Academic stress and active learning of nursing students: A cross-sectional study

Background: The active role of nursing students is particularly important in the delivery of health care, since playing an active role at the bedside and the use of active and collaborative engagement of students in the nursing activities has been associated with improved student learning. This is consistent with Karasek's learning hypothesis, but it has never been tested on nursing students. This study aimed at investigating whether nursing students in high control conditions reported lower levels of work impairment than students in the conditions with low control, compared them with a group of healthcare workers (HCWs), and tested the moderating role of social support at work. Methods: 633 nursing students and 160 HCWs completed the Nursing Work Functioning Questionnaire (NWFQ), and the Demand-Control-Support questionnaire (DCS). Findings: Results showed that nursing students reported higher levels of work impairment and were less likely to be classified as active (high demand/high control) or low strain (low demand/high control) than HCWs, and that social support at work moderated the association between being in active or low strain condition and work impairment. Conclusions: Programs to enhance the learning of nursing students must not only fight strain and isolation but must also promote active learning, by increasing the control over the job, team work, and support from teachers.