Stressors in Clinical Nursing Education in Iran: A Systematic Review

Tahereh Changiz, Alireza Malekpour, Ali Zargham-Boroujeni



Clinical education is a critical and complex component of nursing education that is influenced by many variables. One of them is stress, which may disturb students’ learning, too. Stressors may differ according to the learning situation and environment, and recognizing them, seems to be essential for corrective interventions. The present work was performed to identify stressors in clinical nursing education in Iran, according to the published research reports.


In this systematic review, all published research reports available in Iranian and International web-based data bases and search engines were searched. Also the archives of peer reviewed Iranian nursing and medical education journals (published between 1989 and 2009) were hand searched. Out of 1104 retrieved records (by a more general terms of “clinical education” AND “Nursing”), after stepwise screening, 15 original research articles were selected for content analysis. Coded data were classified and their frequency was represented in tables.


The following themes were obtained to classify main areas of importance for factors related to stress in clinical nursing education: a) clinical competence and ability to play one’s roles, b) care load, or stress due to care, c) main area of education, d) interpersonal relationships and interactions, e) clinical environment (facilities and equipments, space, learning opportunities, etc,…). Subthemes were also identified in each theme. 


Published studies in Iran provide appropriate background evidences for planning and evaluating interventional programs to reduce stress among nursing students and instructors. Each identified theme in this study could be considered as a subject for planned interventions. Among them, it seems that “interpersonal relationships and interactions” is of the highest priority.

Key words:

Clinical education, stress, Iran, stressor, systematic review

Full Text:



  • There are currently no refbacks.