Prevalence and Types of Workplace Violence Against Clinical Nursing Students: A Systematic Review and Meta-Analysis
AI Summary
Pooled prevalence of workplace violence against clinical nursing students during internships was 40% across included international studies, with substantial heterogeneity.
Verbal violence was most common (47%), sexual violence 12% and physical violence 10%; publication bias suggests physical and sexual rates may be underestimated.
Findings call for urgent institutional and policy action: enhanced preventive training, comprehensive reporting and support systems, and a zero tolerance safety culture.
J Adv Nurs. 2026 Jun 5. doi: 10.1111/jan.70650. Online ahead of print.
ABSTRACT
AIM: To assess the prevalence of workplace violence (WPV) against clinical nursing students during internships and quantify the prevalence of different types of violence, such as physical, verbal and sexual.
DESIGN: Systematic review and meta-analysis.
METHODS: Eligible cross-sectional studies that reported WPV prevalence among clinical nursing students were included. Two researchers independently screened literature and extracted data. The Joanna Briggs Institute tool was used to evaluate bias risk. Pooled prevalence rates, heterogeneity and publication bias were examined.
DATA SOURCES: A comprehensive search was conducted across eight databases, from the inception of each database to 31 March 2025.
RESULTS: A total of 16 cross-sectional studies from eight countries involving 8037 nursing students were included in the analysis, with 11 studies (n = 5550) contributing to the overall pooled estimate. Using a random-effects model, the pooled prevalence of WPV of any type was found to be 40%, with substantial heterogeneity. Verbal violence emerged as the most prevalent subtype (47%), followed by sexual violence (12%) and physical violence (10%). Significant publication bias was detected for both physical and sexual violence, indicating a potential underestimation of the true prevalence.
CONCLUSIONS: This systematic review indicated that WPV is a significant occupational hazard encountered by clinical nursing students across diverse international contexts represented during internships.
IMPACT: These findings highlight the urgent need for educational and healthcare institutions and policymakers to implement coordinated measures, such as enhanced preventive training, comprehensive reporting and support systems and a zero tolerance safety culture to protect the future nursing workforce.
REPORTING METHOD: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.
STUDY REGISTRATION: The research protocol was registered with PROSPERO (CRD420251027354).
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