• Title/Summary/Keyword: Experience of Clinical Practice

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The Perceived Causal Structure Model on Stress Experienced by Nursing Students during Clinical Practice (간호학생의 임상실습스트레스에 관한 인지적 인과구조모형)

  • Park, Mi-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.10 no.1
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    • pp.54-63
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    • 2004
  • The purpose of this study is to identify the factors that influence stress experienced by nursing students and to provide a perceived causal structure model among these variables. The ultimate goal of this study is to develop efficient guidance to clinical nursing education in this population. This study intends to apply perceived causal structure: network analysis method which was developed by Kelly(1983), and has been applied in nursing research. This method is selected to show dynamic relationship of stressor using network method. Data was collected from convenient sample of 186 junior college nursing students who had the clinical practice experience during 10 weeks. Data collection and analysis was conducted in 2 steps from December, 9, 2002 to February, 8, 2003. Step 1.: Data was collected using literature review(10 articles) to identify the causes of stress. Nine causes of stress were extracted. Step 2.: As perceived casual structure network study, data was collected using questionnaires which included 9 extracted cause and stress. The questionnaire contained a 10 X 10 grid table with 10 causes and effects printed. In network analysis, 'Yes' was scored as 1, 'No' was scored as 0, and the mean(maximum 1, minimum 0) was calculated. Construction of the network under inductive eliminative analysis which stopped the construction of the network when the consensual agreement level dropped near 50% was proceeded by adding causes in order of the mean rating level. In this study, construction of the final network was stopped by consensual agreement level of 52% of the total subjects. The results are summarized as follows : Step 1: Investigation of the causes of stress ; The extracted causes of stress from quality data was identified 9 categories ; negative nurse, lack of clinical practice opportunity, ambiguous role, negative patient, lack of nursing knowledge and skill, difficult of personal relations, inefficient clinical practice guidance, gap of theory and practice, lack of support. Step 2 : Construction of the perceived causal structure model ; 1) The most central cause of stress is ambiguous role in the systems of causation. 2) The distal cause of stress is inefficient clinical practice guidance 3) The causes that have a number of outgoing link are negative nurse, ambiguous role. 4) The causes that have a number of incoming link are ambiguous role, gap of theory- practice, lack of clinical practice opportunity, lack of nursing knowledge- skill. 5) There is a mutual relationship between stress and difficult of personal relations, stress and ambiguous role, ambiguous role and negative nurse, ambiguous role and lack of clinical practice opportunity, ambiguous role and lack of nursing knowledge-skill, lack of nursing knowledge-skill and gap of theory- practice. In conclusion, the network suggests that the first centre cause is related on ambiguous role and the second on negative nurse, inefficient clinical practice guidance in the systems of causation

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Development of Clinical Practice Guidelines in a Hospital (병원단위의 임상진료지침 개발과정)

  • Shin, Youngsoo;Kim, Chang-Yup;Oh, Byung-Hee;Han, Kyou-Sup;Yoon, Byung-Woo;Han, Joon-Koo;Khang, Young-Ho
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.82-103
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    • 1997
  • Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

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A Study on the Nurse's Image Perceived by Nursing College Students (간호대학생이 지각한 간호사 이미지에 관한 연구)

  • Park, Mi-Hwa;Yang, Jin-Ju
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.1
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    • pp.107-121
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    • 2002
  • The purpose of this study was to identify how nurse's image was perceived by nursing college students. The subjects included were 315 students experienced clinical practice during $20{\sim}22$ weeks and 134 students not with a total of 449 nursing students in Gwangju and Chonnam. The data were collected from November 21 to December 5, 2001 by the structured questionnaires. The research tool was measured by 30 items divided into four dimensions; traditional, professional, social and personal image of nurse. Cronbach $\alpha$ for the tool of nurse's image was 0.8960. The data were analysed by SPSS 8.0 for Windows program using frequency, percentage, mean, standard deviation, t-test, ANOVA and scheffe. The results of this study were as follows; 1. In the nurse's image related to general characteristics, there were significant differences for school graduation, applicative motivation, interpersonal relationship and image forming factor. 2. In the Image forming factors, nursing college students perceived the nurse's image by visiting hospital or admission(37.9%), watching TV(25.8) and others; nurses' appearance during clinical experience(16.3). 3. The mean score for nurse's image of clinical experience group (2.76$\pm$0.28) was lower than that of non-clinical experience group(2.89$\pm$0.31) in significance (t=4.319, p=0.000). 4. In the nurse's image according to clinical experience, there were significant differences for traditional, professional, social, personal image between two groups and the lower mean scores were found in the clinical experience group in all dimensions. The ranks of dimensions were professional image(3.08), traditional image(2.76), social image(2.65), the personal image(2.59) in clinical experience group, whereas professional image(3.21), traditional image(2.93), social image(2.75), personal image(2.71) for non-clinical experience group.5. The high score items of nurse's image were 'worthwhile work(3.48)', 'always working hard(3.30)', 'profession(3.17)', 'strong responsibility toward work(3.08)', 'have a high technical skill(3.05)' in clinical experience group and 'worthwhile work(3.69)', 'always working hard(3.28)', 'clean and decent(3.22)', 'profession(3.21)', 'have a bountiful professional knowledge(3.18)' in non-clinical experience group. 6. The highest mean score for nurse's image related to the image forming factors was 86.8 by novels or literature and the second highest was 84.3 by visiting hospital or admission. And others(mean=82.1)was the most negative nurse's image by clinical experience. In conclusion, nurse's image perceived by nursing college students will be the mirror of themselves. And clinical experience will be the important opportunity to form the professional image with white uniformed nurses in future. Therefore it is important for clinical nurses to play professional roles rightly so that nursing students could form positive nurse's image.

