Nursing Student

U ndergraduate nursing students encounter many first-time, anxiety-provoking situations. They learn to manage their fears and perform practice skills according to the expectations of the psychiatric faculty and nursing staff. Perhaps one of the most upsetting clinical experiences for nursing students is the psychiatric-mental health practicum in which they are expected to communicate therapeutically with hospitalized patients who are mentally ill. Because of patient aggression and threats of violence in psychiatric settings (Morrison, 1998), caring for mentally ill persons invokes strong responses by the students, including "anxiety, learning, failure, and growth" (Frisch & Frisch, 1998, p. 5). To ease students' progression into the professional nursing role, psychiatric-mental health faculty prepare the students, during class and clinical conferences, for contact with patients who are mentally ill. Techniques used to prepare students include the following: (a) describing the biopsychosocial theories that explain the behavior of patients and the interventions of health care providers; (b) examining stereotypical behavior; (c) teaching students therapeutic communication approaches and safety techniques; (d) stimulating students to increase self-awareness; (e) reassuring students that seasoned staff and nursing faculty are nearby; and (f) asking students to seek faculty and staff assistance when they are concerned about the behavior of psychiatric patients. Few literature sources (Krikorian & Paulanka, 1984; Nieswiadomy, Arnold, & Johnson, 1989; Perese, 1996) have examined baccalaureate nursing students' clinical experiences in psychiatric-mental health settings. No specific investigations were located that examined nursing students' experiences when com

Background: Italian Nursing Faculties use a range of tutorial strategies (laboratory sessions, intensive clinical tutoring, weekly tutoring) aimed to enhance nursing students' diagnostic reasoning: these strategies have different impacts on promoting student critical thinking. By using critical thinking methods, students develop abilities to check, monitor and constantly evaluate the accuracy of the diagnostic reasoning process. However, there is little evidence to show how effective tutorial strategies are on the accuracy of diagnostic reasoning. There is also very little known about the complexity of tutorial strategies because these are made up of several components (e.g. tutor questioning abilities, the value of the setting, the impact of the environment, the expertise of the tutor and the impact of the Faculty's philosophy of learning), tutorial strategies cannot be standardised and depend on multiple factors which are difficult to control. Objectives: The objective was to establish a relationship between tutorial strategies orientated to enhance critical thinking and the accuracy of diagnostic reasoning (i.e. the number of correct answers given by students on simulated cases in two different nursing education contexts). It was hypothesised that students who had had one laboratory session using intensive tutorial strategies had less probability of making reasoning errors in diagnosing a simulated case than a control group that had weekly tutorials or routine tutoring. Design: A double pragmatic experimental study was adopted involving two Italian Nursing Faculties at universities in Verona and Udine. Participants: A total of 144 students in the first year of their Nursing Science Degree course were involved; in Verona, two random groups of 41students were taken (an intervention group and a control group). Random selections of 39 students for the intervention group and 29 students for a control group were made from the second campus in Udine. Data analysis was conducted comparing student outcomes in the same faculty (intra-trial analysis) and between the two campuses involved (inter-trial analysis).

AbstractIntroduction: To ensure that nursing education stay abreast with modern technology advances has the Schoolof Nursing (SoN) of The University of the Western Cape integrated e-learning into the curriculum. This methodarticulates well with the case-based approach adopted by the SoN. The Learning Management System,Knowledge Environment for Web-Based Learning (Kewl), Next Generation (KNG), was used to facilitate onlineteaching and learning.Objectives: The primary aim was to gather baseline data on e-learning by exploring the perceptions andexperiences of the first pilot group of undergraduate nursing students who were exposed to this strategy.Methods: A descriptive cross-sectional quantitative design was used to determine the students' understandingand valuing of e-learning, the benefits and skills gained and challenges experienced, by means of a structured,close-ended questionnaire with space for comments. Convenience sampling was used and the questionnairewas distributed to...

