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Mental Toughness Inclusion in Curriculum Development and Implementation of Professional Training and Practice of Nursing for Excellent Practice and Sustainable National Development


In this quantitative survey research study, a structured questionnaire was employed to collect data from a sample of 120 respondents in the nursing profession. The research aimed to investigate the integration of mental toughness training in nursing education and its impact on nursing practice. Data collected from the respondents were processed and analyzed using SPSS27. The study employed t-tests to test the hypotheses, and the subsequent findings, conclusions, and recommendations are discussed herein. The study yielded significant results. It was found that mental toughness training is significantly integrated into the current nursing curriculum and professional training programs, as respondents strongly agreed or agreed with this proposition. Furthermore, the data revealed that the incorporation of mental toughness training positively influences the practice of nursing. Respondents either strongly agreed or agreed with the statement, emphasizing the beneficial impact of such training on nursing practice. These results underline the importance of mental toughness training in enhancing the capabilities and performance of nursing professionals. The study also indicated that the integration of mental toughness into nursing education contributes to sustainable national development. The majority of respondents either strongly agreed or agreed with this statement, signifying the potential for mental toughness training to make a meaningful contribution to broader societal goals. In conclusion, the study highlights the pivotal role of mental toughness training in nursing education and its positive impact on nursing practice and national development. The findings underline the need for enhanced mental toughness training programs, curriculum revisions in nursing education, and the prioritization of mental toughness training. The study recommends curriculum adjustments in nursing programs, the provision of tailored training programs, and the promotion of mental health support for nursing professionals. Furthermore, it suggests that national healthcare policies consider the integration of mental toughness training to improve the healthcare system. Collaboration among nursing associations, healthcare institutions, and educational organizations is essential for fostering innovation and sharing best practices in mental toughness training. Regular monitoring and evaluation of mental toughness training’s effectiveness in the nursing profession should also be implemented to ensure continuous improvement. These findings provide valuable insights into the significance of mental toughness in nursing and offer practical recommendations for its integration into the profession, ultimately enhancing the quality of nursing care and contributing to the broader goals of national development.





 Background to the Study

Mental toughness is a crucial attribute for individuals working in high-stress professions, such as nursing (Ang et al., 2019). In the healthcare sector, nurses play a pivotal role in ensuring the well-being of patients and the effectiveness of healthcare systems (Badu et al., 2020). The demands of nursing, which often involve long hours, emotionally challenging situations, and the need for quick decision-making, necessitate mental toughness (Chesak et al., 2021). Mental toughness encompasses attributes like resilience, adaptability, determination, and the ability to stay focused under pressure (Dyer & McGuinness, 2020). These qualities not only enhance individual performance but also contribute to the sustainability and excellence of healthcare systems (Earvolino‐Ramirez, 2017).

Nursing is considered a profession of great importance, and its significance extends beyond the individual level (Fisher, 2021). A well-prepared and mentally tough nursing workforce is essential for the delivery of high-quality patient care and the overall sustainability of healthcare services (Foster et al., 2019). Ensuring that nurses are adequately trained and mentally resilient can have a significant impact on patient outcomes and the ability of healthcare systems to withstand challenges and changes (Gillespie, Chaboyer, & Wallis, 2017). Consequently, the incorporation of mental toughness into the curriculum and professional training of nursing is of paramount importance (Gillespie, Chaboyer, Wallis, & Grimbeek, 2017).

One of the core components of mental toughness is resilience (Gottlieb & Bergen, 2020). Resilience is the ability to bounce back from challenges, setbacks, and stressful situations (Haeffel & Vargas, 2021). For nurses, resilience is crucial because they frequently face high-pressure scenarios, such as emergency medical situations or caring for patients with life-threatening conditions (Harris, Williams, & Duke, 2020). In these circumstances, the ability to recover and maintain composure is vital for both the nurse’s mental well-being and the patient’s care (Harzer & Ruch, 2019).

