Stress Influences In Clinical Performance

Stress Influences In Clinical Performance

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Stress Influences In Clinical Performance

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Stress Influences In Clinical Performance

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Discuss about the Stress And Influences In Clinical Performance.

The title of the article which is going to be review in this assignment is “Nursing students’ perceived stress and influences in clinical performance”. According to Parahoo (2014), the title of the article articles helps the readers to get a brief idea about what the researcher is going to analyse. Here title framed by Akhu-Zaheya, Shaban and Khater (2015) indicates that the article is going to discuss the effect of stress over the clinical performance of the nursing students. Thus the title provides a clear indication of idea of the research. However, the article title did not featured the adopted methodology which is another important category that must be taken into consideration as proposed by Parahoo (2014).
Article presentation
The overall demonstration of the article was done with proper headings and subheading with a detailed tabular representation of the demographic of the focus group. According to Fothergill and Lipp (2014), a qualitative research article must have a detailed flow of writing with proper sub-headings. Fothergill and Lipp (2014) further highlighted that the qualitative research articles based on interview must contain a detailed illustrations of the list of questionnaire. However, the qualitative study conducted by Akhu-Zaheya, Shaban and Khater (2015) lacks list of questionnaire.
Terms defined
The main variable used in this research is stress. The authors Akhu-Zaheya, Shaban and Khater (2015), succinctly defined the term stress at the very beginning of the article. Another term, perceived stress scale (PSS) which is used to measure stress is also defined in detail by the authors.
Background of the study: Purpose of the study
The main purpose of the study is to analyse the association between the perceived stress and factors related to stress and their effects in the overall clinical performance of the nursing students. This purpose is extremely relevant in the present day scenario because, Reeve, Shumaker, Yearwood, Crowell & Riley (2013) highlighted that the graduate or under-graduate nursing students suffer from poor clinical performance and stress can be one of the factor.
The target population
The main target population of this study Jordanian bachelor nursing students enrolled under four-year of undergraduate clinical nursing course. The nursing students of second, third and fourth year from two public universities in North Jordan were recruited in the study. This selection of the target population coincides with the aim of the research.
The significance of the study
Proper analysis of the relation between perceived stress of nursing students during clinical training and their clinical performance is important. This is because, elucidation of the relationship will help to provide the nursing students effective interventions to reduce stress and thereby helping them to work on their clinical performance during their undergraduate enrolment. This improvement of the clinical performance will help them to attain professional proficiency during the later stages of their career (Bogossian et al., 2014).
Literature cited
The research paper of Akhu-Zaheya et al. (2015) has a separate section named “literature review” where the authors cited authentic and relevant literatures in order to justify the gaps in the past research and current scope of the research.
Ethical consideration
According to the Ritchie et al. (2013) while conducting qualitative interview based research, it is the duty of the researcher to abide by all the ethical consideration like seeking permission, informed consent, confidentiality and privacy. This is again emphasised by the Data Protection Act of 1998. The study conducted by Akhu-Zaheya et al. (2015) stated that the proposal of the study was at first approved by the Institutional Review Board (IRB). All the students who were recruited in the study were asked to sign the informed consent through the provision of an information cover letter which contained a detailed outline of the confidentiality. The interview was undertaken under the area of practice of the students. According to Ritchie et al. (2013), conducting an interview as per the convenience of the interviewee helps to obtained the best possible results while observance of the ethical consideration. None of the participants were forced and all the participants were given liberty to leave the study at any point of time. The authors also claimed that the list of questionnaire also contained no personal questions.
The study: Research design and its relation with the research topic
The researcher here selected descriptive, correlation and cross-sectional design since the aim of the research was to describe the relationships between the variables of the research at one point of time (cross-sectional). The correlation research design helped the researcher to obtain the co-relation between the perceived stress of the nursing students and their clinical performance along with the correlation between the students’ clinical performance and clinical training stress. The qualitative descriptive style research design helped the research towards comprehensive summarization of stress events experienced by under graduate nursing students (Lewis, 2015). Thus it can be said that the research design selected by the researcher is appropriate to the research topic.
