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Objectives: This research aims to explore the perceptions of nursing students and directors of bachelor of nursing degree courses regarding reasons for attrition amongst nursing students., Methods: A qualitative descriptive study was conducted using inductive thematic analysis. The study included a purposeful sample of 12 students and 4 directors of bachelor of nursing degree courses., Results: As reasons for attrition, the directors highlighted a lack of preparation for nursing studies and students' limited awareness of possibilities for support and learning. The students emphasized insufficient support from academic staff and poor course organization. Economic and family issues and a misunderstanding of the professional role of a nurse were cited as reasons by both directors and students., Conclusions: The findings provide important insight into attrition in the nursing programme. Further research is warranted, particularly in other contexts. Addressing student attrition requires a comprehensive approach that includes the provision of adequate support systems, mentorship, and resources for students., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Aim: To test the mediating role of burnout in the relationship between self-efficacy and academic success in nursing students., Design: This was a cross-sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students., Methods: We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018-2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self-Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed., Results: The participants (n = 556) had a median age of 20 years (IQR 19-22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self-efficacy on academic success and also a significant indirect effect of this relationship via burnout., Conclusion: The mechanism by which self-efficacy influences academic performance in nursing students is more complex than a simple direct relationship. Universities should consider screening students for variables affecting academic success to decrease academic costs and increase ranking systems classification., Impact: Nurses' professors should be engaged in strategies to promote self-efficacy. The area of intervention should be structured both during classes and internships, in tandem with the mentor and the clinical nurse., (© 2022 John Wiley & Sons Ltd.)

Student academic satisfaction is one of the most important factors affecting the success and quality of a higher education institute and is an indicator about teaching and learning. This study aims to summarize and critically evaluate the instruments assessing academic satisfaction in nursing education. A systematic review was undertaken, PRISMA were used for the screening of studies. MEDLINE, Cochrane, Scopus and CINAHL were searched using MeSH terms; seven eligible articles were identified referring to five assessment tools. COSMIN was used for evaluation of the methodological of the instruments. The systematic review identified five satisfaction measurement tools used in nursing education. The analysis of the instruments rarely considered a confirmative validity structure, measurement error or criterion validity. The best available instrument was the Nursing Students Satisfaction Scale (NSSS) for validation methodology; however, it needs further validation studies that consider CFA, reliability, criteria validity, hypothesis testing and measurement error., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Moral distress, defined as moral suffering or a psychological imbalance, can affect nursing students. However, many new instruments or adaptations of other scales that are typically used to measure moral distress have not been used for nursing students., Aim: This study aimed to translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Moral Distress Scale for Nursing Students (It-ESMEE) for use with delayed nursing students (students who could not graduate on time or failed the exams necessary to progress to the next level)., Research Design: The study used a cross-sectional research design., Participants and Research Context: Incidental sampling resulted in a sample of 282 delayed nursing students (mean age = 26.73 ± 4.43 years, 73% female) enrolled between May and August 2020 in a University of central Italy., Ethical Considerations: The research protocol was approved by the internal review board of the university, and all participants provided their written informed consent., Results: The study confirmed a multidimensional second-order factorial structure for the It-ESMEE with five dimensions: improper institutional conditions to teach user care, authoritarian teaching practices, disrespect for the ethical dimension of vocational training, lack of competence of the teacher and commitment of ethical dimension of user care. The internal consistency was high (0.753-0.990 across the factors), and the standard error of measurement and smallest detectable change were adequate., Discussion: The It-ESMEE is able to assess moral distress in delayed nursing students with good validity and reliability. It can be used in research and to determine moral distress levels, helping teachers to monitor the condition in nursing students., Conclusion: This instrument can help in comprehending moral distress, enabling students to develop coping and intervention strategies to maintain their well-being, and to ensure the quality of nurse education.

