Influence of a b-learning model to improve perceived stressors in final-year nursing students during clinical placements: a quasi-experimental study

Identificador:  imarina:9499067

Handle: https://hdl.handle.net/20.500.11797/imarina9499067

Autores:  Reverte-Villarroya, Silvia; Gil-Mateu, Elsa; Fernandez-Saez, Jose; Martorell-Poveda, Maria-Antonia; Raventos-Torner, Rosa; Barcelo-Prats, Josep

Resumen:
Background Clinical placements are essential for nursing students’ competence development but represent one of the most stressful components of their training. High levels of perceived stress may hinder learning, undermine confidence, and negatively affect clinical performance. Evidence on pedagogical strategies to mitigate these stressors remains inconsistent, and the potential of blended-learning models during placements is not well established. This study evaluated the effect of a tutored blended-learning model (i-MHA) on perceived stressors among final-year nursing students. Methods A prospective quasi-experimental pre–post study with a control group was conducted across three campuses of the Rovira i Virgili University (Spain) during the 2021–2022 academic year. The intervention group received a structured blended-learning model incorporating moderated online forums, guided reflection, and weekly tutor-led supervision. The control group followed the traditional supervision approach. Perceived stress was assessed before and after placements using the Kezkak questionnaire. Between-group differences were analysed using the Mann–Whitney U test, and within-group changes using the Wilcoxon test. Effect sizes (Cohen’s d) and attrition analyses were performed to validate internal consistency. Results A total of 126 students participated (86.89% women; mean age 23.64 years). No significant baseline differences were found between groups across any Kezkak dimensions. After the intervention, the only significant between-group difference emerged in Factor 3 (Relationship with tutors and peers), with lower stress scores in the intervention group (p = 0.030). In the paired intragroup analysis (n = 61), the intervention group showed a significant improvement in the same dimensio