This randomized controlled study will aim to evaluate the effect of a peer-supported video and interaction-based clinical orientation program on reality shock and adaptation during the first clinical experience. The study will be conducted with nursing students who will start their first clinical practice. Participants will be randomized into intervention and control groups. The intervention group will receive a peer-led orientation program including videos recorded in real clinical settings by senior students, interactive question-answer sessions, a structured hospital tour, and ongoing digital communication support. The control group will receive the routine clinical orientation. Data will be collected at two different time points. The first measurement will be performed at the end of the second week of clinical practice to allow students to experience the clinical adaptation process. The second measurement will be conducted four weeks after the first assessment. Reality shock and clinical adaptation levels will be evaluated using valid and reliable scales. This study is expected to provide evidence on the effectiveness of peer-supported and technology-enhanced orientation strategies in facilitating students' adaptation to clinical environments and contribute to the development of innovative practices in nursing education.
This randomized controlled study will aim to evaluate the effect of a peer-supported video and interaction-based clinical orientation program on reality shock and clinical adaptation among nursing students during their first clinical experience. The study will be conducted with first-year nursing students at the Faculty of Health Sciences, Siirt University, in the spring semester of 2026. Students who meet the inclusion criteria will first be stratified according to gender and grade point average (GPA), and then assigned to the intervention and control groups using computer-assisted block randomization. The sample size was calculated using G\*Power, and a total of 90 students will be included in the study. The intervention group will receive a multi-component peer-supported orientation program, including videos recorded in real clinical settings by senior students, interactive question-answer sessions, a structured hospital tour, peer mentor support during the clinical practice process, and continuous guidance through digital communication groups. The control group will receive the routine verbal clinical orientation provided in the institution. Data will be collected at two time points. The first measurement will be conducted at the end of the second week of clinical practice to allow students to experience the clinical adaptation process. The second measurement will be performed four weeks after the first assessment. Data will be collected using the Introductory Information Form, the Reality Shock Scale for Nursing Students, and the Clinical Adjustment Scale for Student Nurses. In addition, educational satisfaction will be evaluated in both groups using a visual analog scale (VAS). An open-ended feedback form will be administered only to the intervention group to explore students' experiences and perceptions of the program. The data will be analyzed using SPSS software. Descriptive statistics will be presented, and appropriate parametric or non-parametric tests will be used for group comparisons. Effect sizes will also be calculated. This study is expected to provide evidence on the effectiveness of peer-supported and technology-enhanced clinical preparation programs in reducing reality shock and improving clinical adaptation. The findings may contribute to the development and integration of innovative, student-centered orientation strategies in nursing education.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
TRIPLE
Enrollment
90
Participants in the experimental group will receive a multi-component peer-supported clinical orientation program prior to their first clinical placement. The intervention will include video-based orientation recorded in real clinical settings by senior nursing students, interactive question-answer sessions, and a structured hospital tour. In addition, peer mentors will provide on-site guidance during the initial clinical days and ongoing support through a digital communication platform. The program aims to reduce uncertainty, enhance clinical readiness, and facilitate adaptation to the clinical environment.
Participants in the control group will receive the routine clinical orientation provided by the institution before their first clinical placement. This orientation will consist of a standard PowerPoint-based educational session covering hospital rules, clinical procedures, student roles and responsibilities, and basic safety and communication principles. No peer support, video-based education, or additional digital mentoring will be provided to this group.
Siirt University Faculty of Health Sciences
Siirt, Siirt, Turkey (Türkiye)
Reality Shock Scale for Nursing Students
The Reality Shock Scale for Nursing Students is a 31-item Likert-type instrument developed to evaluate the mismatch experienced by student nurses between their clinical practice and their expectations regarding clinical procedures, communication, role responsibilities, and professional expectations. Each item is rated on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate greater levels of reality shock. The scale consists of four subdimensions: interpersonal relationships in the workplace, perception of professional competence, professional commitment, and role overload with psychosocial outcomes. The information regarding the scale was obtained from the form provided for the present study.
Time frame: Week 2
Clinical Adjustment Scale for Student Nurses
The Clinical Adjustment Scale for Student Nurses (CAS-SN), Turkish version is a 15-item, 5-point Likert-type instrument designed to evaluate the level of clinical adaptation among nursing students. The scale consists of three subdimensions: professional development and interpersonal interaction, clinical competence and confidence, and coping and support strategies. The total score ranges from 15 to 75, with higher scores indicating better clinical adaptation to the clinical environment. The total Cronbach's alpha coefficient of the Turkish version has been reported as 0.918. Information regarding the content of the scale was obtained from the scale file provided for the present study
Time frame: Week 2
Satisfaction survey
The Satisfaction Questionnaire was used to evaluate students' satisfaction with the orientation education using a visual analog scale (VAS). Students were asked to rate their level of satisfaction on a scale from 0 to 10, where 0 indicated "not satisfied at all" and 10 indicated "extremely satisfied." The total score ranged from 0 to 10, with higher scores reflecting greater levels of satisfaction. This questionnaire was used to assess students' overall satisfaction with either the routine or peer-supported orientation methods, as well as their perceived effectiveness in enhancing learning experiences and reinforcing clinical skills.
Time frame: Week 1
Student Feedback Form
An open-ended feedback form will be administered to the students in the experimental group who participate in the peer-supported clinical orientation program. Students will be invited to share their opinions about the aspects of the peer-supported orientation that they found beneficial, the challenges they experienced, and areas they believe could be improved. This form will be used to explore students' experiences, perceptions, and suggestions regarding the effectiveness of the peer-supported orientation approach.
Time frame: Week 1
Reality Shock Scale for Nursing Students
The Reality Shock Scale for Nursing Students is a 31-item Likert-type instrument developed to evaluate the mismatch experienced by student nurses between their clinical practice and their expectations regarding clinical procedures, communication, role responsibilities, and professional expectations. Each item is rated on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate greater levels of reality shock. The scale consists of four subdimensions: interpersonal relationships in the workplace, perception of professional competence, professional commitment, and role overload with psychosocial outcomes. The information regarding the scale was obtained from the form provided for the present study.
Time frame: Week 6 (follow-up).
Clinical Adjustment Scale for Student Nurses
The Clinical Adjustment Scale for Student Nurses (CAS-SN), Turkish version is a 15-item, 5-point Likert-type instrument designed to evaluate the level of clinical adaptation among nursing students. The scale consists of three subdimensions: professional development and interpersonal interaction, clinical competence and confidence, and coping and support strategies. The total score ranges from 15 to 75, with higher scores indicating better clinical adaptation to the clinical environment. The total Cronbach's alpha coefficient of the Turkish version has been reported as 0.918. Information regarding the content of the scale was obtained from the scale file provided for the present study
Time frame: Week 6 (follow-up).
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.