This study was conducted to test a path model for the factors related to undergraduate nursing students' clinical practicum stress, based on Lazarus and Folkman's stress-coping model.

This study utilized a path analysis design. A total of 235 undergraduate nursing students participated in this study. The variables in the hypothetical path model consisted of clinical practicum, emotional intelligence, self-efficacy, Nun-chi, and nursing professionalism. We tested the fit of the hypothetical path model using SPSS/WIN 23.0 and AMOS 22.0.

The final model fit demonstrated a satisfactory statistical acceptance level: goodness-of-fit-index=.98, adjusted goodness-of-fit-index=.91, comparative fit index=.98, normed fit index=.95, Tucker-Lewis index=.92, and root mean square error of approximation=.06. Self-efficacy (β=−.22, p=.003) and Nun-chi behavior (β=−.17, p=.024) were reported as significant factors affecting clinical practicum stress, explaining 10.2% of the variance. Nursing professionalism (β=.20, p=.006) and self-efficacy (β=.45, p<.001) had direct effects on emotional intelligence, explaining 45.9% of the variance. Self-efficacy had indirect effects on Nun-chi understanding (β=.20, p<.001) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. Nursing professionalism had indirect effects on Nun-chi understanding (β=.09, p=.005) and Nun-chi behavior (β=.09, p=.005) through emotional intelligence. The variables for self-efficacy and nursing professionalism explained 29.1% of the Nun-chi understanding and 18.2% of the Nun-chi behavior, respectively.

In undergraduate nursing education, it is important to identify and manage factors that affect clinical practicum stress. The findings of this study emphasize the importance of Nun-chi, self-efficacy, emotional intelligence, and nursing professionalism in the development of an educational strategy for undergraduate nursing students.

The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale (NASC-CDM^©) for Korean nursing students.

Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the NASC-CDM^© were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity.

The Korean version of the NASC-CDM^© (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's α was .93 for self-confidence and .95 for anxiety.

The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students’ clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original NASC-CDM^© version.

This study was conducted to evaluate the validity and reliability of the Korean version of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES+T) that measures the clinical learning environment and the conditions associated with supervision and nurse teachers.

The English CLES+T was translated into Korean with forward and back translation. Survey data were collected from 434 nursing students who had more than four days of clinical practice in Korean hospitals. Internal consistency reliability and construct validity using confirmatory and exploratory factor analysis were conducted. SPSS 20.0 and AMOS 22.0 programs were used for data analysis.

The exploratory factor analysis revealed seven factors for the thirty three-item scale. Confirmatory factor analysis supported good convergent and discriminant validities. The Cronbach's alpha for the overall scale was .94 and for the seven subscales ranged from .78 to .94.

The findings suggest that the 33-items Korean CLES+T is an appropriate instrument to measure Korean nursing students'clinical learning environment with good validity and reliability.

The current study was aimed to investigate the transformational experience of a female student nurse living with type 1 diabetes.

A case study of a 24-year-old diabetes patient was conducted, with interviews concerning the evolving process she had lived through during the period from her later high school years to her graduation from nursing college.

Followings were identified as 5-transformation process: With her diabetes-related limitation, the participant experienced ‘ conflict involving choosing a college and major’. The participant tried to be in charge of managing her diabetes and stepped forward to ‘ adaptation to college life as a new environment’, and she learned more about the process of ‘ evolving awareness of caring’ and developed herself further through the process of ‘ integration of the nurse identity into self-identity’, and finally through the process of ‘ progression and preparation for getting a job’ she achieved her goals, being positive about the future.

The results of the study can provide individuals with diabetes a way of self-management and help the patients and their families in diabetes education. Further research will be needed to refine the results of this study and to learn more about the experiences of patients with type I diabetes in college years.

The purpose of this study was to develop a critical thinking disposition scale for nursing students.

The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year. These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's alpha with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools.

There were 35 final items which were sorted into 8 factors. The factors were identified as ‘ intellectual integrity(6 items)’, ‘ creativity(4 items)’, ‘ challenge(6 items)’, ‘ open-mindedness(3 items)’, ‘ prudence(4 items)’, ‘ objectivity(4 items)’, ‘ truth seeking(3 items)’ and ‘ inquisitiveness(5 items)’. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was .892 and the factors' ranged from .562-.836.

The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.

This study investigated changes in attitudes toward elders in general and elders with dementia after students finished a gerontological nursing practicum.

