Nursing Students

This study investigated the implementation of a gamified English for Specific Purposes (ESP) speaking instructional framework using spinning wheel media among nursing students. A qualitative case study approach was conducted involving 25 nursing students at STIKES Bina Usada Bali. Data were gathered over five instructional sessions through classroom observations, semi-structured interviews, and document analysis, followed by thematic analysis. The analysis revealed five themes: students’ engagement, speaking anxiety, speaking confidence, the relevance of nursing-based communication tasks, and classroom participation. The findings suggested that students perceived the randomized speaking prompts as engaging and considered nursing-related scenarios relevant to their prospective professional communication needs. Some participants further described feeling more comfortable and confident through repeated opportunities to practice speaking. Drawing on the classroom implementation, the study identified six related instructional components: context-based nursing tasks, randomized prompts, individual speaking performance, peer interaction, constructive feedback, and repeated practice. This study offers practical insights into the integration of gamification in ESP speaking instruction for nursing students. Nevertheless, the findings represent students’ experiences and perceptions; they do not demonstrate a causal improvement in speaking proficiency or establish the formal validity of the framework. Future research should investigate the framework in diverse educational contexts and explore its association with objectively assessed speaking outcomes.

This research explores the critical intersection of consistency, standards and complexity in academic assessment integrity using focus groups consisting of academic staff and undergraduate nursing students. While academic quality standards are mandated by accreditation bodies to ensure accountability and skill acquisition, the marking process remains a complex, intuitive task heavily reliant on a marker's experience and practicality. Significant challenges arise when marking becomes overly criteria-driven at the expense of core assessment goals, leading to variability in judging relevant student ideas or specific technical skills such as referencing. Such variability undermines the reliability and objectivity essential for assessment fairness. To mitigate these risks, pre-marking meetings are identified as essential for establishing shared requirements and expectations among staff. Strategic timing of these supports, ideally pre-semester, provides the necessary framework for quality assurance and enables markers to make meaningful and accurate judgements regarding a student’s true knowledge and performance. Keywords: student/ marking/ assessment/ quality/consistency/ tertiary education

Introduction: During the first year of the COVID-19 pandemic, the global prevalence of anxiety and depression rose by about 25%, with women and young people most affected. Now that the emergency phase is over, it is necessary to know the mental health status of university students' families, a group that is rarely measured directly. Objective: To describe the levels of anxiety, depression and perceived stress among nursing students and their family members, and to explore their relationship with age, gender, socioeconomic stratum and religion. Methods: Quantitative, descriptive, cross-sectional study with non-probability convenience sampling. Thirty-nine people aged 17 to 79 took part: third-semester nursing students at Universidad Metropolitana de Barranquilla and their family members. The GAD-7, the PHQ-9 and the 10-item Perceived Stress Scale (PSS-10) were administered. Associations were tested with the chi-square test and, because of the small cell counts, with an exact test estimated by Monte Carlo simulation.Results: Of the participants, 67% were women, 31% were aged 17 to 25, 49% belonged to socioeconomic stratum 2 and 87% were Catholic. Absence of symptoms and mild levels predominated. Mild anxiety was the most frequent category among those aged 17 to 25 (66.7%), and 25% of those aged 44 to 52 had severe anxiety. The chi-square test suggested an association between age and anxiety (p = 0.046), but the exact test did not confirm it (p = 0.080). No other variable was significantly associated with anxiety, depression or stress. Conclusions: Participants mostly showed mild or no symptoms, with no significant differences by sociodemographic variables. The cross-sectional design and the sample size do not allow these levels to be attributed to the pandemic, but the cases of severe anxiety and moderately severe depression among middle-aged family members warrant follow-up of family mental health in the post-pandemic period.

Anxiety is a psychological condition that college students may experience, particularly when they face exams that require clinical skills, such as the Objective Structured Clinical Examination (OSCE). Increasing anxiety leading up to the OSCE can affect students’ sleep quality. The purpose of this study was to analyze the relationship between anxiety levels and sleep quality among nursing students at Muhammadiyah University of Semarang leading up to the OSCE. This study was conducted as a cross-sectional study with random sampling. The sample consisted of 100 undergraduate students in the Nursing program at Muhammadiyah University of Semarang who were scheduled to take the OSCE. Data were collected via a questionnaire assessing anxiety levels and sleep quality. The data were analyzed univariately and bivariately using the chi-square test and Spearman’s rank correlation. The results showed that the majority of respondents experienced high anxiety (50 individuals, 50%), while the sleep quality of most respondents fell into the “poor” category (38 individuals, 38%). The results of the Spearman’s rank correlation test showed a correlation coefficient (r) = 0.509 with a p-value (p < 0.001), indicating a significant moderate-strength relationship between anxiety levels and sleep quality among students prior to the OSCE exam.

