfulness meditation can reduce stress and anxiety, while increasing mindfulness and self-compassion levels in nursing students. This could be useful for nurse educators assisting students to manage the stress and anxiety often experienced in nursing education. Nursing programs could screen students to evaluate their levels of stress, anxiety, and mindfulness. Stress relief techniques, such as mindfulness meditation, could be incorporated into nursing programs as part of a wellness program or curricular offering. Mindfulness meditation could also be part of orientation programs in clinical sites for new nurses and offered to all nursing staff as part of continuing education. Further research, using rigorous scientific methods, will be needed to study the most effective methods to evaluate and manage stress and anxiety. This could ultimately decrease the stress and anxiety levels and improve well-being for student nurses and nurses, which could in turn positively impact patient care and outcomes.

Undergraduate nursing students face tremendous stress in regards to academic and clinical demands while emotional intelligence (EI) is a topic of interest in the nursing field. This study examined whether problem-focused coping methods for stress are related to ability and personality. In this study, EI represented ability and locus of control (LOC) represented personality. Confrontive coping, seeking social support, and planful problem-solving represented the problem-focused coping variables. A survey instrument which represented a combination of the Assessing Emotions Scale, Perceived Stress Scale, Ways of Coping Scale (Revised), and the Rotter Locus of Control Scale was administered to 11 undergraduate nursing schools during the spring semester of 2019. The results indicated that EI had strong and statistically significant correlations with each of the other variables in the study which were LOC, stress, confrontive coping, seeking social support, and planful problem-solving. The results further supported that EI was a statistically significant predictor for each of the three problem-focused coping variables. It was concluded that level of stress did not mediate the relationship between EI and any of the three problem-focused coping methods. In addition, LOC moderated the relationship between EI and stress. The limitations and possibilities for future research are addressed in this study. Specifically, future research should examine specific stressful encounters in addition to the participants' perception on if the stressful encounter was impactful and if the participant had the resources to cope with the stressful encounter. This information would provide insight into each participant's primary and secondary appraisals.

An integrative review was used to examine the effects of being a tutor versus not being a tutor. The matrix method was used to guide the research process, to identify articles that met the inclusion criteria, and to reduce data into common topics of peer tutoring. The results of the integrative review yielded 20 articles and suggested that students in the position to assist others are more confident in communicating in groups and have higher knowledge in the subject they help with than their fellow peers. The literature showed that students in the position to assist others have defined personal and professional standards and leadership skills. However, there is little research on the benefits of being a tutor when compared with the benefits tutees obtain from coming to tutoring sessions. More research is needed to examine the effects of being a tutor. More specifically, there are no studies where the skills of nursing student tutors are compared with nursing student non-tutors. In this study, the researcher created a survey to evaluate nursing student tutors and non-tutors, their communication and leadership skills, as well as their personal and professional growth. Focus groups were created to provide tutors a means of discussing the personal and professional impact that tutoring has had on them. The study results indicated that tutors have decreased nervousness in public speaking, have higher confidence in their communication skills, share their life experiences to help others more often, and readily reach out to instructors and other tutors for assistance.

Thesis (M. A. (Nursing)) -- University of Limpopo, 2019 / A master’s program in nursing is an essential tool to prepare students to manage and offer health care services to the public professionally and successfully. However, there has been low enrolment of professional nurses into masters studies of nursing in a higher educational institution. Therefore the study aimed to develop recruitment strategies for professional nurses into Master studies of Nursing at a higher educational institution. METHODS The qualitative research method was used to develop recruitment strategies of professional nurses in Mankweng Hospital into a Master's Studies at the University of Limpopo. The population were professional nurses with honours equivalent and those with honours degree.Semi-structured interviews were conducted from eighteen professional nurses who were purposely selected to participate in the study. Tech`s coding method of data analysis was used to analyze audio-recorded data. RESULTS The results indicated that lack of study leaves, shortage of nurses, lack of information about requirements for enrolling into masters, lack of recognition for postgraduates and financial instability contributed to most professional nurses not registering for master's studies. CONCLUSION The study concludes that the institution of higher learning should develop recruitment strategies for master's studies in nursing. Findings revealed lack of recruitment strategies, information about the masters degree, and scholarship as well as employer related factors such as lack of study leaves as challenges for recruiting nurses into a masters studies. Such strategies vi include the increase of funding scholarships by the universities that can facilitate the postgraduate uptake and allocation of study leaves for professional nurses by the Department of Health.