Objectives: To develop a self-report scale to measure academic motivation among nursing students and to test its psychometric properties., Methods: a cross-sectional validation study with a convenience sample of nursing students (n=1,635) was performed. The Motivation Nursing Students Scale was developed; content, face, construct validity, hypothesis testing and reliability were evaluated., Results: The validity structure revealed a four-factor solution and the model reached a satisfactory fit (χ 2 =622.835 df=160, p<0.01, CFI=0.90, TLT=0.83, RMSEA=0.060 (90% [CI] 0.055-0.064, p=0.001, SRMR=0.067). The hypothesis testing was confirmed with a positive correlation of the academic self-efficacy with Introjected, Intrinsic motivation and a negative correlation with Amotivation., Conclusions: We verified a link between academic self-efficacy and motivation. Both motivation and self-efficacy may increase academic achievement and the possibility for HEIs to degrees a number of students in line with demands., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Aims and Objectives: To describe the sociodemographic and academic characteristics of nursing students who report academic failure and to identify the determinants of academic failure (no degree on time) in a population of nursing students., Background: Although prior studies have shown that academic failure is influenced by multiple factors, the studies mentioned have mostly focused on specific single variables associated with academic failure, and they have reported inconsistent results., Design: A prospective follow-up study design was used in an Italian Baccalaureate Nursing Degree program. A total sample of 2,040 at baseline and a random subsample of 753 students were considered for academic failure determinants. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology)., Methods: We included in the model academic background, self-efficacy, sociodemographic variables and self-efficacy in psychomotor skills and motivation. We used the Academic Nurse Self-Efficacy Scale (ANSEs), the Nursing Self-Efficacy in Psychomotor Skill Scale (NSE-PS) and the Motivation Nursing Students' Scale (MNSS) which have been validated on nursing students. For the assessment of predictors of academic failure, a two-stage hierarchical logistic regression analysis was performed., Results: Students who had academic failure were 69.4% of the sample. Predictors of academic failure were the secondary school certification grade, the university pre-admission test score; the academic self-efficacy, self-efficacy in psychomotor skills and clinical training examination grades were additional predictors., Conclusions: The secondary school certification grade, the University pre-admission test score, low academic self-efficacy, low self-efficacy in psychomotor skills and low clinical training examination grades were predictors of academic failure in nursing students., Relevance to Clinical Practice: Our findings suggest that the universities could consider a cut-off in the pre-admission test score as a critical value for identifying students who are likely to fail. In addition, nursing faculty staff should consider strategies for developing self-efficacy and motivation., (© 2021 John Wiley & Sons Ltd.)

Background: Student satisfaction is one indicator of quality in higher education, allowing access to funding and coming with repercussions on student performance. This theme is considered complex and highly studied; however, in the nursing literature, there are no studies that summarize and combine the variables and predictors of satisfaction, as well as the existing conceptual models., Purpose: The purpose of this study is to define the following: 1) nursing students' academic satisfaction, 2) the existing theoretical models, 3) the academic satisfaction trend during the course, 4) the differences in academic satisfaction level between nursing student characteristics, and 5) the variables involved in the satisfaction process., Methods: An integrative review using Whittemore and Knafl's (2005) methodologies was conducted. The electronic databases CINAHL, PubMed, Cochrane, and Scopus were used. Two reviewers independently conducted the quality appraisal of the selected studies using the checklist proposed by Edwards (2015) and the Joanna Briggs Institute (JBI) tool., Findings: Nineteen papers were included. The articles were published between 1990 and 2018., Conclusions: The review highlights the lack of a shared conceptual framework to guide the empirical research in the nursing degree field. Four dimensions that predict satisfaction with the curriculum have been identified: faculty, curriculum, social, and development., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Aim: To analyse any changes seen in the academic self-efficacy of nursing students during the three years of their academic education as well as the associated predictive factors., Design: A longitudinal study design was applied., Methods: The sample included 220 students who attended a large university in central Italy. The students' academic self-efficacy was measured using the Academic Nurses' Self-Efficacy Scale. Data were collected annually from 2014/2015 to 2017/2018 at the beginning of the first year (T0), at the end of the first year (T1), at the end of the second year (T2) and at the end of the third year (T3). A repeated measure univariate analysis of variance (ANOVA) was conducted to detect any possible changes in the students' academic self-efficacy scores over the four measurement points. To identify the factors that are predictive of academic self-efficacy, a linear regression model was used., Results: Overall, the students' academic self-efficacy did not change significantly over the three-year period of their education. Both sex (female) and age (24-50 years) during T0-T2 significantly predicted changes in the students' academic self-efficacy over time. Moreover female students started with lower academic self-efficacy scores than male students, although their academic self-efficacy increased over time, while the male students' academic self-efficacy actually decreased over time. In addition, students with a scientific background reported higher academic self-efficacy than other students., Conclusions: Although the students' academic self-efficacy did not change over time, from a theoretical perspective, academic self-efficacy can be developed using a number of strategies such as a well-organised tutorial during the clinical learning phase and feedback or encouragement., Impact: Academic staff should monitor nursing students' academic self-efficacy over time, particularly in the case of male and younger students, students with a partner and students with a humanities background during the first 2 years of the course., (© 2021 John Wiley & Sons Ltd.)

