الفهرس 
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Abstract
Practical training is a vital element in nursing programs because it provides nursing students with opportunities to integrate learning and the acquisition of motor skills, and develop their skills in the practice of nursing, and the application of theory to reality. It is also an essential part of nursing education and more than half of the nursing curriculum.
Moreover, practical training is essential for nursing students to become socially qualified in the nursing profession, to expand their awareness of their role in the future and learn types of behavior that are professionally acceptable or unacceptable. However, clinical practice takes place in a socially complex environment, where nurses care for patients and nurse teachers teach students to provide care at the same time, in addition to the decrease in the necessary facilities for education and the low number of nurse teachers to oversee the educational process.
Nursing programs where clinical teaching arrangement must be joined between educational institute and services agencies, great care must take to ensure that the agency can provide experience that will likely allow students to achieve the nursing program’s learning objectives, provide the necessary learning activities, materials, provide an atmosphere that is conductive to students learning, it is imperatives, that clinical instructors available to guide students as they learn to problem solving in the complex patient situations.
Aim of the study:
This study aim to assess factors influencing quality of education of nursing students during the practical training in technical nursing institutes of ministry of health in Alexandria.
Research question:
What are the nursing students’ opinions regarding factors influencing quality of education of nursing students during the practical training in technical nursing institutes of ministry of health in Alexandria?
Research design:
Cross-sectional survey was used to assess factors influencing quality of education of nursing students during the practical training in technical nursing institutes of ministry of health in Alexandria.
Settings:
This study was carried out at six technical institute of nursing selected by a stratified random sample method with equal allocation namely; AL jumhuria, AL-Amriya,
Ras-EL Teen, Abu Qir, Burj Al Arab, and Dar Ismail).
Pilot study:
A Pilot study was carried out on a sample of 30 nursing students selected randomly from Al-Amriya institute to test the feasibility, applicability of tool, clarity of language and estimate the time required for completing the tool and ensure the clarity of Arabic questionnaire. Data obtained from the pilot study was identifying the obstacle and problems that may encountered during data collection and to estimate the time needed to complete the questionnaire items. Students representing 10 % of the total sample, and were excluded from the actual study.
Subjects:
The study subjects comprised (260) nursing students who were available at the time of data collection and selected from all nursing students enrolled at the second and third year of the previously mentioned institute.
Tool:
One tool was used by the researcher to collect the data of the study. This questionnaire was developed by the researcher after reviewing the related literature, to assess factors influencing quality of education of nursing students during the practical training in the technical nursing institutes of ministry of health in Alexandria. It included three parts:
Part I: Academic characteristics:
Inform of, institute’s name, scholastic grade, total grade of nursing in previous year and the reason for joining the technical nursing institute.
Part II:
70 items regarding the following seven main dimensions:
1. Student preparation including 33 items (Student ethical preparation, Student psychological preparation, Student scientific preparation )
2. Learning opportunities including 3 items.
3. Student relationships including 15 items.(relationships between the Student and the nurse teacher, relationships between the Student and health team, relationships between the Student and her colleagues, relationships between the Student and the patient and his relatives).
4. Nurse teachers characteristics including 5 items such as( appearance, patience, flexibility and clinical skills). Cooperation to remove difficulties.
5. Clinical evaluation including 2 items (done and post evaluation).
6. Facilities provided from hospital to support clinical training including 6 items such as (capacity of training places, hangouts, the dressing room, instruments, bathroom, and infection control).
7. Facilities provided from institute administration to support clinical training including 6items such as; lab equipment, maintenance, and …….
It was measured by using a five point Likert scale, the scales ranges from (1:5) where: 1=strongly disagree & 5=strongly agree.
Part III: One open ended question:
- Suggestion to improve the educational process during practical training in technical nursing institutes from nursing student the point of view.
Method:
1. Permission to conduct the study was obtained from the responsible authorities of the institutes of nursing after explaining the purpose of study.
2. The tool of the study was developed by the researcher after review of related literature.
3. Content validity for the study tool was done for testing the applicability of content by experts in nursing field and director of technical nursing institute, Alexandria. Accordingly, necessary modifications were done, for example, adding one open ended questions to help students describe freely suggestion to improve education. They experienced in clinical training.
4. The reliability of tool was ascertained by cronbach`s alpha coefficient with value (r=0,92). It was proved to be strongly reliable.
The questionnaire was distributed to the study subjects in small groups, at their institutes after class hours according to their schedule and they filled it on their own under the supervision of the researcher, then the questionnaire was collected. Data collection was carried out during the first semester of the academic year 2019-2020 in the period from15/ November/2019 till 23/January /2020.
The most important findings of our study were:
According to nursing students’ academic characteristics at nursing institutes under study, regarding “total grade of success in the previous years,” good level for 46.5%, the majority of students (70%) of total subjects have total grade (100). As regards the “reason for joining the technical nursing institute”, it was noted that more than two-thirds of the subjects (79.6 %) joined the institute out of their own choice. In relation to “the reason of their own choice,” it was observed that more than one-quarter (44.4%) wanted to help their parents financially.
Results related to the distribution of mean score of the facilitating and hindering factors that affect clinical training. It was revealed that nurse teacher characteristics is a facilitating factor and its (3.15 ± 0.87) and the hindering factors are student preparation, preparation (ethical, psychological scientific), learning opportunities, student relationships with (nurse teacher, health team, her colleagues, and patient and his relatives), clinical evaluation. facilities provided from hospital to support clinical training, and facilities provided from institute administration to support clinical training where the mean scores were 2.91, 1.67, 2.77, 2.61, 2.15,and 1.86 respectively
In relation to hospital to support clinical training, (Wasat) AL jumhuria –Dar Ismail is considered two of the hospitals are 3.224 odds to have better score toward facilities provided from hospital to support clinical training compared to (Gharb ) AL-Amriya - Burj -AL Arab and (Sharq) Ras EL Teen- Abu Qir.
Logistic regression model predicting good score for total score is statistically significant. Model explains (22.3%), significant predictors were institute region (Wasat) score are 8.861 odds to have better score toward total score compared to (Gharb) score by 9 times. while institute region (Sharq) score are 7.566 odds to have better score total score compared to (Gharb) score by 7.5 times. While Second grade were 1.801 odds to have better score compared to third grade by 2 times.
Student opinion regarding practical training, the educational process to be improved, there should be separation of curriculum into two semesters and taking exams for the first and second semesters, listen to the problems that facing the students and expediting their solution by the administration of the institute, providing transportation to transport students to places of practical training, training center listens to our problems and works to solve, providing personal protective equipment for students in hospital, change institute uniform, modifying institute internal regulations obligating the hospital administration to provide PPE, improving the relation between nursing staff and nursing student.in hospital.