Aims: The study examined the effects of brief monthly practice on nursing students' CPR psychomotor skill performance at 3, 6, 9, and 12 months compared to a control group with no practice, and of repeating the initial BLS course at 12 months. Methods: Nursing students (n = 606) completed either HeartCode TM BLS or an instructor-led course and were then randomly assigned to an intervention group practice schedule, consisting of experimental (6 min of monthly practice on a voice advisory manikin) or control (no practice) and test out month. Every 3 months, a subset of students was randomly selected from both groups for reassessment of their CPR psychomotor skills. Outcome measures were compression rate and depth, percent of compressions performed with adequate depth, percent performed with correct hand placement, ventilation rate and volume, and percent of ventilations with adequate volume. Results: At 3 months, there were no differences between the groups in mean ventilation volume (p = 0.71), but with practice by 6 months students were able to ventilate with an adequate volume; this skill continued to improve with monthly practice. In the control group, the mean ventilation volumes were less than the recommended minimum throughout the 12 months. The control group had a significant loss of ability to compress with adequate depth between 9 and 12 months (p = 0.004). By practicing only 6 min a month, students maintained or improved their CPR skills over the 12-month period. Conclusion: The findings confirmed the importance of practicing CPR psychomotor skills to retain them and also revealed that short monthly practices could improve skills over baseline.

Percutaneous injuries, caused by needle sticks and other sharps, are a serious concern for all health care workers (HCWs) and pose a significant risk of occupational transmission of blood borne pathogens. Needle stick injuries (NSI) are wounds caused by sharps such as hypodermic needles, blood collection needles, iv cannulas or needles used to connect parts of iv delivery systems. The causes include various factors Needle stick injuries among health care workers in a tertiary care hospital of India Background & objectives: Percutaneous injuries caused by needlesticks, pose a significant risk of occupational transmission of bloodborne pathogens. Their incidence is considerably higher than current estimates, and hence a low injury rate should not be interpreted as a non existent problem. The present study was carried out to determine the occurrence of NSI among various categories of health care workers (HCWs), and the causal factors, the circumstances under which these occur and to, explore the possibilities of measures to prevent these through improvements in knowledge, attitude and practice.

This article presents the development and implementation of simulated learning experiences for baccalaureate pediatric nursing students at the University of Utah College of Nursing. Learning experiences include use of simulated human pediatric patients and a simulated electronic medical record and are included in both didactic and clinical courses. Objectives include demonstration of pediatric nursing skills, synthesis of assessment findings, prioritization of nursing interventions, documentation, and multidisciplinary communication. Student feedback indicates improved confidence when approaching pediatric patients and better preparation to respond to acute changes in the patient's condition. Plans include ongoing refinement of simulated learning experiences and the linking of actual clinical outcomes to simulation-based learning.

Promoting clinical reasoning in undergraduate nursing students through application of the Outcome Present State Test (OPT) Model of Clinical Reasoning, is a challenge that can be successfully managed through effective teaching-learning strategies. Empirical evidence to support teaching strategies that foster both cognitive and metacognitive skill acquisition is limited. The purpose of this research was to evaluate the development of clinical reasoning skills among nursing students through the application and evaluation of teaching-learning strategies associated with self-regulated learning and the OPT model (Pesut & Herman, 1998; 1999; Pesut, 2004). The model and self-regulated learning prompts were used to structure learning with junior level baccalaureate nursing students during a ten-week, medical-surgical clinical experience in acute care telemetry units. Data analysis revealed students effectively made gains in learning associated with the OPT model. Qualitative analysis of self-regulated learning prompt journal data revealed students made significant gains in self-observation, self-judgment, knowledge work and use of health care personnel resources during clinical experiences. Results indicated the intentional use of guided reflection coupled with structure and learning tools of the OPT model significantly enhanced clinical reasoning skill acquisition, and provided evidence for the effectiveness of structured teaching learning strategies.

