Effective Stressors in Clinical Education

Document Type : Original Article


1 Department of Nursing, Mahabad Branch, Islamic Azad University, Mahabad

2 Department of Nursing, Mahabad Branch, Islamic Azad University, Mahabad,

3 Department of Health Services Management, Baqiatallah University of Medical Sciences, Tehran, Iran



Aims: Nursing and midwifery students experience multiple stressors in the clinical setting that can affect their proper functioning. Therefore,
the objective of this research was the effective stressors in clinical education among nursing and midwifery students of Islamic Azad University,
Mahabad in 2016. Materials and Methods: This study was a cross‑sectional study of applied type. The statistical population was nursing
and midwifery students of the Azad University of Mahabad in 2016. The sample size was selected in clinical setting to be 300 person. The
data gathering tool was a researcher‑made questionnaire consisting of two sections of demographic information and a section of the stressful
factors of clinical education in eight domains and 106 items. The validity of this questionnaire was determined by content validity. Hence, the
reliability of this tool was confirmed by a test–retest method with a correlation of 0.89. The partial least square (PLS) method, independent
t‑test, and Friedman test were used for data analysis. Results: The results showed that there is a positive and significant relationship between
the interpersonal communication, environmental factors, educational planning, personal–social factors, university education factors, unpleasant
experiences, and clinical experiences with stress (P = 0.000). However, there was not a statistically significant relationship between the
humiliating experiences and the feeling of tension in students (P ≤ 0.218). Furthermore, Friedman test showed that the most important stressor
on students’ perception of their stress in the clinical environment is environmental factors. Conclusion: The results of stressful factors in clinical
education indicated lack of significance in all areas except for humiliating experiences area. Therefore, the authorities should take necessary
steps to control and manage stress in students and increase the quality of education by holding workshops and the formation of the committee
or the community to examine these factors, given all the stressful areas in the clinical education setting, especially environmental factors.