اضطراب یک وضعیت روان‌شناختی است که دانشجویان دانشگاه ممکن است تجربه کنند، به‌ویژه زمانی که با آزمون‌هایی مواجه می‌شوند که نیازمند مهارت‌های بالینی هستند، مانند آزمون ساختاریافته عینی بالینی (OSCE). افزایش اضطراب در آستانه برگزاری OSCE می‌تواند بر کیفیت خواب دانشجویان تأثیر بگذارد. هدف این پژوهش تحلیل ارتباط بین سطح اضطراب و کیفیت خواب در میان دانشجویان پرستاری دانشگاه محمدیه سمارانگ پیش از برگزاری OSCE بود. این پژوهش به صورت مقطعی و با نمونه‌گیری تصادفی انجام شد. نمونه شامل ۱۰۰ دانشجوی کارشناسی رشته پرستاری دانشگاه محمدیه سمارانگ بود که قرار بود در آزمون OSCE شرکت کنند. داده‌ها از طریق پرسشنامه‌ای که سطح اضطراب و کیفیت خواب را ارزیابی می‌کرد، جمع‌آوری شد. داده‌ها به صورت یک‌متغیره و دو‌متغیره با استفاده از آزمون کای‌اسکوئر و همبستگی رتبه‌ای اسپیرمن تحلیل شدند. نتایج نشان داد که اکثریت پاسخ‌دهندگان دارای اضطراب بالا بودند (۵۰ نفر، ۵۰٪)، در حالی که کیفیت خواب اکثر پاسخ‌دهندگان در دسته «ضعیف» قرار داشت (۳۸ نفر، ۳۸٪). نتایج آزمون همبستگی رتبه‌ای اسپیرمن ضریب همبستگی (r) = ۰.۵۰۹ با مقدار p (p < ۰.۰۰۱) را نشان داد که بیانگر وجود رابطه معنادار با قدرت متوسط بین سطح اضطراب و کیفیت خواب دانشجویان پیش از آزمون OSCE است.

Background This study compared educational outcomes between nursing students receiving a CDIO-guided case-based and gamified teaching program and those receiving conventional teaching. Materials and methods This two-class quasi-experimental study included 140 nursing students from two classes between March and June 2025. Classes were assigned by lottery to the intervention ( n = 65) or control ( n = 75) group. The intervention integrated progressive cases, microlectures, teamwork, board games, and escape-room simulation, whereas the control received traditional lectures and Small Private Online Course self-study. Self-directed learning, critical thinking, and learning engagement were assessed before and after the course. Post-course outcomes included theoretical performance, cardiopulmonary resuscitation performance, course performance, and teaching evaluation. Analysis of covariance, Welch’s t tests, and Holm correction were applied. Results The intervention class had higher adjusted post-course scores for self-directed learning (mean difference, 7.68; 95% CI, 3.29–12.07), critical thinking (15.27; 95% CI, 11.53–19.00), and learning engagement (7.06; 95% CI, 1.82–12.30). It also achieved higher theoretical, cardiopulmonary resuscitation, course, and teaching-evaluation scores. Students generally found the activities engaging, although some reported nervousness. Conclusion The program was associated with improved educational outcomes, but intervention and class effects could not be separated. Multicenter studies with multiple classes per arm are required.

زمینه: این مطالعه پیامدهای آموزشی دانشجویان پرستاری دریافت‌کننده برنامه آموزشی مبتنی بر مورد و بازی‌وارسازی با راهنمایی CDIO را با دانشجویان دریافت‌کننده آموزش متداول مقایسه کرد. مواد و روش‌ها: این مطالعه شبه‌آزمایشی دوکلاسه شامل ۱۴۰ دانشجوی پرستاری از دو کلاس بین مارس تا ژوئن ۲۰۲۵ بود. کلاس‌ها به‌صورت قرعه‌کشی به گروه مداخله (n = 65) یا کنترل (n = 75) اختصاص یافتند. مداخله شامل موارد پیشرونده، میکرولکچرها، کار تیمی، بازی‌های رومیزی و شبیه‌سازی اتاق فرار بود، در حالی که گروه کنترل آموزش سنتی و خودآموزی Small Private Online Course را دریافت کرد. یادگیری خودراهبر، تفکر انتقادی و درگیری یادگیری قبل و بعد از دوره ارزیابی شد. پیامدهای پس از دوره شامل عملکرد نظری، عملکرد احیای قلبی‌ریوی، عملکرد دوره و ارزیابی تدریس بود. از تحلیل کوواریانس، آزمون t ولچ و تصحیح هولم استفاده شد. نتایج: کلاس مداخله نمرات تعدیل‌شده بالاتری در یادگیری خودراهبر (تفاوت میانگین، ۷٫۶۸؛ ۹۵٪ CI، ۳٫۲۹–۱۲٫۰۷)، تفکر انتقادی (۱۵٫۲۷؛ ۹۵٪ CI، ۱۱٫۵۳–۱۹٫۰۰) و درگیری یادگیری (۷٫۰۶؛ ۹۵٪ CI، ۱٫۸۲–۱۲٫۳۰) پس از دوره داشت. همچنین نمرات بالاتری در عملکرد نظری، احیای قلبی‌ریوی، عملکرد دوره و ارزیابی تدریس کسب کرد. دانشجویان به طور کلی فعالیت‌ها را جذاب یافتند، اگرچه برخی احساس اضطراب داشتند. نتیجه‌گیری: این برنامه با بهبود پیامدهای آموزشی همراه بود، اما اثرات مداخله و کلاس قابل تفکیک نبود. مطالعات چندمرکزی با چند کلاس در هر بازو مورد نیاز است.

