Nursing students' emotional intelligence, coping styles and learning satisfaction in clinically simulated palliative care scenarios: An observational study
Introduction
Numerous studies have demonstrated that emotional intelligence (EI) is an important and desirable characteristic in nursing professionals as, on the one hand it contributes towards establishing appropriate relationships with others (Augusto-Landa and López-Zafra, 2010, Farshi et al., 2015) and, on the other, it is helpful for improving the management of the many emotions derived from the care process (stress, burnout, grief, etc.) (Cherry et al., 2014, El-Sayed et al., 2014). Emotional intelligence seems to provide an appropriate response to the numerous vicissitudes that a person must face in their daily life, facilitating a positive state of mind, and decreasing negative incidences together with abnormal or dysfunctional emotional reactions (Zeidner et al., 2016, Mayer and Salovey, 1997).
The interest raised by emotions in nursing practice is well-known, supported by the theoretical reasoning underpinning the discipline. One of such contributions is the “Theory of Human Caring” presented by Jean Watson. Here, the practice of caring is directly related with the emotional dimension of the person cared for as well as that of the professional providing care. Doctor Watson defends nursing from a phenomenological and existentialist perspective, where the complexity of each individual is contemplated from an affective point of view, including feelings and emotions (Watson, 2012, Watson and Smith, 2002). Feelings or emotions and thinking have been identified as forces that may affect one's learning styles (Kolb, 2014), emotional social intelligence, and success (Bar-On et al., 2004) and coping styles (Suliman, 2010). An overview of emotions, emotion functioning and regulation is alluded to, to give credence to the application of the transactional model of stress and coping as purported by Lazarus & Folkman. The central assumption of this theory is that the interaction between an individual and the environment creates stress experienced by the individual. The cognitive transactional model of stress-appraisal-coping can be applied in the sense making process for nursing students. The model is cognitive because it is based on the assumption that students' thinking processes will act to mediate in determining stress and coping resources. If we assume that Emotional Intelligence is a particular type of intellectual ability, the construct should overlap with cognitive ability to some extent (Mayer et al., 2000). According to Mayer's model as ability model, EI as a combination of four emotion-related abilities: the perception of emotions, the integration of emotions through thought processes, the understanding of relations between emotions and circumstances, and the regulation of emotions, also called emotion management (Mayer et al., 2000).
An increasing number of articles establish a relation between EI, coping styles in response to stress and academic performance among Health Science students (Suliman, 2010, Beauvais et al., 2014, Farshi et al., 2015, Saklofske et al., 2012). These studies, albeit non-conclusive, seemingly establish that those students with greater EI and appropriate coping styles display improved academic performance and more adaptive learning styles (Benson et al., 2010, Fernandez et al., 2012).
Considering the characteristics of the curricular education of nursing students who must face critical life situations, such as death or pain during their clinical placements, these students ultimately undergo considerable levels of stress (Edo-Gual et al., 2011, Reeve et al., 2013, Grobecker, 2016). Emotional intelligence is known to be directly connected with social relations, which, in turn, impacts one's own emotional control and the way stressful situations are faced (Codier and Odell, 2014, Codier et al., 2010). Relations have been established between EI and learning styles, which seem to indicate that certain learning styles, such as reflective thinking and clinical placements, favor the development of components of EI, such as self-control, motivation and relations with others (Por et al., 2011, Pool and Qualter, 2012).
Of all the possible stressful situations students face for the first time during their clinical placements, one of the most shocking is patient death (Alzayyat and Al-Gamal, 2014, Pulido-Martos et al., 2012). Concerning the process of dying, the education in end-of-life palliative care during nursing studies is not only aimed at acquiring knowledge on the appropriate end-of-life care, but rather focused also on the development of personal skills, such as communication, empathy, and teaching students to manage their emotions (Mok et al., 2002, Gillan et al., 2014). Related research suggests that there is a correlation between students with greater EI presenting more effective coping styles which, at the same time, results in a greater satisfaction with their professional development (Beauvais et al., 2014, Chan et al., 2016, Rivera et al., 2014).