Aims and Objectives: To examine nursing students' health habits. More specifically, the objectives were to determine whether there were any changes in their health habits during their course of study, and to understand whether the students' perceptions about good health conditions cohered with their health-related behaviour., Background: The transition from high school to university has an undesirable effect on students' health habits, and nursing students' unhealthy behaviours may prevent them from helping patients improve their poor health habits., Design: A longitudinal design was used. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology)., Methods: All students were recruited from a nursing science degree course in an Italian university. The sample consisted of 351 nursing students. Data were collected at the baseline during their entrance into the university (T0) and at the end of their third year of coursework (T3). We developed the Nursing Student Health Habits Scale, which was administered by a trained researcher. The McNemar test and the Wilcoxon signed-rank test to evaluate the differences in health habits between T0 and T3, and a logistics model to assess the factors influencing students' good health perceptions were used., Results: From T0 to T3, there were decreases in the number of students who requested physician consultations (p = .01) and increases in those who exercised daily (p = .003). There was also a change in the nutrition model (p = .018). In the multivariate model, physician consultations for medical problems and performing physical exercise were factors influencing good health perceptions., Conclusions: Future research is needed to illuminate other aspects of students' health habits., Relevance to Clinical Practice: Universities are advised to address these problems by reflecting on undergraduate and postgraduate curriculum content concerning health management and disease prevention., (© 2020 John Wiley & Sons Ltd.)

Background and Purpose: Perceptions toward nursing diagnosis (ND) may represent core drivers of its adoption within clinical practice. Few studies have investigated perceptions toward ND within nursing academic contexts. The study was conducted to validate the Italian version of the Minnesota Nurses' Perceptions of Nursing Diagnoses (MNPND) scale on a sample of Italian nursing students and explore the psychometric structure of perceptions in a sample drawn from this population., Methods: A cross-sectional survey with an online self-administered questionnaire was used. The study used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)., Results: A three-factorstructure was obtained from parallel analysis and EFA. This was confirmed using CFA; fit statistics: MLRχ² (132) = 230.150, p <. 001; CFI = 0.94; TLI = 0.93; RMSEA = 0.05 [90% CI = 0.041-0.064]; SRMR = 0.056)., Conclusions: The MNPND scale is a useful instrument to measure nursing students' perceptions of ND., (© Copyright 2020 Springer Publishing Company, LLC.)

Background: University time is considered to be a period of vulnerability among nursing students for substance abuse, which can create an unsafe clinical practice. The aim of this study was to investigate the substance abuse of nursing students in the form of alcohol, drugs and tobacco use during the course of studies. In addition, another study aim was to describe a typical socio-demographic profile for substance-abusing students., Methods: A longitudinal study design based on a sample of 254 nursing students was used. Data from the same cohort of students at the baseline level (T0), at the end of the first year (T1), at the end of the second year (T2) and at the end of the third year (T3) were analysed., Results: A decrease in the number of nursing students who smoke regularly, an increase in the number of those who use drugs to lose control and of those who drink weekly were found., Conclusion: The early recognition of substance-abusing students can be fundamental to their health, academic background and safe clinical practice.

Background: Self-employment represents a new work opportunity for new nursing graduates; however, little is known about nursing students' Intention to meet this new demand from the labour market., Aims: To develop a theory-driven questionnaire to assess students' Intentions for self-employment and psychometrically test this scale., Method: A cross-sectional study was conducted investigating 344 nursing students in their final year in an Italian university. The content, face, construct, convergent and discriminant validity, and reliability were evaluated. We also tested the theory of planned behaviour., Results: The Planned Self-Employment Scale demonstrated satisfactory validity and good reliability. A moderate Intention to be self-employed emerged among nurses (3.6 ± 1.5 out of 7). This level of Intention was predicted by the Attitudes and Perceived Behaviour Control dimensions., Conclusion: The Planned Self-Employment Scale exhibited good validity and reliability and can thus be used with nursing students., Implications for Nursing Management: Educators need to design a curriculum to improve students' decision-making and autonomy. At the central level, there is a need to produce guidelines that offer guidance to both nurses and patients, as well as the system as a whole with regard to this new form of nursing service., (© 2020 John Wiley & Sons Ltd.)