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Effect of Nurses' Incivility Experienced by Nursing Student, Coping on Burnout in Clinical Practice (임상실습에서 간호대학생이 경험하는 간호사의 무례함, 대처가 소진에 미치는 영향)

  • Hong, Yunkyung;Kim, Younghae;Son, Hyunmi
    • Journal of Korean Academy of Nursing Administration
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    • v.22 no.4
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    • pp.323-331
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    • 2016
  • Purpose: The purpose of this study was to identify the effects of nurse's incivility experienced by nursing students and coping against incivility on burnout in clinical practice. Methods: A cross-sectional correlation study design was used. The subjects were 120 nursing student from four universities in Busan and Yangsan, South Korea. A self-report questionnaire was used to collect data on incivility, coping, and burnout. Finally total 117 nursing students' data was analyzed except 3 nursing students who had never experienced nurse's incivility for clinical practice. Data analyzed using descriptive statistics, Pearson correlation coefficient, independent t-test, ANOVA, and multiple regression. Results: 97.5% of subjects (n=120) experienced incivility. Incivility was positively correlated with seeking social support coping, avoiding focused coping and burnout. Incivility and avoiding focused coping had a significant positive effect on burnout. The explained variance for burnout was 10.0% and avoiding focused coping was the most significant factor in burnout. Conclusion: Most of nursing students experience the nurses' incivility. Judging incivility as a difficult problem to solve, students use more avoiding focused coping strategy and burnout is increased. Therefore education is needed to improve the coping strategies at incivility. Additionally colleges and hospitals should establish the formal reporting system to handle the incivility.

Korean Clinical Practice Guideline for the Treatment of Depressive Disorder(II) (한국형 우울증 임상진료지침 개발(II))

  • Kang, Rhee-Hun;Kim, Soo-Young;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.219-225
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    • 2006
  • Depression has been causing huge direct and indirect losses to people's health because of its high prevalence, various clinical patterns, drug reaction and diverse courses different among individuals, but its treatment has not been systematic but dependent on individual clinicians' experience and knowledge. To correct this problem, it has been highly necessary to develop clinical guidelines defined as "systematically developed statements to assist practitioners' and patients' decisions about appropriate healthcare for specific clinical circumstances." Currently, countries throughout the world are making efforts to establish evidence-based guidelines among different levels of guidelines and to evaluate and test them. Although such efforts have been unsatisfactory in Korea because of several constraints including lack of high-quality RCT, the Korean Depression Clinical Practice Guideline has started to develop evidence-based guidelines, which are established through strictly designed processes. Thus, the present study purposed to review methods adopted in the development processes and to present the processes of developing the evidence-based guidelines clearly and transparently.

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Nursing Students' Self-evaluation Analysis on Pediatric Nursing Clinical Practice (간호대학생의 아동간호학 임상실습 자가평가 분석)

  • Lee, Young-Eun;Park, Sun-Young;Choi, Eun-A;Kim, Eunyoung
    • Journal of Digital Convergence
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    • v.15 no.9
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    • pp.355-364
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    • 2017
  • The purpose of this study was to investigate the level of achievement and satisfaction of pediatric nursing clinical practice by nursing students' evaluation. The subjects were 115 nursing students from the K university of B city and completed the child nursing practice from February 24 to June 24, 2016. Collected data were analyzed using SPSS 18.0 program and content analysis. Nursing students' achievement of learning ability and satisfaction of clinical practice were high, and there was a significant difference in achievement of learning ability according to age. 'To feel a sense of frustration about restricted practice experience' were from self-evaluation. Therefore, it is necessary to develop a clinical practice strategy that can improve the achievement of the learning ability of the technology area and improve the satisfaction of the training institute.

