The impact of anxiety on undergraduate generation Z nursing students during clinical placement: A narrative synthesis

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In the contemporary educational landscape, nurse education has been confronted with multidimensional challenges, both in the classroom and clinical learning environments. Anxiety amongst nursing students has been on the increase globally with many students seeking counselling and therapies. The range of stressors students are exposed to affects not only their physical health but also their mental health. The study aimed to explore how anxiety impacts undergraduate Gen Z nursing students in clinical placement. Following Arksey and O'Malley (2005) ; Peters et al., 2020 ) review framework, an eight-step literature review was conducted. In February 2023, seven electronic databases -CINAHL, PsycArticles, Proquest Psychology Journals, Web of Science, PubMed, ERIC and Nursing and Allied Health Database were searched. A textual narrative synthesis was conducted. From a total of 10 international studies, two main themes were generated from the synthesis (i) The impact of clinical learning environment on anxiety and (iii) Measures taken by students to overcome anxiety and seek support. Anxiety is an issue for current and future pre-registration or undergraduate nursing students. Universities and practice placement providers need to ensure mechanisms support positive coping strategy development for all aspects of psychological wellbeing. Recommendations are offered. Northumbria University • For the next decade, Gen Z will be the dominant demographic in nurse educational settings. • Understanding Gen Z's experiences of placement and anxiety is essential to enable the identification of students at risk for high-levels of anxiety • Nurse educators need to employ evidence-based measures to create quality learning environments which prioritise student well-being

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