On the other hand, concerning styles of learning, more recently, the use of clinical simulation (CS) has been noteworthy in improving the acquisition of professional competence (Norman, 2012, Foronda et al., 2013). Specifically, in recent years, several studies have highlighted the use of simulation in the context of end-of-life care, especially regarding the development of skills such as communication and the development of empathy (Edo-Gual et al., 2015, Lewis et al., 2016, Fabro et al., 2014, Kunkel et al., 2016, Ladd et al., 2013). In this sense, CS enables the ability to create safe learning environments for students, and the use of the same is related with a high student satisfaction, who see it as a particularly relevant method of learning within palliative care (Sarabia-Cobo et al., 2016, Dame and Hoebeke, 2016). Satisfaction with one's own learning seems to be related with increased academic performance (Lahti et al., 2014, Papathanasiou et al., 2014) and, likewise, with more effective coping styles for facing stressful situations and with greater EI (Beauvais et al., 2014, El-Sayed et al., 2014). If the learning method encourages greater student satisfaction, it seems recommendable to further explore this resource as, if we can develop satisfactory learning environments, this in turn, can improve the acquisition of professional competences.
To our knowledge, there are no studies that have explored the existing relation between EI, coping styles and satisfaction with one's own learning in the simulated environment of a stressful situation, such as the care of dying patients. The studies seem to suggest that, in general, nursing students who have high levels of EI and the appropriate coping strategies for stress, achieve high scores in the scales measuring satisfaction and self-confidence in learning (Lee and Gu, 2013, Suliman, 2010). However, these studies are inconclusive as the conclusions are not easily generalizable and the definition of concepts (IE, coping styles, etc.) are different in each study, which means further studies are needed along these lines. Therefore, it is necessary to explore whether the activity of learning in itself can influence satisfaction in one's own learning. If we consider that the process of learning favors the acquisition of competences highly related to EI and personal styles of coping, a positive relation may be established between learning style, EI and coping.
The aim of the present study was to analyze the possible relation between EI, coping styles and satisfaction with one's own self-learning in nursing students participating in simulated scenarios related to palliative care at the end of life.
Section snippets
Design
A descriptive, observational and correlational study.
Subjects
Nursing students who were in their second year of undergraduate studies based at a university participated in this study. This research took place during the 2015/2016 academic year. The participation was voluntary and offered to all students enrolled in the course (a total of 74). The sample selection was therefore for convenience. The University is public and serves a whole region of northern Spain. The students performed a practice based
Results
The study participants were 74 students in their second year of nursing studies with a mean age of 20.3 years, of which 91.4% were women. All students were Spanish.
Table 1 displays the mean results of the scores in all three dimensions of the TMME-24 scale and the statistical test to determine the differences between men and women (N = 74).
As can be observed, there were no differences between men and women (the sample of men was very low in comparison with the female participants). The most
Discussion
Among the main results of this study, the association between satisfaction with learning and the attention subscale of EI was noteworthy (which is where students obtained the highest scores) and two specific styles of coping (FSP, with high scores and open emotional expression). Our hypothesis is partly confirmed: the highest score on the attention to emotions subscale is associated with certain coping styles and with satisfaction with learning however, there does not seem to be a relation with
Conclusions
In conclusion, research of this type is necessary in educational contexts. The establishment of relations between psychological variables, such as coping with stress or EI with attitudinal variables such as one's own satisfaction with learning gives us tools for improving the design of the educational curriculum in nursing. This is relevant in professions such as nursing in which the importance of being trained in attitudes, skills and personal values is crucial. Areas such as palliative care
Conflict of Interest
No conflict of interest has been declared by the authors.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding Information
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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2022, Nurse Education TodayCitation Excerpt :Therefore, clinical simulation as a methodology that promotes learning in a controlled environment improves self-efficacy in students (Karabacak et al., 2019). On the other hand, the management of emotions has also been related to clinical simulation (Alconero-Camarero et al., 2018). It has been shown that the capacity for emotional regulation or emotional intelligence facilitates the establishment of appropriate relationships with others (Farshi et al., 2015), in addition to producing an improvement in the management of emotions derived from the caring process (Cherry et al., 2014; El-Sayed and El-Zeiny, 2014).