Nursing education refers to formal learning and training in the science of nursing encompassing of both theory and clinical aspects to accelerate the patient’s return to normal health. Clinical nursing is one among the critical parts in nursing profession that determines the clinical competences among nurse students. Its impact is not limited to grades but also to the extent a student nurse delivers quality and cost-effective clinical services that are appropriately to each patient’s condition. A number of factors have been implicated to affect nurse student’s competency on clinical nursing.

Objective: Current study intended to assess perception and attitude of clinical nursing among student nurses in Nigeria.

Method: The study employed analytical cross-sectional study with quantitative research approach that involved 488 randomly selected respondents from eight nursing training institutions in Enugu state, Nigeria. Self-administered semi-structured questionnaires were the main data collection tools. Statistical Package for the Social Sciences (SPSS version 23) was used for data entry, cleaning, processing and analysis.

Results: Study revealed that 51 % of the respondents had a low perception towards clinical nursing while 49% had a high perception. The results of the fitted model revealed that, the odds of female student nurses were 6.737 more times likely to have high perception on clinical nursing than male students (AOR: 6.737; 95% CI: 1.63; 4.75, p= 0.008). Clinical nursing perception was also affected by living in campus (AOR: 43.8; 95% CI: 34.2; 54.4, p= 0.001) and studying in urban (AOR: 0.008; 95% CI: 0.01; 0.066, p= 0.001) area.

Conclusion: Factors like gender, location of training institution and staying in or out campus have positive influence on positive perception of diploma nurse students on clinical nursing. It is therefore recommended to seriously consider these aspects in order to build and produce very competent and motivated nurse graduates into nursing practices.

Key words: clinical competence; perception; student nurses; training

• Background information
Nursing education refers to formal learning and training in the science of nursing and includes the functions and duties in the physical care of patients and combination of different disciplines that both accelerate the patient’s return to health and to maintain it (Bigdeli et al., 2015).

Nursing education internationally and nationally has gone through many changes from what it is today. These various changes; Technological, Emerging diseases, political diversity and population growth, have driven to meet the need of the individuals, families, communities, stockholder’s and customers who are to be served within the country as well as outside the country (Mohamed et al., 2016).

To accommodate these changes student nurses need to be well prepared and informed especially on the aspect of perception and attitude of clinical nursing through good clinical nursing with clinical evidences, critical thinking and judgment in order to provide a reasonable care to patients. (Müller, 2010).

In reflection to inadequate clinical nursing at clinical settings, public complaints have progressively been thrown against nursing practices which in turn denotes that there might be something missing in preparing them (Müller, 2010). Historically, student nurses faced many factors on theoretical and clinical setting during their study years due to a ‘learn on the job’ apprentice style of education (Karabulut, 2015b). Various studies (Cook & Polgar, 2015; Hunt et al., 2012; Melnyk et al., 2012) have studied the progressive gap between social demographic characteristics and perception in nursing and came up with a number of factors contributing to it including lack of qualified faculty, and clinical mentors. Other factors include unqualified clinical instructors or preceptors (who are even not able to motivate, support and mentor nurse students to clinically learn effectively), inadequate medical supplies and equipment and limited time to practices.

Diploma student nurses are also known to have a limited perception of their actual clinical practice which is a cornerstone during nursing education process (Hunt et al., 2011). Therefore it is of interest to examine how student nurses perceive whether positively or negatively in clinical nursing environments that they have assigned as a learning part of training in nursing education (Bigdeli et al., 2015).

Despite that little has been demonstrated on the influence of nurse students’ socio- demographic traits and perception on clinical nursing which if well explored would contribute much on the extent nurse students practice in clinical settings (Natarajan et al., 2017). Previous study findings (Ibrahim, 2014; Jones, 2014) indicate that perception has posed a lot of confusion to the student nurses on connecting what they learnt in the classroom as they found to be very different from what was trained in clinical areas. The trend existed to an extent nurse student felt a progressive theory- practice gap which led them fail to integrate well what they learnt in classroom and that of clinical settings (Hunt et al., 2012).

Nurse students still exhibit clinical traits that indicate they may either not positively motivated to practice in clinical settings or they get limited clinical support or what they have learnt in the classroom do not match with what is found in the clinical settings (ANA, 2010; UBC, 2015). Moreover, previous reported findings, reveals the perception that graduate nurses are under prepared for clinical practice which was influenced by a multiplicity of perceptions among nurse students themselves towards clinical learning (Woods et al., 2015).