The main target population was under graduate nursing students who are enrolled under the four-year of undergraduate degree course of clinical nursing. The students of second, third and fourth year were selected for the study. According to Khalaila (2015), mainly the academic pressure of the under graduate nursing students increases after first year of the course. Thus the selection of the focus group students from the second year of the clinical nursing course is justified. A total of 539 students were selected for the study. According to Yang et al. (2014), selection of the large sample size in the qualitative research helps to decrease the biased response.
Data collection
The data collection was done via the distribution of the survey questionnaire among the nursing students. The perceived stress level was calculated via the use of the perceived stress scale (PSS). The data collection also included the demographic information of the chosen group and population like the age, gender, year of education and the interest in the nursing profession along with previous nursing experience.
Data analysis
Data analysis was done via the Statistical Package for Social Science (SPSS) for Windows Version 17. According to Pallant (2013), SPSS help in accurate analysis of the survey questionnaire.
Findings:Findings of the research
The research findings highlighted that the perceived level of stress does not varies with gender differences. The pressure of the completion of the students assignments were regarded as the main source of stress followed by the stress associated with the patient care and finally stress coming from the teachers of the other nursing staffs. One of the lowest source of stress is lack of professional knowledge and skills among the nursing students. However, the level of stress causes significant damage in the clinical performance by the female nurse students in comparison to the male nursing students (Akhu-Zaheya et al., 2015). Over the statistical findings of the research was not represented in a tabular format which decreased the overall presentation style of the study (Burns, Bush & Sinha, 2014).
Conclusion drawn
The main conclusion of the study is, there is a negative co-relation between the perceived stress level among the under graduate nursing students and their overall clinical performance. The effect of stress over the clinical performance is more prominent over the female nurse students in comparison to the make nurse students.
Recommendation put forth
The main recommendation as proposed by the researchers is a need of framing strategies in order to increase the confidence of the students while they are taking care of the patients. This will help to reduce the stress level to certain extent. The researcher also proposed nurturing of supportive environment by the nursing mentors will further help to reduce the perceived stress among the nursing students and thereby helping to increase their clinical performance.
Limitations of the study
According to Akhu-Zaheya, Shaban & Khater (2015), female performance was greater than male. Though there was no significant difference in stress level but his could be associated to the course module and the students enrolled under it. However, it was not possible from author’s end to look into this in detail.
Student’s Comment
From the student’s perspectives it can be said that study conducted by Akhu-Zaheya, Shaban and Khater (2015) showed that stress factor during their under graduate course decrease or hampers their clinical performance. However, if the authors have stated the list of questions in details then it would have been easier for me to understand the approach taken by the authors in noting the views and the though process of the students.
Student’s Conclusion
Thus from the critical analysis of the paper, it can be concluded that Akhu-Zaheya, Shaban and Khater (2015) conducted descriptive, correlation, cross-sectional design in order to access the relation between stress of nursing students and their clinical performance. The result showed significant negative co-relation between stress and clinical performance. At the end, the author’s also proposed suitable recommendations in order to overcome such challenges. The study design and approach taken in order to meet the goals of the research are clearly justified along with the discussion of limitations.
Akhu-Zaheya, L. M., Shaban, I. A., & Khater, W. A. (2015). Nursing students’ perceived stress and influences in clinical performance. International Journal of Advanced Nursing Studies, 4(2), 44.
Bogossian, F., Cooper, S., Cant, R., Beauchamp, A., Porter, J., Kain, V., … & FIRST2ACT™ Research Team. (2014). Undergraduate nursing students’ performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study. Nurse Education Today, 34(5), 691-696.
Burns, A. C., Bush, R. F., & Sinha, N. (2014). Marketing research (Vol. 7). Harlow: Pearson.
Fothergill, A., & Lipp, A. (2014). A guide to critiquing a research paper on clinical supervision: enhancing skills for practice. Journal of psychiatric and mental health nursing, 21(9), 834-840.
Khalaila, R. (2015). The relationship between academic self-concept, intrinsic motivation, test anxiety, and academic achievement among nursing students: Mediating and moderating effects. Nurse Education Today, 35(3), 432-438.
Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five approaches. Health promotion practice, 16(4), 473-475.
Pallant, J. (2013). SPSS survival manual. McGraw-Hill Education (UK). Retrieved from:
Parahoo, K. (2014). Nursing research: principles, process and issues. Macmillan International Higher Education. Retrieved from:,+process+and+issues&ots=RBwCUzLoy_&sig=4SNJE3kU4FaZwae4uy2HUqKqOZc
Reeve, K. L., Shumaker, C. J., Yearwood, E. L., Crowell, N. A., & Riley, J. B. (2013). Perceived stress and social support in undergraduate nursing students’ educational experiences. Nurse Education Today, 33(4), 419-424.
Ritchie, J., Lewis, J., Nicholls, C. M., & Ormston, R. (Eds.). (2013). Qualitative research practice: A guide for social science students and researchers. Sage. Retrieved from:
Yang, J., Zaitlen, N. A., Goddard, M. E., Visscher, P. M., & Price, A. L. (2014). Advantages and pitfalls in the application of mixed-model association methods. Nature genetics, 46(2), 100. Retrieved from:

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