Effectiveness of a Structured Paediatric Clinical Orientation Programme on Clinical Anxiety and Confidence among Student Nurses during Initial Paediatric Clinical Posting: A Pre-Experimental Study

Abstract

Background: The transition from classroom-based nursing education to direct clinical practice represents a critical stage in the development of clinical competence. Initial paediatric clinical postings may generate anxiety because students encounter unfamiliar clinical environments, vulnerable children, family-centred care, complex communication demands, and concerns about making clinical errors. Structured preparation and orientation may reduce uncertainty and improve student’s psychological readiness for clinical learning.

Aim: To evaluate the effectiveness of a structured paediatric clinical orientation programme on clinical anxiety and confidence among student nurses during their initial paediatric clinical posting.

Methods: A quantitative pre-experimental one-group pre-test–post-test design was adopted. A sample of 60 student nurses scheduled for their initial paediatric clinical posting was selected using a non-probability sampling technique. Baseline clinical anxiety and confidence were assessed before the intervention. Participants subsequently received a structured paediatric clinical orientation programme covering paediatric ward organisation, child- and family-centred communication, infection prevention, paediatric assessment, vital-sign measurement, medication safety, common paediatric procedures, documentation, emergency preparedness, and clinical responsibilities. Post-test assessment was conducted following the orientation and initial clinical exposure. Descriptive statistics and paired t-tests were used for analysis.

Results: The mean clinical anxiety score decreased from 48.62 ± 7.18 at pre-test to 35.74 ± 6.21 at post-test, representing a mean reduction of 12.88 points (t = 13.45, p < 0.001). The mean clinical confidence score increased from 56.83 ± 8.12 to 75.26 ± 7.44, representing a mean increase of 18.43 points (t = 15.27, p < 0.001). These findings demonstrate statistically significant changes in both clinical anxiety and confidence following the structured paediatric clinical orientation programme.

Conclusion: The findings suggest that a structured paediatric clinical orientation programme may be a useful educational strategy for preparing student nurses for their first paediatric clinical experience. Integrating structured orientation, supervised practice, simulation, communication preparation, and clinical mentoring into paediatric nursing education may strengthen student’s psychological readiness and confidence.