Nonmedical prescription drug (NMPD) use is a well-documented problem among college students, but few studies have examined nursing students' attitudes regarding NMPD. The purpose of this study was to compare nursing and non-nursing students' attitudes, risk factors, and current substance use. This descriptive, comparative design utilized a convenience sampling and social media to reach students over 18 years of age and enrolled in a Midwestern university. Twenty-nine students, 14 non-nursing and 15 nursing students, participated in this online survey. Substance use attitudes were measured using the Drug Attitude Scale (DAS). Risk factors for substance use were used as demographic questions and current drug use was measured using the Drug Abuse Screening Tool (DAST). Logistic regression (Chi-Square/Fisher's Exact) analyses were used to observe the association between risk factors for substance abuse and nursing/non-nursing students. Additionally, a Simple Linear Regression (Two-Sample T-tests) was used to assess the relationship between DAS and DAST scores between nursing/non-nursing students. Prior to discussing the results of the statistical tests, descriptive statistics of the demographic variables of the participants are presented. Data analysis revealed no significant difference in attitude, risk factors, and substance use among nursing students and non-nursing students. Limitations included the low number of participants and access to students via social media only. The fact that nursing students receive additional training in pharmacology, we presume these students know the risks of drug use, therefore nursing students would have a lower rate of substance use; however, this study revealed no significant difference in attitudes or current substance use among nursing and non-nursing students.

Background: Nurses entering the workforce may have limited education in gerontological nursing. Therefore, many nurses are unprepared to provide quality care to older adults. An unprepared nursing workforce could negatively influence older adults’ health outcomes and care experience. Purpose: To determine differences in senior nursing students’ knowledge, attitudes, and perceived competency about older adults based on enrollment in a bachelor of science in nursing degree (BSN), associate’s degree nursing (ADN), and practical nursing (PN) program that offers geriatric content in curricula. Theoretical Framework: Bandura’s social cognitive theory, triadic reciprocal determinism model provided the theoretical framework. Methods: A non-experimental, descriptive survey design with a convenience sample of students enrolled in a BSN, ADN and PN program. A total of 178 students participated in this dissertation study. Palmore Facts on Aging Quiz 2, Kogan’s Attitudes Toward Old People Scale, and the Hartford Geriatric Nurse Competency tool was used to collect data. Results: Students enrolled in BSN, ADN, and PN programs demonstrated limited knowledge about facts on aging. Students’ attitudes toward older adults were positive, and a correlation was found between knowledge and attitudes. Students perceived competency about older adults were high, but purely subjective. Students’ preference to work with older adults post graduation in the PN group were higher compared with students in both the BSN and ADN group. Conclusions: This study underscore the need to systematically design an evidence-based curriculum inclusive of geriatric content across (BSN, ADN, and PN) programs to prepare the future nursing workforce to care for older adults.

The COVID pandemic led to a sudden expansion of telehealth in the delivery of nursing services. At the same time, nursing education was forced to extend clinical learning to online approaches. However, telehealth clinical experiences are limited in the nursing curricula of entry-level programs. Nursing simulation is an educational activity that prepares students for clinical practice by supporting the learning of fundamental clinical competencies. This study was designed to explore prebriefing methods for simulation to prepare entry-level nursing students for telehealth patient care visits. Standardized patient (SP) methodology was used to simulate a telehealth video conferencing call for an infectious disease case interview. Simulations were conducted remotely using Zoom technology with breakout rooms adhering to Healthcare Simulation Standards of Best PracticeTM, and informed by NLN Jeffries Simulation Theory and Experiential Learning Theory. The experiment compared two different methods for prebriefing: traditional prebriefing with a narrated script and structured prebriefing with a narration script plus learners viewed a role modeling video and participated in guided reflection. Participants from one private university in the Northeast (N =126) were randomized and simulations took place over one semester. In conclusion, the standardized patient simulations were an effective teaching strategy for developing fundamental telehealth skills of therapeutic communication and confidence with patient safety. Learners in the structured prebriefing group had significantly higher scores for confidence in quality and safety, faculty assessed therapeutic communication, and simulation effectiveness. There were significant improvements of therapeutic communication scores over time for both groups, but there were no differences between groups. Future research might extend the explanations of how to best prepare learners for telehealth experiences; it is important to further explore telehealth clinical competencies with entry-level nursing students.