Aims: An available strategy to counteract academic failure is the development and implementation of student academic self-efficacy; however, to date, there are no instruments measuring it. The aim of this study was to develop and psychometrically test an academic nurse self-efficacy scale., Design: A longitudinal study design was used in accordance with Consensus-based Standards for the Selection of health status Measurement Instruments guidelines., Methods: A convenience sample of 1,129 nursing students attending the first year of the course were involved. The data collection began in 2014 and went on for 3 years. Data were collected at the beginning of the first (T0), at the end of the first (T1), at the end of the second (T2), and at the end of the third (T3) year. The academic nurse self-efficacy scale was evaluated for content and face validity, for construct validity with explorative, confirmative factor analysis and hypothesis testing and for reliability. The standard error and the smallest detectable difference were also evaluated., Results: Scree plot analysis suggested a four-factor solution and confirmative factor analysis model reached a good fit. We verified the first hypothesis, partially the second and not the third. The dimensions show a Cronbach's α 0.72-0.83. The smallest detectable difference was 26%., Conclusions: The academic nurse self-efficacy scale had good validity and reliability and should be considered for nursing students., Impact: These findings may have an impact on universities, mainly in nursing degree programmes because nurse educators can identify nursing students with low academic self-efficacy and help them in their academic duties. Indirectly, academic self-efficacy monitoring can be used for evaluating the effect of different teaching strategies or mentorship support over time., (© 2019 John Wiley & Sons Ltd.)

Considering the ethical issues related to nursing and that Ethics is an integral part of the nursing education in the degree course, one would suppose that academic dishonesty might be less frequent in nursing students than in students of other disciplines. However, several studies show that this trend of deceitful behaviour seems to be similar among the university nursing students and those of other disciplines. The aim of this study is to investigate the phenomenon of academic dishonesty in the classroom from a longitudinal perspective within a cohort of Italian nursing students. A non-experimental longitudinal design was used. All nursing students were recruited from the Nursing Science Bachelor Degree Program of a big Italian university in the centre of Italy and participants were part of an ongoing longitudinal research project which started in 2011 on nursing students' wellbeing. The results show that students get accustomed to taking academically deceitful actions. They come to consider their behaviours acceptable and normal, thereby stabilizing them, which increases the probability of stabilizing subsequent deceitful behaviours. The stability through time of academic cheating behaviours committed during higher education, within the study's timeframe, provides important perspectives into the establishment of rigorous standards of ethical and moral behaviours by the students., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Aim: The evaluation of academic education has become crucial in the European Union since the Bologna Process encouraged all European universities to reach high quality standards in education. Although several studies have been conducted on the quality of undergraduate nursing education, few studies have explored this topic from the students' perspective. The purpose of this study was to describe the experience of educational quality in undergraduate nursing students., Method: The phenomenological method was used to study 55 students (mean age 24 years; 73% female) pursuing a baccalaureate degree in nursing in three universities in central Italy., Results: The following five themes emerged from the phenomenological analysis: 1) quality of faculties: teaching skills, preparation, sensitivity to students, self-discipline; 2) theory-practice integration and communication between teaching and clinical area; 3) general management and organization of the programme; 4) quality of infrastructures: libraries, classrooms, information technology, services, administration, and communication; and 5) clinical tutorship: humanity, relationships and ability of the clinical tutor to guide and support., Conclusion: This study's novel finding was a deeper understanding of the educational quality's meanings among undergraduate nursing students. Students thought educational quality consisted of the faculty members' sensitivity towards their problems and the clinical tutors' humanity, interpersonal skills, guidance and support.