Questionnaires developed for Asian cultures were administered pre practicum, immediately post practicum, and at 8-months follow up to 31 senior students in a baccalaureate nursing program. The 1-week practicum occurred at two adult day care centers: a center for elders with dementia and a center for elders with stroke. Repeated measures ANOVA and Bonferroni correction procedures were used to analyze data.

Students' evaluation of elder vitality and flexibility increased significantly at post practicum, however this increase was not sustained at follow up. Score of generosity of elders, the only positively evaluated dimension for elders in general, improved partly at post practicum. Students evaluated flexibility and generosity of elders with dementia more negatively than general elders. All of the decreased attitudes at follow up were not significantly different from those at pre practicum.

Students had more negative attitudes toward elders with dementia. Attitudes of students in direct contact with elders with dementia were improved through the practicum regarding generosity and flexibility. However the sustainability of the immediate effect was not observed at follow up.

The purpose of the study was to categorize nursing students' subjectivity in their attitude toward their jobs, and thereby understand the differences among these attitude types.

The study used a Q-method to measure nursing students' attitude toward jobs identity types. In-depth and objective interviews and literature review formed Q sample. The P sample consisted of 25 nursing students.

The results of the study show that nursing students can be categorized into three types, depending on their attitudes toward their jobs. The firs type, “interest-oriented” students, strongly disagree to the following: giving priority to job over marriage, standing unfair treatment in the workplace, the importance of promotion opportunity, irresponsibility, and uncertainty. The “reward-oriented” students, on the other hand, strongly disagree to the following: indifference to career prospects, employment-related relocation of residence, irresponsibility, standing difficulties, and compromises with others. The third type of nursing students is the possession-oriented students, who strongly disapprove of irresponsibility, refusal to compromise with reality, standing unfair job allocation or promotion and career uncertainty.

The study on nursing college students' attitude toward their jobs is meaningful in the following aspects: First, the study clarifies nursing college students' attitudes toward their job by categorizing it. Second, the study confirms the changing attitudes of nursing students toward jobs with the change of times and calls for proper educational programs to foster healthy career attitudes. Third, proper decision-making as regards jobs and job allocation for nurses, or their career attitudes, is beneficial to individuals, the medical industry, and society.

The aim of this study is to explore the variation in perceptions about problem-based learning(PBL) according to the level of academic achievement and learning attitude in the nursing students of a junior college (3-year program).

Students (n=39) learned the respiratory and cardiac system with seven PBL packages and group-based learning for a semester in 2002. Students were asked to write reflective journals that focused on their learning perception after an experience with each learning package. A total of 208 journals were used for analysis.

Students positively perceived that PBL making them increase their sense of responsibility for learning and felt satisfaction with the learning process, and had a confidence in the use of clinical nursing interventions. On the other hand, they negatively perceived that PBL was a burden because it took more time than traditional learning tasks, and they experienced an anxiety about regular tests and felt conflicts and diffidences in the learning process. The negative perceptions were expressed more often from students with a low academic achievement and low learning attitude compared to others.

Students perceived the PBL as effective in understanding the learning concepts in the clinical practice environment. PBL need to be supplemented by feedback-based lecture and facilitative strategies for academically low-achieved students.

The primary purpose of this study was to reexamine underlying dimensions of attitudes toward the elderly held by undergraduate nursing students. A secondary purpose was to investigate characteristics of nursing students associated with attitudes toward elders.

A survey was performed using self-report questionnaire completed by nursing students from a total of 10 nursing schools or departments each selected randomly from one province of Korea. Students' responses (N=366) were analyzed using factor analysis, correlation coefficients, t-test, and ANOVA.

Three attitudinal dimensions explaining 35.29% of the variance were extracted: vitality, generosity and flexibility. From a neutral point of 4.0 in the range of 1 to 7, only generosity (4.47) was evaluated positively, whereas vitality (3.31) and flexibility (2.91) were evaluated negatively. The mean scores of the vitality and generosity dimensions were significantly different by students' level of communication with the elderly, experience living with the elderly, and interest in elders or in issues related to elders. Interest in elders/elder issues was the only characteristic affecting significant mean score difference in flexibility.

Educational process should increase students' exposure to healthy elderly to modify negative attitudes toward the elderly among nursing students.

Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decisionmaking that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care.

Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software.

Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes.

This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.

This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education.

Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students’ skill training, and evaluators’ training. Forty-eight senior nursing students (25 in the experimental group and 23 in the control group) participated in the simulation-based ELC education using a high-fidelity simulator. Debriefing based on the clinical judgment was compared with the usual debriefing.

