Building resilience: Resilience for nursing students undertaking their final clinical placement

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Authors
Watson, Deborah
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Degree
Master of Health Science
Grantor
Eastern Institute of Technology
Date
2017
Supervisors
Marshall, Bob
Monson, Kathy
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
New Zealand
nursing students
clinical placement
resilience
stress
coping skills
education
ANZSRC Field of Research Code (2020)
Citation
Watson, D. G. (2017). Building resilience: Resilience for nursing students undertaking their final clinical placement. (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Health Science). Eastern Institute of Technology (EIT), New Zealand.
Abstract
INTRODUCTION In order for graduates to be work ready and to retain them in the labour force, nursing schools need to be effective in preparing students with the skills to cope with their role in often challenging workplaces (Milton-Wildey, Kenny, Parmenter, & Hall, 2014). Resilience is the recovery that occurs to successfully find a way through stress and adversities (Stephens, 2013). This research evaluated an educational intervention with follow up support to improve resilience and decrease perceived stress in nursing students undertaking their final clinical placement. RESEARCH DESIGN The research design was a quasi-experimental pilot study. Participants were students from the Bachelor of Nursing degree at a regional tertiary institute in New Zealand. The pre-clinical data collection consisted of a questionnaire that was based on the Brief Resilience Scale (BRS) (Smith et al., 2008) and the Perceived Stress Scale (PSS) (Cohen, 1994) delivered via SurveyMonkey™. A three-hour educational workshop was delivered to the Intervention Group after the first questionnaire was completed, and this group received follow up support at two weekly intervals. The participants' clinical placement was nine weeks in length; and then the second questionnaire was completed. In the post-clinical questionnaire, as well as identical questions based on the scales, there were also open-ended questions. FINDINGS There were 15 participants in the Intervention Group and 14 participants in the Control Group who completed the pre-clinical questionnaire. The post-clinical questionnaire was completed by 15 participants from the Intervention Group (100%) and 7 from the Control Group (50%) of the original sample that completed the pre-clinical questionnaire. When the individual responses to the questionnaires were examined and compared, the results indicated that the students in the Intervention Group displayed more optimism and active coping skills. There was a significant increase in overall BRS scores (p value = 0.028) from pre-clinical to post-clinical scores for the Intervention Group. There was also a significant decrease in PSS scores (p value= 0.010) from pre-clinical to post-clinical. This contrasts with the Control Group who demonstrated no significant change from pre-clinical to post-clinical scores in either the BRS or PSS scores. In the first open-ended question there were groups of similarities for general beneficence, stress management, and the related group of self-care. When commenting on strategies to deal with stressful events, both groups mentioned debriefing or reflecting. However, as the Intervention Group mentioned "relaxation techniques" more frequently, this could point to a decrease in rumination, and perhaps a reframing of self-care as 'relaxing'. The process of reinforcing self-help techniques via email was supported and may have contributed to the decrease in perceived stress. CONCLUSION It appears that the content of the educational workshop, along with the regular emails, were effective strategies to influence a significance increase in resilience and a significant decrease in perceived stress in the Intervention Group. This contrasted with the Control Group who had no change in either measure. The results could indicate that the students in the Intervention Group displayed more optimism and active coping skills, and less rumination. This research adds to the emerging literature on promoting resilience in nursing students.
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