Aims: The objectives of this study were first to develop a valid and reliable instrument that measured the sensitivity of Italian nursing undergraduates, and, second, to conduct an observational study in second- and third-year Italian nursing students to provide new insight into the efficacy of nursing ethics education to develop ethical sensitivity., Methods: A quantitative, descriptive, observational pilot study was conducted in two Italian universities. To investigate the students' sensitivity, a brand new scale entitled "Ethical sensitivity scale undergraduates nursing students" (ESS-UNS) was produced. Twenty items that referenced the principles of the Italian Nursing Code of Ethics were identified (2009)., Results: The measured exploratory factorial analysis outlined a two-factor solution. Based on the semantics of the items, the first dimension was named "Ethical sensitivity as a positive attitude" and it was created to detect the perceptions and opinions of the students regarding good behaviours in nursing. The second dimension was named "Ethics sensitivity as a negative attitude" in virtue of the perceptions of the students regarding the behaviours considered ethically negative., Conclusions: The added value of our study is in the verification that academic ethical education significantly increases students' awareness regarding the possible ethical violations observed and lived in during clinical training. This can help students understand and identify the ethical conflicts in relationship with their moral maturity.

To evaluate all the variables that affect nursing education is important for nursing educators to have valid and reliable instruments that can measure the perceived quality of the Bachelor Degree in Nursing. This study testing the Scale for Quality Evaluation of the Bachelor Degree in Nursing instrument and its psychometric properties with a descriptive design. Participant were first, second and third year students of the Bachelor Degree in Nursing Science from three Italian universities. The Scale for Quality Evaluation of Bachelor Degree in Nursing consists of 65 items that use a 4 point Likert scale ranging from "strongly disagree" to "strongly agree". The instrument comes from a prior version with 41 items that were modified and integrated with 24 items to improve reliability. Six hundred and fifty questionnaires were completed and considered for the present study. The mean age of the students was 24.63 years, 65.5% were females. Reliability of the scale resulted in a very high Cronbach's alpha (0.96). The construct validity was tested with factor analysis that showed 7 factors. The Scale for Quality Evaluation of the Bachelor Degree in Nursing, although requiring further studies, represents a useful instrument to measure the quality of the Bachelor Nursing Degree., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Introduction. The evolution of nursing profession in Italy and the modification of university currilula have stimulated the adoption of new didactic methods according to the new educational needs. In the present study the developement of tools and methods for evaluating and measuring clinical competences of undergraduate nursing students at Tor Vergata University of Rome are presented. These methods and tools have been developed by all professionals involved in nursing education.Methods. The new didactic methods have been implemented from the Academic Year 2006/2007. The developed methods and tools have been: the educational web site, the objectives and plans of clinical training for each year of course, the coordinators of clinical activities, the training diary and task, and the in-progress and final evaluation per each year.Results and Discussion. After the two-year experimentation, the distributed training diaries have been 185; all the training tasks with a positive outcome have been 637; students who passed the exam with the new methods and tools have been 294. Conclusion. The preliminary results of the present study do not allow yet to demonstrate all the competencies acquired by the students (this will be possible after November 2009), but show that they more adhere to the clinical education. In addition, the new educational methods and tools implemented in this study demonstrate as the students progress in nursing education.

Unlabelled: Current questionnaires for assessing satisfaction of university students are not specific for nursing education., Aim: The aim of this study was to develop an instrument to measure the quality of baccalaureate nursing education., Method: Guidelines by DeVellis were adopted to develop the instrument. After expert review the initial 98 items identified were reduced to 63. The questionnaire was administered to 325 nursing students in Latium and Tuscany regions. A Delphi survey was carried out to validate the contents according to the students' opinions, expressed on a 5 point Likert scale., Results: Three-hundred-ten questionnaires were completed and considered for the present study. The mean age of the students was 25.4 years, 69.3% were females. Items which scored less than 2.5 on average at the Delphi survey were removed, as well as those which correlated less than 0.40 with the total score. Thus, 41 items were definitely considered for the Scale for Quality Evaluation of the Bachelor Degree in Nursing (SQEBDN). Reliability of the Scale resulted in a very high Cronbach's alpha (0.93). The construct validity was tested with factor analysis that showed 10 factors, while criterion-related (divergent) validity showed statistically significant correlations of all the items with those assessing the dissatisfaction for educational activities. Third year students as well as older students had the worst perception the quality of nursing education., Conclusions: The SQEBDN, although requiring further studies, represents a useful instrument to measure the quality of the bachelor nursing degree.