Turkiye Klinikleri Journal of Medical Ethics-Law and History

.: RESEARCH
Nursing Students' Experienced Ethical Problems in Clinical Practicum and Clinical Self-Regulated Learning Levels:A Cross-Sectional Study
Hemşirelik Öğrencilerinin Klinik Uygulamada Yaşadıkları Etik Sorunlar ve Klinik Öz-Düzenlemeli Öğrenme Düzeyleri: Kesitsel Bir Çalışma
Hediye UTLİa , Mahmut DİNÇb , Ahmet BÜTÜNc
aDepartment of Elderly Care, Mardin Artuklu University Vocational School of Health Services, Mardin, Türkiye
bDepartment of Surgery Nursing, Batman University Faculty of Health Sciences, Batman, Türkiye
cDepartment of Internal Nursing, Mardin Artuklu University Faculty of Health Sciences, Mardin, Türkiye
Turkiye Klinikleri J Med Ethics. 2023;31(2):98-105
doi: 10.5336/mdethic.2022-93976
Article Language: EN
Full Text
ABSTRACT
 During the coronavirus disease-2019 (COVID-19) pandemic, clinical training, which is essential to nursing practice, has been largely delayed. The aim of this study is to identify the predictors of nursing students' experienced ethical problems in clinical practicum and self-regulated learning levels during the COVID-19 pandemic. The sample of this cross-sectional study consisted of 306 nursing students studying in the third and fourth grades of 2 universities located in the east of Türkiye. The data were collected by using a Student Introduction Form, the Scale of Ethical Problems in Clinical Teaching in Nursing, and the Self-Regulated Learning Scale for Clinical Nursing Practices form. The independent sample t-test, one-way ANOVA F test, Pearson correlation test, and multiple regression were used in the analysis of the data. It was determined that there was a positive and moderately significant relationship between the total mean score of the Scale of Ethical Problems in Clinical Teaching in Nursing and the Self-Regulated Learning Scale for Clinical Nursing Practices, total mean score (r=509, p<0.001). A regression model indicated that 4 predictors (clinical educator, health professionals, learning strategies, and self-regulated learning levels) explained 28% of the variance (R=0.516, Adjusted R2=0.284, F=13.255, p<0.001) in their ability to identify ethical problems in clinical practicum. In this study, it was determined that health professionals and self-regulated learning levels positively affected students' ability to identify ethical problems in the clinical practice setting. The level of clinical educator was found to negatively affected students' ability to identify ethical problems in the clinical practice setting.

Keywords: COVID-19; clinical practicum; ethics; nursing students; self-regulated learning
ÖZET
 Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemisi sırasında hemşirelik uygulamaları için gerekli olan klinik eğitim büyük ölçüde ertelenmiştir. Bu çalışmanın amacı, pandemi sürecinde hemşirelik öğrencilerinin klinik uygulamada yaşadıkları etik sorunlar ve klinik öz-düzenlemeli öğrenme düzeylerinin yordayıcılarını belirlemektir. Kesitsel tipteki bu araştırmanın örneklemini, Türkiye'nin doğusunda yer alan 2 üniversitenin 3 ve 4. sınıflarında öğrenim gören 306 hemşirelik öğrencisi oluşturdu. Veriler, Öğrenci Tanıtım Formu, Hemşirelikte Klinik Öğretimde Etik Sorunlar Ölçeği ve Klinik Hemşirelik Uygulamalarına Yönelik Öz Düzenlemeli Öğrenme Ölçeği ile toplandı. Verilerin analizinde bağımsız gruplarda t-testi, tek yönlü ANOVA F testi, Pearson korelasyon testi ve çoklu regresyon kullanıldı. Hemşirelikte Klinik Öğretimde Etik Sorunlar Ölçeği toplam puan ortalaması ile Klinik Hemşirelik Uygulamaları İçin Öz-Düzenli Öğrenme Ölçeği toplam puan ortalaması arasında pozitif yönde ve orta düzeyde anlamlı bir ilişki olduğu belirlendi (r=509, p<0,001). Bir regresyon modeli, 4 yordayıcının (klinik eğitimcisi, sağlık profesyonelleri, öğrenme stratejileri ve öz-düzenlemeli öğrenme düzeyleri) klinik uygulamada etik sorunları saptama yeteneklerindeki varyansın %28'ini açıkladığını göstermiştir (R=0,516, adjusted R2=0,284, F=13,255, p<0,001). Bu araştırmada, sağlık profesyonelleri ve öz-düzenlemeli öğrenme düzeylerinin, klinik uygulamada öğrencilerin etik sorunları saptama becerilerini olumlu yönde etkilediği saptandı. Klinik eğitimci düzeyinin ise klinik uygulamada öğrencilerin etik sorunları saptama becerilerini olumsuz yönde etkilediği saptandı.