''Annie'' CPR manikin allows ''hand-on skills practice'' for learners to become certified in Basic Life Support Healthcare Provider (BLS-HCP). Instructors often only observe, which makes it challenging to provide accurate feedback and meaningful correction to a class of learners. Kay and associates (1991) found instructors did not do a good job with learner skill refinement during training sessions. Research has shown that the skill performance of learners who successfully completed an instructor-led course is poor, even immediately after completing the course (Kay & Mancini, 1986). Studies have indicated that skill performance at three-and twelve-month evaluations is also poor (Donnelly, Assar, & Lester, 2000; Broomfield, 1996). The traditional manikins have been enhanced to record compression and ventilation data electronically. An important addition is the computer-based voice advisory manikin (VAM) feedback system which provides real time instructional feedback. The American Heart Association (AHA) has developed a new learning modality for BLS-HCP called ''BLS Anytime.'' This modality provides the BLS book and CD that is used in the instructor-led class and also provides the learner with a DVD with interactive video skill demonstrations and practice. The kit includes adult and infant CPR supplies that allow the learner to practice while following the DVD instructions. The practice manikins have an optional auditory click to provide feedback regarding depth of compressions. The BLS Anytime kit not only allows practice for initial certification, but also enables skills to be refreshed between certifications. In our baccalaureate program, students have to maintain current AHA BLS-HCP certification throughout the program to meet clinical agency requirements. The School of Nursing has offered traditional instructor-led classes to assist in meeting this requirement. This is a costly, time consuming endeavor that is often hard to fit into the busy schedule of incoming students. The BLS Anytime program and VAM manikins provide an alternative method of certification and the opportunity to refresh skills throughout the curriculum. A research study was designed to compare CPR skill acquisition and retention among BSN students (n ¼ 99) who completed a traditional instructor-led classroom course and those who completed an independent study course. Students were divided into three groups: Group A students completed a traditional, instructor-led CPR training course after program entry; Group B students completed an independent study course (''BLS Anytime'') after program entry; Group C students completed a traditional instructor-led CPR training course prior to entering the program. After three months, all three groups demonstrated CPR skill performance on VAM manikins. This presentation will report on the results of this study, highlighting the benefits and challenges. The experiences of faculty who completed recertification with the VAM manikins with the BLS Anytime will also be discussed.

Aim: This paper profiles a study that explored nursing students' information and communication technology competence and confidence. It presents selected findings that focus on students' attitudes towards information and communication technology as an educational methodology and their perceptions of its relevance to clinical practice. Background: Information and communication technology is integral to contemporary nursing practice. Development of these skills is important to ensure that graduates are 'work ready' and adequately prepared to practice in increasingly technological healthcare environments. Methods: This was a mixed methods study. Students (n = 971) from three Australian universities were surveyed using an instrument designed specifically for the study, and 24 students participated in focus groups. Findings: The focus group data revealed that a number of students were resistant to the use of information and communication technology as an educational methodology and lacked the requisite skills and confidence to engage successfully with this educational approach. Survey results indicated that 26 per cent of students were unsure about the relevance of information and communication technology to clinical practice and only 50 per cent felt 'very confident' using a computer. Conclusion: While the importance of information and communication technology to student's learning and to their preparedness for practice has been established, it is evident that students' motivation is influenced by their level of confidence and competence, and their understanding of the relevance of information and communication technology to their future careers.

Aim: This paper profiles a study that explored nursing students' information and communication technology competence and confidence. It presents selected findings that focus on students' attitudes towards information and communication technology as an educational methodology and their perceptions of its relevance to clinical practice. Background: Information and communication technology is integral to contemporary nursing practice. Development of these skills is important to ensure that graduates are 'work ready' and adequately prepared to practice in increasingly technological healthcare environments. Methods: This was a mixed methods study. Students (n = 971) from three Australian universities were surveyed using an instrument designed specifically for the study, and 24 students participated in focus groups. Findings: The focus group data revealed that a number of students were resistant to the use of information and communication technology as an educational methodology and lacked the requisite skills and confidence to engage successfully with this educational approach. Survey results indicated that 26 per cent of students were unsure about the relevance of information and communication technology to clinical practice and only 50 per cent felt 'very confident' using a computer. Conclusion: While the importance of information and communication technology to student's learning and to their preparedness for practice has been established, it is evident that students' motivation is influenced by their level of confidence and competence, and their understanding of the relevance of information and communication technology to their future careers.

The aim of this study was to examine the psychometric properties, including predictive validity, of the newly-developed nursing self-efficacy for mathematics (NSE-Math). The NSE-Math is a 12 item scale that comprises items related to mathematic and arithmetic concepts underpinning medication calculations. The NSE-Math instrument was administered to second year Bachelor of Nursing students enrolled in a nursing practice subject. Students' academic results for a compulsory medication calculation examination for this subject were collected. One-hundred and twelve students (73%) completed both the NSE-Math instrument and the drug calculation assessment task. The NSE-Math demonstrated two factors 'Confidence in application of mathematic concepts to nursing practice' and 'Confidence in arithmetic concepts' with 63.5% of variance explained. Cronbach alpha for the scale was 0.90. The NSE-Math demonstrated predictive validity with the medication calculation examination results (p = 0.009). Psychometric testing suggests the NSE-Math is a valid measure of mathematics self-efficacy of second year nursing students.

s u m m a r y Aim: To analyse recurring adjustments made in practice settings and the support strategies put in place to enable disabled students to achieve the levels of proficiency required on pre-registration nursing programmes. Background: Legislative and regulatory changes in the UK require higher education institutions to make reasonable adjustments for disabled students whose needs must be considered and adjustments made before their programmes of study begin. The student practice learning advisor's (SPLA) primary role is to support disabled students and to operationalise recommended adjustments in practice.