Indiana University-Purdue University Indianapolis (IUPUI) / It is unknown whether timing of human patient simulation (HPS) in a semester, demographic (age, gender, and ethnicity), and situational (type of program and previous baccalaureate degree and experience in healthcare) variables affects students’ perceptions of their clinical reasoning abilities. Nursing students were divided into two groups, mid and end of semester HPS experiences. Students’ perceptions of clinical reasoning abilities were measured at Baseline (beginning of semester) and Time 2 (end of semester), along with demographic and situational variables. Dependent variable was Difference scores where Baseline scores were subtracted from Time 2 scores to reveal changes in students’ perceptions of clinical reasoning. Students who were older and had previous healthcare experience had higher scores, as well as students in the AS program, indicating larger changes in students’ perceptions of clinical reasoning abilities from Baseline to Time 2. Timing of HPS, mid or end of semester, had no effect on Difference scores, and thus students’ perceptions of clinical reasoning abilities.

The purpose of this exploratory study was to measure the cultural competence of nurse educators in accredited baccalaureate (BSN) nursing programs in Tennessee (TN) and investigate the relationship, if any, between nurse educators' cultural competence and the percentage of minority nursing students recruited into and graduated from these schools in the previous 5 years. With the rapid rise of the minority population in the United States, more minority healthcare providers, including nurses, are needed to provide culturally congruent care in underserved communities. Literature has implied that nurse educators' lack of cultural competence and sensitivity regarding minority nursing students' educational needs could be a contributing factor to minority nurses' underrepresentation. Nurse educators in 9 accredited colleges of nursing in TN completed the "Cultural Diversity Questionnaire for Nurse Educators." Some of the participating schools and the American Association of Colleges of Nursing Research Data Center provided the percentage of students recruited and graduated in each school by ethnicity. The findings revealed that the majority of respondents were at least moderately culturally competent. There was no correlation between Tennessee schools' mean cultural competence scores and their percentages of minority students recruited into BSN programs in the past 5 years. But there was a significant statistical correlation between Tennessee schools' mean cultural competence scores and their percentages of minority students graduated from BSN programs in the past 5 years (p = .015). There was a statistically significant difference between the mean cultural competence score of respondents who had lived in a culture different from the United States and those who had not (p = .01). There was also a statistically significant difference between the mean cultural competence score of respondents who had attended multicultural education seminars in the past 5 years and those who had not (p = .0005). The researcher recommended that nursing faculty engage in activities that would increase their cultural competence, enabling them assist students from diverse cultural backgrounds stay in school and graduate.

The critical shortage of competent nurses, disillusionment, and high attrition rate among graduates entering the workforce provided the impetus for this investigation. The purpose of this study was to determine the perceived level of empowerment among graduating nursing students of two basic nursing educational programs and the relationship of empowerment to selected variables. The selected variables were self-directed learning readiness, self-esteem, level in the program, and demographics. In addition, predictors of empowerment were investigated. A sample of 294 nursing students of associate and baccalaureate degree programs from five schools of nursing in the Mid-Atlantic region participated in the study. Instruments used were the Vincenz Empowerment Scale, Self- Directed Learning Readiness Scale, and Self-Esteem Inventory and a data sheet for demographics. The survey was completed from June to September 1994. Nursing students in general perceived themselves to have fairly high levels of empowerment, self-directed learning readiness, and self-esteem which was significantly higher for graduating students as compared to freshman students. There were no significant differences among the variables under study between baccalaureate and associate degree students or the type of institution they represented as private or public. Similarly, there were no differences in their perceived levels of empowerment, self-directed learning readiness, or self-esteem based on gender, racial/ethnic background, or affiliation with Student Nurses' Association. The wide variation in age and educational background ranging from high school to graduate degrees were associated with the participants' levels of self-directed learning readiness and self-esteem. In addition, participants who were involved in community organizations reported higher levels of empowerment. Regression analysis indicated self-directed learning readiness and self-esteem contributed significantly to the variance in empowerment. The findings add to the empowerment literature. Implications for nursing education include: (a) enhancing students' level of self-directed learning readiness and self-esteem may assist in empowering them, and (b) the basic educational process plays a significant role in nursing students' perceived levels of empowerment. / Ed. D.