Background/Aim. Clinical learning is a main part of nursing education. Students' exposure to clinical learning environment is one of the most important factors affecting the teaching-learning process in clinical settings. Identifying challenges of nursing students in the clinical learning environment could improve training and enhance the quality of its planning and promotion of the students. We aimed to explore Iranian nursing students' challenges in the clinical learning environment. Materials and Methods. This is a qualitative study using the content analysis approach. The participants consisted of seventeen nursing students and three nursing instructors. The participants were selected through purposive sampling method and attended semistructured interviews and focus groups. Results. Three themes emerged after data analysis, including ineffective communications, inadequate readiness, and emotional reactions. Conclusion. Nursing students in Iran are faced with many challenges in the clinical learning environment. All challenges identified in this study affected the students' learning in clinical setting. Therefore, we recommend that the instructors prepare students with a specific focus on their communication and psychological needs.

IntroductionOn entry into the clinical environment, nursing students are confronted with many challenges. It is a common problem throughout the world, including Iran. Although many studies have been conducted on the problems of nursing students in the clinical environment, limited information is available on nursing students’ experiences of the clinical learning environment and the way they respond to these experiences. Identifying nursing students’ experiences is essential to develop interventions to reduce challenges.ObjectiveThis study aimed to explore nursing students’ experiences in a clinical learning environment and the way they responded to these experiences.DesignThe present study was conducted based on the qualitative research design of the grounded theory methodology.SettingThis study was conducted at schools of nursing in academic settings in Iran.ParticipantsThe participants included 19 nursing students, 4 nursing instructors and 3 clinical nurses.MethodsThe data were collected using semistructured interviews, field notes and observation, and were analysed using Strauss and Corbin’s approach.ResultsStudents, as a result of the inadequacy of the educational environment, were faced with ‘confusion of identity’, stating this as their main concern. When confronted with this concern, they employed specific strategies, some of which prevented them from getting into unpleasant conditions. These strategies did not help students solve their problems and also prevented them from accepting their professional roles and responsibilities. Conversely, some other strategies led them to advanced professional development and enabled them to accept their role and the clinical environment.ConclusionAccording to the results of this study, educational policymakers should focus on improving the clinical environment. Identifying professional models and increasing their influence on management, education and clinical education, as well as teaching positive and constructive strategies, will promote positive strategies in coping with inadequate educational contexts. This is necessary for the professional development of nursing students.

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Injuries caused by needles and sharp and cutting objects include wounds, cuts, or abrasions caused by medical devices that may have already been contaminated with blood or other body fluids. 1 In most studies on injuries caused by needles and sharp objects, the injuries are introduced as an important occupational hazard for healthcare workers. 2,3 There are about thirty-five million healthcare workers in the world who make up 12% of the world labor force. 4 The Center for Disease Control and Prevention estimates that 385 000 healthcare workers in America annually experience injuries caused by needles and sharp objects. 5 In some countries, including Iran, despite safety precautions, injuries caused by needles and sharp objects still occur, inflicting significant economic and human costs. 6 More than 90% of infections caused by sharp tools among healthcare workers occur in low-income countries where these injuries are preventable. 7,8 Given the necessity for a coherent review study regarding injuries caused by needles, sharp objects, blood and body fluids, the current study aimed to make an analytical review of previous research conducted in this regard to determine the prevalence of the phenomenon among Iranian healthcare workers. Methods This study was a systematic review of the research conducted in the field of injuries caused by needlestick, sharp objects, and exposure to blood and body fluids among Iranian healthcare workers.

Objectives Students of medical sciences are exposed to many emotional and mental problems. In light of the importance of sleep quality in learning and liveliness, this study was conducted to examine the relationship between psychological variables (stress, anxiety, and depression) and sleep quality of students. Design This research is a cross-sectional analytical study, where all students studying at Fasa University of Medical Sciences in 2012-2013 year were selected. To examine the students' stress, anxiety, and depression values, the standardized 21-item DASS-21 was used, and to examine their sleep quality, Pittsburgh Sleep Quality Index (PSQI) was used. Results The results of the study demonstrated that 73% of the students have moderate and severe stress, and 46.4% of them have PSQ scores ≥ 5. The students' mean sleep quality score was 4.65 ± 2.37, and their stress score was 8.09 ± 5.14. A statistically significant relationship was found between the students' stress levels and sleep quality (P < 0.001). Conclusion The high stress levels decrease students' sleep quality. High stress levels and also the significant relationship between stress value and decrease in students' sleep quality call for more attention to and care for students' emotional and mental issues and timely proper interference on the part of authorities.