Purpose: This study examined with the aim of examining the levels of exposure to cyberbullying and emotional abuse among students in health sciences–related fields.Material and Methods: The sample for this cross-sectional study comprised 590 students enrolled in the departments of Midwifery (n = 200), Nursing (n = 144), Physiotherapy and Rehabilitation (n = 128), and Health Management (n = 118) at a Faculty of Health Sciences of a university. Data were collected using the Personal Information Form, the Revised Cyber Bullying Inventory–II (RCBI-II), and the Emotional Abuse Exposure Scale (EAES).Results: 41.9% of students reported witnessing cyberbullying at least once, while 36.1% reported being exposed at least once. Among exposed students cyberbullying, 27.3% indicated that cyberbullying occurred through social networking sites, and 53.9% reported awareness of emotional abuse. The mean RCBI-II scores were 13.92 ± 5.93 for cyber victimization and 12.47 ± 4.83 for cyberbullying, whereas the total EAES mean score was 54.27 ± 26.78. A statistically significant moderate positive correlation was identified between RCBI-II (cyber victimization and cyberbullying) scores and total EAES scores (p < 0.001).Conclusion: The findings indicate that students experience higher levels of cyber victimization and moderate levels of emotional abuse. As cyber victimization and cyberbullying levels increase, exposure to emotional abuse increases. Students in the midwifery department were found to experience lower levels of cyber victimization, to engage less frequently in cyberbullying behaviors, and to be exposed to lower levels of emotional abuse overall.

هدف: این پژوهش با هدف بررسی میزان مواجهه با آزار اینترنتی و سوءاستفاده عاطفی در میان دانشجویان رشته‌های مرتبط با علوم سلامت انجام شد. مواد و روش‌ها: نمونه این مطالعه مقطعی شامل ۵۹۰ دانشجو از دانشکده علوم سلامت یک دانشگاه بود که در رشته‌های مامایی (n = 200)، پرستاری (n = 144)، فیزیوتراپی و توانبخشی (n = 128) و مدیریت سلامت (n = 118) تحصیل می‌کردند. داده‌ها با استفاده از فرم اطلاعات فردی، پرسشنامه بازنگری‌شده آزار اینترنتی–II (RCBI-II) و مقیاس مواجهه با سوءاستفاده عاطفی (EAES) جمع‌آوری شد. یافته‌ها: ۴۱/۹٪ از دانشجویان گزارش کردند که حداقل یک بار شاهد آزار اینترنتی بوده‌اند، در حالی که ۳۶/۱٪ گزارش دادند که حداقل یک بار در معرض آن قرار گرفته‌اند. در میان دانشجویان در معرض آزار اینترنتی، ۲۷/۳٪ بیان کردند که آزار اینترنتی از طریق شبکه‌های اجتماعی رخ داده است و ۵۳/۹٪ از سوءاستفاده عاطفی آگاهی داشتند. میانگین نمرات RCBI-II برای قربانی شدن اینترنتی ۱۳/۹۲ ± ۵/۹۳ و برای آزار اینترنتی ۱۲/۴۷ ± ۴/۸۳ بود، در حالی که میانگین کل نمره EAES برابر با ۵۴/۲۷ ± ۲۶/۷۸ بود. همبستگی مثبت متوسط و معناداری بین نمرات RCBI-II (قربانی شدن اینترنتی و آزار اینترنتی) و نمره کل EAES مشاهده شد (p < 0.001). نتیجه‌گیری: یافته‌ها نشان می‌دهد که دانشجویان سطوح بالاتری از قربانی شدن اینترنتی و سطوح متوسطی از سوءاستفاده عاطفی را تجربه می‌کنند. با افزایش سطوح قربانی شدن اینترنتی و آزار اینترنتی، میزان مواجهه با سوءاستفاده عاطفی نیز افزایش می‌یابد. دانشجویان رشته مامایی سطوح پایین‌تری از قربانی شدن اینترنتی، مشارکت کمتر در رفتارهای آزار اینترنتی و مواجهه کمتر با سوءاستفاده عاطفی را تجربه کردند.