Impact of Applying 'Nursing Process Program' to Nursing Practice - Based on I.C.U Nursing Practice - (임상실습에서의 간호과정 전산프로그램 활용결과 분석 - 일 간호대학의 중환자 실습을 중심으로 -)

  • Park Soon-Ok;Park Hyoun-Kyoung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.1
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    • pp.24-34
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    • 2001
  • This study was done to identify the effectiveness of applying a 'Nursing Process Program' to the nursing students' clinical practice. The data collection period was from September 2000 to January 2001, and the subjects of the study were 39 students who were doing clinical practice in the ICU. The results are as follows : 1. Most subjects had a personal computer, had experience in using computers for one year and usually did word processing and internet, and wanted computerization of nursing work. The average results of the questions on the need for, and the effectiveness of applying a 'Nursing Process Program' to clinical practice were, on five point scales, 4.07 and 4.21 respectively. 2. There were no significant differences in the mean scores for suhjects' attitudes toward computers and computer anxiety between before and after using a 'Nursing Process Program'. 3. The total case study frequency using a 'Nursing Process Program' was 68, and 'Risk for infection' was the most frequent nursing diagnosis.

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Factors Influencing Clinical Nurses' Practice of Personal Information Protection: Focusing on Knowledge of Personal Information Protection Law and Nursing Patient Advocacy (임상간호사의 개인정보보호 실천 영향요인: 개인정보보호법 지식, 옹호간호를 중심으로)

  • Kim, Dongeun;Park, Wanju
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.3
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    • pp.261-270
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    • 2023
  • Purpose: This study aimed to identify the influence of knowledge of personal information protection law and nursing patient advocacy on practice of personal information protection among nurses. Methods: The subjects were 130 nurses who have worked for six months or more in the ward of the tertiary or general hospitals. Data were collected from February 20 to March 3, 2023. Results: Factors influencing practice of personal information protection were acting as an advocate (β=.32, p=.004), environmental and educational influences (β=.21, p=.040), knowledge of personal information protection law (β=.19, p=.013) and clinical experience for five years or more but less than ten years (β=.17, p=.036). The regression model showed an explanatory power of 34.0%. Conclusion: Acting as an advocate has the most effect on practice of personal information protection. To promote practice of personal information protection for nurses, it is necessary to provide education related to privacy protection and encourage nursing patient advocacy.

The Relationship between Clinical Practice Stress, Communication Competence and Burnout in Nursing Students (간호대학생의 임상실습스트레스, 의사소통능력 및 소진과의 관계)

  • Kim, Hye-Jeong
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.433-441
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    • 2021
  • This study was carried out to provide basic data for development of a program for reducing burnout by examining the relation among clinical practice stress, communication competence and burnout. For this study, data were collected from third-year and fourth-year nursing students from one university in M city, who have experience in clinical practice, from 17th to 30th September 2020. The mean score of clinical practice stress, communication competence and burnout in nursing students was 3.08, 3.38 and 2.94 out of 5 points respectively, which means they were above the average. Clinical practice stress significantly differed depending on practice satisfaction(F=7.058 p=.001) of nursing students, and burnout showed statistically significant differences depending on age(F=5.159 p=.007), admission motives(F=3.034 p=.019) and practice satisfaction(F=7.718 p=.001). There was a significant negative correlation(r=-.223, p<.001) between clinical practice stress and communication competence, a significant positive correlation(r=.194 p<.001) between clinical practice stress and burnout and a significant negative correlation(r=-.155, p=.032) between communication competence and burnout. In conclusion, there is a need to seek educational plans for reducing burnout of nursing students and develop a program for improving their communication competence.

A Focus Group Interview(FGI) on Experience During Clinical Fieldwork of Students in Occupational Therapy (작업치료과 학생들의 임상실습 경험에 대한 포커스그룹 인터뷰)

  • Kang, Jin-Ho;Nam, Young-Ok;Oh, Myung-Hwa
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.299-309
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    • 2019
  • The purpose of this study was to investigate about student's experiences in occupational therapy through clinical fieldwork, such as the change in perception of occupational therapy, the stress that students experience, and the satisfaction of clinical fieldwork. We conducted a focus group interview with 10 participants to see what they experienced during the clinical fieldwork. The contents of the interview were recorded and conducted, and the meaning was analyzed according to the focus group interview procedure through repeated listening. Components were psychological experience, professional experience, environmental experience, changes of values, and behavioral changes. In psychological experience, he experienced anxiety and burden. Experiential experience was the connection of theory and clinical experience and realization of major knowledge. In the environmental experience, we experienced clinical guidance management system, and the change of values experienced change of perception of occupational therapy and change of perception of disabled person. Finally, behavioral changes have experienced an active response through clinical practice experience. Clinical fieldwork is a basic element that prepares students to become occupational therapists. It affects the role of occupational therapist and perception performance through various experiences in new environment. It is thought that the efforts of the institution are needed. The results of this study will help occupational therapists to direct clinical fieldwork in the right direction in clinical fieldwork.