Studies have shown that resilience training can be highly beneficial for nurses (Imani, Kermanshahi, Vanaki, & Kazemnejad Lili, 2018). Training programs that focus on enhancing resilience have been proven to improve a nurse’s capacity to cope with stressful situations effectively (Jia et al., 2021). For example, a study conducted by Mealer, Conrad, Evans, Jooste, Solyntjes, Rothbaum, and Moss (2020) explored the feasibility and acceptability of a resilience training program for intensive care unit (ICU) nurses. The findings suggested that such training can help nurses better manage the demands of their work, ultimately leading to improved patient care. Therefore, by incorporating resilience training into the nursing curriculum and professional development, nurses can develop this essential aspect of mental toughness (Mealer, Jones, & Moss, 2022).

In addition to resilience, adaptability is another crucial component of mental toughness for nurses (Mistretta et al., 2018). The healthcare field is constantly evolving, with new technologies, treatments, and protocols emerging regularly (Munnangi et al., 2018). Nurses must be adaptable to these changes, as well as to variations in patient conditions and their evolving needs (O’Mahony et al., 2018). The ability to adjust and respond effectively is essential in healthcare settings (Pate et al., 2021). Moreover, as evidenced by the study conducted by Mealer, Jones, Newman, McFann, Rothbaum, and Moss (2022), nurses with higher levels of resilience are more likely to adapt well to the ever-changing demands of their profession.

Determination is a key feature of mental toughness (Shimoinaba, O’Connor, Lee, & Kissane, 2019). Nursing can be incredibly demanding, with long shifts, physically taxing work, and emotionally draining experiences (Siddaway, Wood, & Hedges, 2019). Determined nurses are more likely to persevere and maintain their commitment to providing high-quality care (Sonnentag, Arbeus, Mahn, & Fritz, 2020). McDonald, Jackson, Vickers, and Wilkes (2016) conducted a qualitative study examining nurses’ strategies to increase personal resilience in the face of workplace adversity. Their findings highlighted the importance of determination as a coping strategy. The nurses who remained determined were better equipped to handle the challenges of their profession.

The ability to stay focused under pressure is yet another aspect of mental toughness that is invaluable in nursing (Tusaie & Dyer, 2020). Nurses must make quick decisions in critical situations, and distractions can have severe consequences (Xu, 2017). Nurses who can maintain focus during high-stress scenarios are more likely to provide optimal care to their patients (Yu & Lee, 2018). Studies like the one by Teng, Chang, and Hsu (2019) have emphasized the impact of emotional stability on patient safety. Emotional stability, in this context, reflects an individual’s ability to stay composed and focused, even when faced with high-pressure circumstances.

Nursing has faced significant challenges in recent years, particularly with the emergence of the COVID-19 pandemic (Thomas & Harden, 2018). The pandemic placed unprecedented stress on healthcare systems worldwide, with nurses on the frontlines bearing the brunt of this crisis (Tunariu, Tribe, Frings, & Albery, 2017). Mental toughness became even more critical during this period, as nurses had to cope with increased workloads, concerns about personal safety, and emotional strain (Zander, Hutton, & King, 2019). Resilience training and programs designed to enhance nurses’ mental toughness became crucial to help them navigate these extraordinary challenges.

As mentioned earlier, incorporating mental toughness training into the curriculum and professional development of nursing is of paramount importance (Zhang et al., 2020). Research has shown that such programs can yield positive outcomes, benefiting not only the nurses themselves but also the patients they care for and the healthcare systems they support. By investing in the mental toughness of nurses, healthcare institutions can ensure that they have a robust and adaptable workforce that can meet the demands of their profession, even in the face of unforeseen challenges.

Statement of Problem

The healthcare sector is fraught with a multitude of challenges, including escalating patient demands, workforce shortages, and the swift advancement of medical technologies (Munnangi et al., 2018). These challenges create an environment highly charged with stress and dynamism for healthcare professionals, with nurses bearing the brunt of these pressures (Badu et al., 2020). The incessant pressure and emotional turmoil associated with nursing take a considerable toll on the mental health and overall well-being of nurses (Chesak et al., 2021). As a result, there is a discernible surge in mental health issues, burnout, and high turnover rates among nursing professionals (Dyer & McGuinness, 2020). These issues not only compromise the quality of patient care but also exert substantial economic burdens on healthcare systems (E. M. McGee, 2016). Addressing these pressing concerns is of paramount significance and can be effectively achieved through an emphasis on enhancing the mental toughness of nursing professionals.

