Self-efficacy and concerns of nursing students regarding clinical experiences.

Background: It is important for nurses to provide safe, high-quality care for patients, and clinical experiences allow nursing students to integrate theory into practice. However, many students have anxiety about clinical rotations.

Objectives: The concerns of nursing students about clinical experiences and factors relating to self-efficacy in a rural Bachelor of Science in Nursing (BSN) program were examined.

Design: This was a mixed-methods study, and students were surveyed prior to and at the end of their clinical experiences.

Setting: The study location is a public liberal arts university in the rural, southeast United States.

Participants: Junior level students (first and second semester) and senior level students (first and second semester) levels of BSN students participated in this project.

Results: Qualitative themes were identified, including concerns regarding clinical competence, expectations of learning, aspects of patient/peer/instructor interactions, as well as learning strategies and preferences. The student's level of confidence regarding communication to patients and physicians, assessment of heart and lung sounds, interview skills, documentation, and discussion of nursing procedures increased significantly from pre to post-survey. Confidence levels in physical assessment skills rose significantly after the clinical experience (t' = -6.3718 with 140 df, p < .001).

Conclusion: Strategies that nurse educators can use prior to, during, and after the clinical experience to address student concerns about clinical experiences include the use of caring, competent clinical instructors, orientation to clinical sites, laboratory and simulation days, self-reflection, peer-support, and debriefing.