ANCOVA showed that there were differences in knowledge (F=4.81, p=.034), skill performance (F=68.33, p<.001), clinical judgment (F=18.33, p<.001) and self-confidence (F=4.85, p=.033), but no difference in satisfaction (t=-0.38, p=.704) between the experimental and control groups.

This study found that debriefing based on the clinical judgement model is effective for supporting nursing students for reflecting on clinical judgment and improving their diverse competencies in complex clinical settings such as ELC.

This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014.

Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression.

An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870).

To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future.

This study aimed to test a proposed structural equation model in which bullying experience, conflict management styles and psychological empowerment predict psychological well-being among Chinese nursing students in clinical placement.

Three hundred and sixty-six nursing students recruited from five hospitals in J city and Y city were assessed with self-report questionnaires on bullying experience, conflict management styles, psychological empowerment and psychological well-being including depression, self-esteem, and academic major satisfaction. Data were analyzed using SPSS version 20.0 and AMOS version 22.0.

The evaluation parameters included the comparative fit index at .90, the goodness of fit index at .93, the root mean square error of approximation at .07, and c²/df ratio at 2.66, indicating that the proposed structural equation model provided a good fit to the data. Experience of being bullied during clinical placement, conflict management styles and psychological empowerment explained 93.0% of the variance and had significant effects on psychological well-being, with conflict management styles and psychological empowerment mediating the association between bullying and psychological well-being.

The findings indicated that mediation by conflict management styles and psychological empowerment alleviated the negative influence of bullying on psychological well-being. To limit bullying and its negative effects, development of effective guidelines to deal with bullying will be a critical tool for both Chinese nursing students and their instructors. Further research should incorporate conflict management styles and psychological empowerment into the specific intervention strategies for handling bullying behaviors among nursing students and staff nurses and promoting nursing students’ psychological well-being.

This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students.

In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group non-synchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing.

Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers.

The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.

This paper was conducted to validate the Korean version of the Peer Group Caring Interaction Scale (PGCIS-K) that measures caring behaviors as experienced by nursing students.

Translation of the PGCIS-K was validated through forward-backward translation methods. Survey data were collected from 218 nursing students in a nursing school. Construct validity and criterion-related validity were evaluated. Internal consistency and the Guttman split-half coefficient were calculated to assess reliability.

The PGIS-K showed reliability except for 4 items (Cronbach's α=.91, Guttman split-half coefficient=.85), which were low (<.30) or negatively correlated with the total scale. A 12-item reduced form of the PGCIS-K was developed by item-analysis and construct validity evidence. Factor loading for the 12 items on 2 factors ranged from .47~.82, which explained 58.4% of the total variance. Two factors were named 'modeling and assistance (Cronbach's α=.87)' and 'communication and sharing (Cronbach's α=.82)'. Convergent validity, discriminant validity, and criterion validity were supported according to the correlation coefficients of the 2 factors with other measure.

The findings suggest preliminary evidence that the 12-item PGCIS-K can be used to measure nursing students' peer group caring interactions in Korea. Additional studies are recommended to continue the psychometric evaluation of this scale. Also, it can be extended to measure graduate nursing students or staff nurses' peer group caring interaction.

This study was conducted to examine effects of a learning portfolio by identifying the learning of nursing students taking a learning portfolio-utilized nursing management class.

A non-equivalent control group pretest-posttest design was used. Participants were 83 senior students taking the nursing management course in one of the Departments of Nursing at 2 Universities. Experimental group (n=42) received a learning portfolio-utilized nursing management class 15 times over 15 weeks (3 hours weekly). Self-directed learning abilities, approaches to learning and learning flow of the participants were examined with self-report structured questionnaires. Data were collected between September 2 and December 16, 2014, and were analyzed using chi-square test, Fisher's exact test, independent t-test and ANCOVA with SPSS/PC version 21.0.

After the intervention the experimental group showed significant increases in self-directed learning abilities, deep approaches to learning and learning flow compared to the control group. However, no significant difference was found between groups for surface approaches to learning.

Learning activities using the learning portfolios could be effective in cultivating the learning competency for growth of knowledge, technology and professionalism by increasing personal concentration and organization ability of the nursing students so that they can react to the rapidly changing environment.

This methodological study was conducted to develop and test a cultural competence scale for nursing students.

