Pre-registration nursing students' anxiety and academic concerns after the second wave of COVID-19 pandemic in Italy: A cross-sectional study

Background The pandemic and its related social restrictions have led to many uncertainties in nursing education, including the fear of infection in clinical learning settings and the challenge of remote learning. The modification of clinical and academic environments generated anxiety and academic concerns among nursing students. Objectives To explore the main determinants of anxiety related to the clinical and classroom environments in nursing education after the second wave of the COVID-19 Pandemic. Design Multicentre cross-sectional study. Settings Ten Universities offering nursing bachelor programs in central and southern Italy. Participants A convenience sample of 842 nursing students. Methods From April to July 2021, the Self-Rating Anxiety Scale and the Altered Student Study Environment Tool were administered to assess, respectively, students' anxiety and their concerns about the study environment. A regression model was tested. Results Most of the nursing students were female (76.6 %), living with family (70.9 %), and full-time students (85.7 %); 44.6 % were third-year of Bachelor in Nursing students. The majority of the participants (88.5 %) showed a level of anxiety. The statistically significant predictors of anxiety levels were concerns about grade attainment (β=0.42, p < 0.001) in the total sample, and, among the first-year students, the completion of clinical placement (β=0.14, p = 0.047). Conclusions Results suggest a need for the redesign of teaching activities and clinical learning experiences to ensure academic outcomes and to preserve students' psychological well-being. Models of learning environments' dynamic adaptation and ongoing psychological support should be implemented to develop tailored interventions