Attrition is a serious issue among Bachelor of Science in Nursing (BSN) students with attrition rates around 50% nationwide. To help minimize BSN student attrition, many nursing programs use commercially available standardized nursing aptitude tests as adjuncts to scholastic aptitude data, usually operationalized as pre-nursing grade point average, to select students for admission. Little is known regarding the usefulness of scholastic and nursing aptitude data for predicting long-term retention in a BSN program and readiness for the National Council Licensure Examination-Registered Nurse (NCLEX-RN). Therefore, the purpose of this study was to describe the relationships among scholastic aptitude, nursing aptitude, BSN student attrition prior to the final semester of the curriculum, and BSN student readiness for the NCLEX-RN. This study's findings, along with other findings in the literature, suggest the need for a parsimonious explanatory model of BSN student attrition that can be used to guide admission and progression policies, and ensure that students ready for the NCLEX-RN are the ones graduating from BSN programs. (Index words: Aptitude; Student attrition; NCLEX-RN, Undergraduate nursing) J Prof Nurs 25: 273-278, 2009.

Background: Student mobility within Europe is encouraged by the EU's 'Bologna process' and financially supported by the Socrates programme. However, relatively few UK nursing students travel to Europe for study. Aims: To compare the willingness to study or work abroad and the perceived barriers and benefits of doing so, amongst students in England and Spain. Methods: Third year nursing students completed a 15 item questionnaire on work and study abroad. Results: Spanish students were younger than UK students, had fewer family commitments, and better language skills. There was little difference between Spanish and UK students in wanting to study abroad, UK students named English speaking countries as likely destinations. Spanish students named Italy; the UK and USA were also popular. Perceived barriers for UK students were funding, family, and language. Family commitments were not a major problem for Spanish students. Spanish were more likely than English students to see language as a problem. Conclusions: UK and Spanish Nursing students are equally enthusiastic about studying or working abroad but UK students have limited language skills, are less able to access Socrates funding for European destinations, and given their age and family commitments, funding is a barrier for 'non-Socrates' destinations.

Objective: This study was conducted to describe learning styles of third year nursing students. Design: An interventional study Setting: a public university in Jordan. Subjects: Used a purposive sample of 92 nursing students who were enrolled in maternity nursing course. Main Outcome measures: Measure the difference in learning styles of nursing students after introducing an intervention of PBL as a teaching methodology. Results: The dominant learning preference of the students was the read/write preference followed by the kinesthetic, still most of the students represented a multimodal learning preference. No significant difference was found between males and females. A significant difference in the learning preferences of the students in the pre-post test was found. In the pretest the mean of the total VARK score 13.9 (SD = 2) where as in the post test the mean of the total VARK score = 16.5 (SD = 3.5). In the pre-test 54% of students had a multimodal preference whereas 68% of students have a multimodal preference post-test. Conclusions: Most students are able to learn effectively as long as the instructor provides different learning activities in the areas assessed in VARK. Active learning might be enhanced in large classrooms by presenting models and demonstrations, discussions, debates, answering questions, and role playing.

The majority of nursing curriculums continue to relate experiences and examples of nursing to the more familiar role of "nurse clinician". Specifically, the use of simulation and technology has been used in the undergraduate nursing program to assist learners in developing nursing skills and knowledge for treating individual patients with acute and chronic conditions. Nursing students are now able to apply learned concepts of nurse clinician when treating virtual patients and while engaging in simulation-based education. The use of such simulation in undergraduate nursing education allows learners to readily apply skills and knowledge within a safe learning environment; however, the use of such technology has not been widely adopted to address the learning needs of today's community health nursing students. In fact, despite its importance, the role and process of community health nursing is often unknown to many undergraduate nursing students. This paper presents a strategy-based, interactive community simulation environment that addresses the learning needs of millennial students within a community health nursing curriculum.