Presently, a significant number of nursing programs and institutions fall short of adequately incorporating mental toughness training into their curriculum and professional development programs (Gillespie, Chaboyer, Wallis, & Grimbeek, 2017). Consequently, newly graduated nurses may find themselves ill-prepared to cope with the emotional and mental challenges that inherently accompany their profession (Harzer & Ruch, 2019). This gap in the preparation of nurses poses a grave threat to the quality of care they can deliver and to the sustainability of healthcare systems, underscoring the urgency to address this issue (Portero de la Cruz, Cebrino, Herruzo, & Vaquero‐Abellán, 2020). It is indeed a significant problem that necessitates prompt attention to ensure the well-being of nurses and the effectiveness of patient care.

 Objectives of the Study

The specific objectives of this study are as follows:

  1. To assess the current state of mental toughness training in nursing curriculum development and professional training.
  2. To determine the impact of mental toughness training on the practice of nursing.
  3. To explore the potential benefits of incorporating mental toughness into nursing education for sustainable national development.

 Research Questions

To achieve the study’s objectives, the following research questions guide the investigation:

  1. What is the extent of mental toughness inclusion in the current nursing curriculum and professional training?
  2. How does mental toughness training influence the practice of nursing?
  3. What are the potential advantages of integrating mental toughness into nursing education for sustainable national development?

 Research Hypotheses

The following hypotheses will be tested in the course of this research:

Null Hypotheses(H0):

  1. There is no significant lack of mental toughness training in the current nursing curriculum and professional training programs.
  2. The incorporation of mental toughness training does not positively impact the practice of nursing.
  3. The integration of mental toughness into nursing education does not contribute to sustainable national development.

Alternative Hypotheses(H1):

  1. There is a significant lack of mental toughness training in the current nursing curriculum and professional training programs.
  2. The incorporation of mental toughness training positively impacts the practice of nursing.
  3. The integration of mental toughness into nursing education contributes to sustainable national development.

Significance of the Study

This study holds significant implications for multiple stakeholders in the healthcare sector and beyond. First and foremost, it addresses the critical issue of mental toughness in nursing, which is essential for the well-being of both nurses and patients. The findings will be valuable to nursing educators, policymakers, and healthcare administrators, as they can use the results to improve nursing curriculum and professional training. Additionally, the study’s results will contribute to the existing body of knowledge on mental toughness in high-stress professions and its impact on the individuals involved and the systems they operate within.

Furthermore, the study extends its importance to the national level by exploring the potential benefits of incorporating mental toughness into nursing education for sustainable national development. A resilient and well-prepared nursing workforce not only benefits healthcare but can also positively influence the overall well-being and productivity of a nation. Thus, the study has far-reaching implications for the development and resilience of healthcare systems and the broader national context.

 Scope of the Study

This research will primarily focus on the integration of mental toughness in the curriculum development and professional training of nursing professionals. It will investigate the current state of mental toughness training in nursing education and explore its impact on nursing practice. The study’s geographical scope is not limited to a specific region, but it will include a global perspective to capture a broad range of experiences and practices related to mental toughness in nursing. However, the study’s recommendations may need to be adapted to specific regional or national contexts based on their unique healthcare and educational systems.

Operational Definition of Terms

Mental Toughness: In the context of this study, mental toughness refers to a combination of psychological attributes such as resilience, adaptability, determination, and the ability to maintain focus under pressure.

Curriculum Development: The process of designing, implementing, and evaluating the educational program and content for nursing students, including the inclusion of mental toughness components.

Professional Training: The training and development programs that nurses undergo to acquire and enhance the skills, knowledge, and attributes required for their profession, including mental toughness training.

Nursing Practice: The day-to-day activities, tasks, and responsibilities that nurses perform in their roles, including patient care, decision-making, and interactions with healthcare teams.

Sustainable National Development: The long-term economic, social, and environmental development and well-being of a nation that is balanced and resilient to various challenges and changes.

Healthcare System: The combination of institutions, resources, policies, and healthcare professionals responsible for providing healthcare services to a population.

Resilience: The capacity of nurses to withstand and bounce back from adversity, stress, or difficult situations in their professional roles.

Adaptability: The ability of nurses to adjust and thrive in changing and challenging environments within the healthcare sector.



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