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
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
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- 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]
- Robb MK. Self-regulated learning: examining the baccalaureate millennial nursing student's approach. Nurs Educ Perspect. 2016;37(3):162-4. [Crossref] [PubMed]
- 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]
- 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]
- Yükseköğretim Kurulu Başkanlığı Tez Merkezi [Internet]. [Cited: March 20, 2022]. Available from: [Link]
- 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]
- Yükseköğretim Kurulu Başkanlığı Tez Merkezi [Internet]. [Cited: March 20, 2022]. Available from: [Link]
- Arslan S, Dinç L. Nursing students' perceptions of faculty members' ethical/unethical attitudes. Nurs Ethics. 2017;24(7):789-801. [Crossref] [PubMed]
- Tsuruwaka M. Consulted ethical problems of clinical nursing practice: perspective of faculty members in Japan. BMC Nurs. 2017;16:23. [Crossref] [PubMed] [PMC]
- 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]
- 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]
- 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]
- Organisation for Economic Co-operation and Development [Internet]. © Organisation for Economic. [Cited: September 1, 2022]. Nursing graduates. 2020. Available from: [Link]
- Yükseköğretim Bilgi Yönetim Sistemi [İnternet]. [Cited: March 20, 2022]. The number of students and teaching staff by education units. Available from: [Link]
- 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]
.: İşlem Listesi