Background: Nursing simulation is said to be a safe learning environment. However, research and anecdotal information suggest it may be safe for patients but not academically safe for students. Academic safety is defined. Method: Nursing students (n ¼ 101) and faculty (n ¼ 24) from schools in the San Francisco area completed online surveys to describe an academically safe learning environment.

collaboration of an interinstitutional, interdisciplinary students: does the method matter? Results Teamwork training with nursing and medical http://qualitysafety.bmj.com/content/19/6/e25.full.html Updated information and services can be found at: These include: References http://qualitysafety.bmj.com/content/19/6/e25.full.html#related-urls Article cited in: http://qualitysafety.bmj.com/content/19/6/e25.full.html#ref-list-1

With the increasing standardization of nursing education in Europe under the Bologna Process Declaration (1999), there is a growing interest in defining a common concept of academic success and/or failure, measuring associated factors and comparing differences and similarities between different countries. While there is literature available on these issues from other countries, the phenomenon has not been studied in Italy. The aim of this study was to define the factors associated with academic success or failure in an Italian cohort of nursing students on a bachelor's degree course. A retrospective multicenter study design was adopted. All students enrolling in the academic year 2004-05 on two different bachelor's courses in the north of Italy were interviewed. Only 81 of the 117 students considered (69.2%) concluded their course in three years. Multivariate analysis identified two factors determining academic success/failure: good results in the entry examination for the bachelor's degree in nursing sciences were associated with academic success (OR 4.217, IC 95% 1.501-11.84), while family commitments, e.g. caring for children or elderly people were associated with academic failure (OR 0.120, IC 95% 0.03-0.471). Academic failure has a strong impact on students, their families, the teaching faculties and the community, and its prevention is a challenge in the countries with a shortage of nurses.

Although often presented as a single basis for educational visual screen design, Gestalt theory is not a single small set of visual principles uniformly applied by all designers. In fact, it appears that instructional visual design literature often deals with only a small set of Gestalt laws. In this project Gestalt literature was consulted to distil the most relevant Gestalt laws for educational visual screen design. Eleven laws were identified. They deal with balance/symmetry, continuation, closure, figure-ground, focal point, isomorphic correspondence, prägnanz, proximity, similarity, simplicity, and unity/harmony.

The authors of this article discuss how a mixed-methods research team designed and conducted a 4-year study (Variations in Teachers' Work and Lives and Their Effects on Pupils) that tracked 300 teachers in 100 schools in England over a 3-year fieldwork period. The authors discuss processes that led to new knowledge. Although mixed methods are becoming more popular, few published accounts describe in detail how researchers have moved beyond the use and integration of mixed methods to arrive at more synergistic understandings. The advantage of synergistic approaches is their consideration and combination of a greater range of data, resulting in more nuanced, authentic accounts and explanations of complex realities.

Learning and teaching have been conceptualized and executed in many styles, such as self-learning, peer learning, and interaction between the learner and mentor. Today, openness to alternative ideas and embracing innovative approaches in nursing education are encouraged in order to meet students' learning interests and needs, and to address ever-changing healthcare requests. Problem-based learning has been widely adopted in nursing education, with various positive effects on students' learning, such as motivated learning, team work, problem-solving skills and critical thinking. Role-plays have been demonstrated as an effective learning strategy that includes an active and experiential feature that facilitates students' autonomy in their health-related learning. However, there is a lack of discussion of whether and how role-play can be used in problem-based learning (PBL). This paper shows the development of a classroom-based innovation using role-play in the PBL class for higher diploma year-one nurse students (a total of 20 students, five per group). This paper consists of five sections: a) the literature on PBL and nurse education, and role-plays as the innovation; b) the PBL case scenario with the illustration of the two role-play scripts, c) student evaluation on role-play in the PBL class; d) discussions on both achievements and limitations of this innovation, and e) the conclusion. It is hoped that this paper will be an example to other nurse educators who are keen on exploring interactive and student-driven learning and teaching strategies in the PBL class.