Based on the five constructs of cultural competency identified in the conceptual analysis of Suh, 76 items for the tool were derived initially. These items were reduced to 58 items after content validity tests (two times) by 6 multicultural experts. Data collected from 526 nursing students were utilized to test the validity and reliability of the preliminary tool. Item analysis, factor analysis, Pearson correlation coefficients, and Cronbach's alpha were used for the analysis.

Twenty-seven items were selected for the final scale, and categorized into 5 factors explaining 62.1% of the total variance. Cronbach's alpha was .91 and the reliability of the subscales ranged from .76 to .91. Criterion validity between the developed tool and empathy (r=.26, p <.001) was significant.

The results show that this scale can provide scientific and empirical data when evaluating the effectiveness of school curriculums or multicultural empowerment programs regarding cultural competence of nursing students.

To develop a Critical Thinking Skill Test for Nursing Students.

The construct concepts were drawn from a literature review and in-depth interviews with hospital nurses and surveys were conducted among students (n=607) from nursing colleges. The data were collected from September 13 to November 23, 2012 and analyzed using the SAS program, 9.2 version. The KR 20 coefficient for reliability, difficulty index, discrimination index, item-total correlation and known group technique for validity were performed.

Four domains and 27 skills were identified and 35 multiple choice items were developed. Thirty multiple choice items which had scores higher than .80 on the content validity index were selected for the pre test. From the analysis of the pre test data, a modified 30 items were selected for the main test. In the main test, the KR 20 coefficient was .70 and Corrected Item-Total Correlations range was .11-.38. There was a statistically significant difference between two academic systems (p=.001).

The developed instrument is the first critical thinking skill test reflecting nursing perspectives in hospital settings and is expected to be utilized as a tool which contributes to improvement of the critical thinking ability of nursing students.

This study was done to identify the awareness of gender equality among nursing college students, and to provide basic data for educational solutions and desirable directions.

A Q-methodology which provides a method of analyzing the subjectivity of each item was used. 34 selected Q-statements from each of 20 women nursing college students were classified into a shape of normal distribution using 9-point scale. Subjectivity on the equality among genders was analyzed by the pc-QUANL program.

Four types of awareness of gender equality in nursing college students were identified. The name for type I was 'pursuit of androgyny', for type II, 'difference-recognition', for type III, 'human-relationship emphasis', and for type IV, 'social-system emphasis'.

The results of this study indicate that different approaches to educational programs on gender equality are recommended for nursing college students based on the four types of gender equality awareness.

This study was conducted to develop an e-Learning program that assists nursing students' clinical practice in operating room nursing and to examine the learning effects.

Based on content and need analysis, 9 learning modules were developed for nursing care in operating rooms and with operating equipment. To verify the effects of the program, a quasi-experimental pretest-posttest control group design was employed. The participants in this study were 74 third-year nursing students (34 in the experimental and 40 in the control group) from a junior college in G-city, Korea, who were engaged in a one week clinical practicum in an operating unit. Frequencies, χ²-test and t-test with the SPSS program 17.0 were used to analyze the data.

Knowledge was significantly higher in the experimental group compared to the control group (p=.018). However, there was no significant difference between the two groups in self-directed learning. The experimental group had significantly higher motivation toward learning, which was examined posttest only (p=.027).

These results indicate that the implementation of an e-Learning program needs to be continued as an effective educational tool, but more research on the best way to implement e-Learning in students' practicum is needed.

This study was done to identify self-directed learning readiness, achievement goal orientations, learning satisfaction and learning achievement, and to evaluate the factors affecting learning achievement for nursing students using a web-based Health Assessment e-Book.

The research design was a cross-sectional study with a structured questionnaire and data were collected before using the web-based Health Assessment e-Book and 1 week after finishing. The participants were 80 nursing students who were taking the Health Assessment class from March to June 2009.

Mean score for subjective learning achievement was 31.26 and for objective learning achievement, 69.25. Subjective and objective learning achievement were positively correlated with self-directed learning readiness, mastery goal, attitude toward distance education, and learning satisfaction. In subjective learning achievement, learning satisfaction and mastery goal were significant predictive factors and explained 64% of the variance. Objective learning achievement was significantly predicted by learning satisfaction and self-directed learning readiness, which explained 24% of the variance.

Learning satisfaction, mastery goal and self-directed learning readiness were found to be very important factors associated with learning achievement for nursing students using a web-based Health Assessment e-Book. To provide high quality and effective web-based courses and to improve nursing students' learning achievement and learning satisfaction, educators should consider the learner's characteristics from the initial stages of lecture planning.