Anahtar Kelimeler: COVID-19; klinik uygulama; etik; hemşirelik öğrencileri; öz-düzenlemeli öğrenme
REFERENCES:
  1. Kırşan M, Akın Korhan E. Hemşirelik öğrencilerinin klinik öğretimde yaşadıkları etik sorun deneyimleri [The ethical problem experiences of nursing students in clinical education: review]. Turkiye Klinikleri J Med Ethics. 2017;25(1):20-7. [Crossref] 
  2. Mehdipour Rabori R, Dehghan M, Nematollahi M. Nursing students' ethical challenges in the clinical settings: a mixed-methods study. Nurs Ethics. 2019;26(7-8):1983-91. [Crossref]  [PubMed] 
  3. Zhang F, Zhao L, Zeng Y, Xu K, Wen X. A comparison of inquiry-oriented teaching and lecture-based approach in nursing ethics education. Nurse Educ Today. 2019;79:86-91. [Crossref]  [PubMed] 
  4. Yoo L, Jung D. Teaching presence, self-regulated learning and learning satisfaction on distance learning for students in a nursing education program. Int J Environ Res Public Health. 2022;19(7):4160. [Crossref]  [PubMed]  [PMC] 
  5. Cho S, Jang SJ. Nursing students' motivational and self-regulated learning during the COVID-19 pandemic: a cross-sectional study. Nurs Health Sci. 2022;24(3):699-707. [Crossref]  [PubMed]  [PMC] 
  6. Dogu O, Karadas A, Eskin Bacaksiz F. The relationships between self-regulated learning in clinical nursing practice and self-efficacy: a cross-sectional study among nursing students. Perspect Psychiatr Care. 2022;58(4):2107-15. [Crossref]  [PubMed] 
  7. Hwang Y, Oh J. The relationship between self-directed learning and problem-solving ability: the mediating role of academic self-efficacy and self-regulated learning among nursing students. Int J Environ Res Public Health. 2021;18(4):1738. [Crossref]  [PubMed]  [PMC] 
  8. Kurt E, Eskimez Z. Examining self-regulated learning of nursing students in clinical practice: a descriptive and cross-sectional study. Nurse Educ Today. 2022;109:105242. [Crossref]  [PubMed] 
  9. Irvine S, Brooks I, Lau R, McKenna L. Self-regulated learning instructional support for students enrolled in an accelerated nursing program. Collegian. 2020;27(4):402-9. [Crossref] 
  10. Kim SH. The mediating effect of self-regulated learning on the relationships among emotional intelligence, collaboration, and clinical performance in Korean nursing students. J Nurs Res. 2022;30(3):e212. [Crossref]  [PubMed] 
  11. Sanaie N, Vasli P, Sedighi L, Sadeghi B. Comparing the effect of lecture and Jigsaw teaching strategies on the nursing students' self-regulated learning and academic motivation: a quasi-experimental study. Nurse Educ Today. 2019;79:35-40. [Crossref]  [PubMed] 
  12. Zhang JY, Liu YJ, Shu T, Xiang M, Feng ZC. Factors associated with medical students' self-regulated learning and its relationship with clinical performance: a cross-sectional study. BMC Med Educ. 2022;22(1):128. [Crossref]  [PubMed]  [PMC] 
  13. Robb MK. Self-regulated learning: examining the baccalaureate millennial nursing student's approach. Nurs Educ Perspect. 2016;37(3):162-4. [Crossref]  [PubMed] 
  14. Yadav SK, Singh S, Gupta R. Sampling methods. Biomedical Statistics: A Beginner's Guide. 1st ed. Singapore: Springer Singapore; 2019. p.71-83. [Crossref]  [PMC] 
  15. Chen JH, Björkman A, Zou JH, Engström M. Self-regulated learning ability, metacognitive ability, and general self-efficacy in a sample of nursing students: a cross-sectional and correlational study. Nurse Educ Pract. 2019;37:15-21. [Crossref]  [PubMed] 
  16. Yükseköğretim Kurulu Başkanlığı Tez Merkezi [Internet]. [Cited: March 20, 2022]. Available from: [Link] 
  17. Iyama S, Maeda H. Development of the self-regulated learning scale in clinical nursing practice for nursing students: consideration of its reliability and validity. Jpn J Nurs Sci. 2018;15(3):226-36. [Crossref]  [PubMed] 
  18. Yükseköğretim Kurulu Başkanlığı Tez Merkezi [Internet]. [Cited: March 20, 2022]. Available from: [Link] 
  19. Arslan S, Dinç L. Nursing students' perceptions of faculty members' ethical/unethical attitudes. Nurs Ethics. 2017;24(7):789-801. [Crossref]  [PubMed] 
  20. Tsuruwaka M. Consulted ethical problems of clinical nursing practice: perspective of faculty members in Japan. BMC Nurs. 2017;16:23. [Crossref]  [PubMed]  [PMC] 
  21. Sinclair J, Papps E, Marshall B. Nursing students' experiences of ethical issues in clinical practice: a New Zealand study. Nurse Educ Pract. 2016;17:1-7. [Crossref]  [PubMed] 
  22. Palese A, Gonella S, Destrebecq A, Mansutti I, Terzoni S, Morsanutto M, et al. Opportunity to discuss ethical issues during clinical learning experience. Nurs Ethics. 2019;26(6):1665-79. [Crossref]  [PubMed] 
  23. Alnajjar PhD HA, Abou Hashish PhD EA. Academic ethical awareness and moral sensitivity of undergraduate nursing students: assessment and ınfluencing factors. SAGE Open Nurs. 2021;7:23779608211026715. [Crossref]  [PubMed]  [PMC] 
  24. Organisation for Economic Co-operation and Development [Internet]. © Organisation for Economic. [Cited: September 1, 2022]. Nursing graduates. 2020. Available from: [Link] 
  25. Yükseköğretim Bilgi Yönetim Sistemi [İnternet]. [Cited: March 20, 2022]. The number of students and teaching staff by education units. Available from: [Link] 
  26. Dığın F, İşcan Ataşen G. Determining the self-regulated learning status of nursing students regarding clinical nursing practices. Humanist Perspect. 2021;3(2):420-32. [Crossref] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com