Nigeria as one among the developing country is also facing the challenge of unsatisfactory clinical nursing resulted from inadequate well-prepared instructors, unsatisfactory clinical learning environment and clinical rotations which are very limited (TNMC, 2014). Available locally literatures (Fisher, 2009; Karabulut, 2015) indicate that the level of readiness and intrinsic motivation of nurse students to practice full in clinical learning is low due what is noted to be the ways they have been perceived, supported, mentored and coached for better clinical competencies.

• Statement of the Problem
There is an extensive gap of perception and attitude among Diploma Student nurses in regard with clinical nursing. This is evident due to the fact that majority of student nurses who perform clinical examination have a negative perception which ranged 53% to73% (Hunt et al., 2011).

Nigeria has made various intervention to overcome the existing gap of unsatisfactory clinical nursing as influenced by students perception, these includes the development of clinical nursing guide which aims at empowering clinical instructors with essential clinical teaching skills (Ismail et al., 2015). From this fact, it is well known that nurse students are well supervised, mentored and supported in clinical settings for them to be competent enough to deliver appropriate, quality and cost-effective care to people (Hunt et al., 2011).

Despite of those interventional done by the government through Ministry of Health Community Development, Gender, Elderly and Children, the problem of unsatisfactory clinical nursing among diploma nurse students is still existing (TNMC, 2014). Therefore, the purposes of this study intended to explore perception and attitude of clinical nursing among student nurses in eight nursing training institutions in Nigeria.

• Research Objectives
• Broad Objective
To explore perception and attitude of clinical nursing among student nurses in Nigeria.

• Specific Objective
• To assess levels of perception on clinical nursing among student nurses at Enugu State University Teaching Hospital, Park Lane, Enugu state, Nigeria

• To determine the influence of socio-demographic characteristics on clinical nursing among student nurses at Enugu State University Teaching Hospital, Park Lane, Enugu state, Nigeria

• Research question
• What are the levels of perception of student nurses on clinical nursing at Enugu State University Teaching Hospital, Park Lane, Enugu state, Nigeria?

• Is there any association between socio-demographic characteristics and perception among student nurses at Enugu State University Teaching Hospital, Park Lane, Enugu state, Nigeria?

• Significance of the study
Adressing how perception might affect student nurses’ acquisition of clinical knowledge, skills and professionalism in nursing is very crucial in training diploma

nursing student as it assist in identifying the constraints that hinder the delivery of quality and cost-effective services to patients. Findings of the current study would help to inform policy makers, Ministry of Health Community Development Gender Elderly and Children, program and curriculum developers as well as other stakeholders on the problem under study so that they can revisit the existing curriculum implementation and solve it especially in clinical settings.

Moreover, the current study findings would create awareness among professional, nurse tutors, lecturers, clinical instructors, mentors and clinical preceptors on the possible educational and assessment methods which are friendly to a student for them to develop positive perception on clinical performance.

To nurse students, findings will help them perceive clinical practices and examination as a means for them to get a head of their academic and profession careers. By doing all these it would ultimately improve the well-being of individuals, family and community as a whole.

• Limitations of the study
This study faced by some limitations that the researcher acknowledges them. These include the issues of;

Small sample size to generalize the findings

Studying only diploma nurse students could lead to information bias

Studying government and non-government owned training institutions at the same time could lead into information contamination and errors.

The researcher addressed this limitation by sampling nursing training institutions with adequate expertise for easy consultation and review of the research tools. Moreover, the analytical cross-section study design which was employed in the current study, constraint the in-depth study of the topic under study for the researcher to describe the real phenomena on clinical teaching in reflection to the clinical examination performance as perceived by diploma nurse students.

Despite that the researcher tried to involve as many nursing training institutions as possible (for this case eight institutions were involved). Data were collected at a single point of time by using self-administered structured questions which was prone to information bias on the ways to assess skills. To address this limitation the research constructed skills question to match with the intended outcome of interest.

Use of nonprobability sampling techniques might increase the risk of biases (selection, information and measurement biases). To control the limitation, the researcher included nurse students available during the study time. The minimum sample size calculated in the current study was not enough to generalize the study findings, the researcher addressed this limitation by calculating attrition rate in order to add (double) the sample size.

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Item Type: Project Material  |  Size: 34 pages  |  Chapters: 1-5
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