Nursing students are increasingly undertaking paid term-time employment to finance their living expenses and studies. However the type and duration of this part-time work is unknown; furthermore there is a limited evidence on the extent to which this part-time employment is impacting on academic performance and the student's experience of higher education. To address this shortfall this study undertook a cross-sectional survey of undergraduate nursing students to explore the incidence of student involvement in term-time employment and to develop an understanding of the relationship of employment on student's academic and clinical achievement, and on their experience of higher education. The results found that the vast majority of the sample were working in part-time employment during term-time. The average number of hours worked per week was sixteen. The number of hours worked per week was found to be a predictor of course performance, the student's experience of college and grades achieved. Students who worked greater hours reported negative outcomes in each of these three domains. The findings also support the contention that it is not working per se that has a detrimental effect on student outcomes but the numbers of hours' students are actually working while attending college. Therefore policy makers, educationalists and health service providers need to be aware of the burden that nursing students may have to contend with in combining work with their academic studies.

Background: Four-or five-option multiple choice questions (MCQs) are the standard in healthscience disciplines, both on certification-level examinations and on in-house developed tests. Previous research has shown, however, that few MCQs have three or four functioning distractors. The purpose of this study was to investigate non-functioning distractors in teacher-developed tests in one nursing program in an English-language university in Hong Kong. Methods: Using item-analysis data, we assessed the proportion of non-functioning distractors on a sample of seven test papers administered to undergraduate nursing students. A total of 514 items were reviewed, including 2056 options (1542 distractors and 514 correct responses). Nonfunctioning options were defined as ones that were chosen by fewer than 5% of examinees and those with a positive option discrimination statistic. Results: The proportion of items containing 0, 1, 2, and 3 functioning distractors was 12.3%, 34.8%, 39.1%, and 13.8% respectively. Overall, items contained an average of 1.54 (SD = 0.88) functioning distractors. Only 52.2% (n = 805) of all distractors were functioning effectively and 10.2% (n = 158) had a choice frequency of 0. Items with more functioning distractors were more difficult and more discriminating.

s u m m a r y Background: The proportion of older people has increased worldwide and so are the health problems related with ageing, such as cardiovascular diseases and cancer that often need long-term nursing care. Nurses therefore, have a pivotal role in the care of older people. Aim: To evaluate the effects of education on nursing students' knowledge and attitudes towards older people in Greece. Method: Two hundred and twenty seven first and final year nursing students at a university and 191 first and final year nursing students at a Technological Education Institute completed a questionnaire, including demographic questions, the Kogan's Old People Scale and the Palmore's Facts on Aging Quiz I. Results: Attitudes towards older people were more positive in final year students in comparison to first year ones in both schools. Knowledge was found better only in relation to physical health in the final year students, in both schools. Age and female gender were found to influence both attitudes and knowledge positively. Conclusions: Nursing education in Greece seems to influence the attitudes and knowledge of nursing students towards older people. However, revisions and improvements in curricula are needed if nursing students are to gain a more holistic perspective of older people.

Aim. This paper reports a study examining the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students with the aim of informing undergraduate curricula. Background. In comparison with registered nurses, physician status is a risk factor for non-compliance with hand hygiene guidelines. Little research has been conducted to determine if differences between the professions in relation to hand hygiene are apparent at the undergraduate level. Cross-disciplinary studies that may provide an insight into this topic are lacking. Methods. A questionnaire was administered to a convenience sample of 117 nursing and 119 medical students in a large university in Rome, Italy, to determine their hand hygiene knowledge, beliefs and practices. The data were collected in 2007-2008. Results. Nursing students' hand hygiene knowledge (F = 9AE03(1,230); P = 0AE003), percentage compliance (Z = 6AE197; P < 0AE001) and self-reported hand hygiene practices (F = 34AE54(1,230); P < 0AE001) were significantly higher than that of medical students. There were no statistically significant differences between hand hygiene beliefs. Mean scores on the knowledge questions were low for both groups, reflecting primarily a knowledge deficit in relation to the use of alcohol-based hand rubs to decontaminate hands in the healthcare setting. Conclusion. Statistically significant disciplinary differences in hand hygiene knowledge and self-reported practices were apparent among undergraduate Italian healthcare students. Further research is needed to determine the causative factors. The overall low scores on the knowledge items indicate that these students require further education on hand hygiene, particularly in relation to the use of alcoholbased hand rubs.

Background: College students are prone to stress due to the transitional nature of college life. High levels of stress are believed to affect students' health and academic functions. If the stress is not dealt with effectively, feelings of loneliness, nervousness, sleeplessness and worrying may result. Effective coping strategies facilitate the return to a balanced state, reducing the negative effects of stress.