LAUSR

OBJECTIVES To synthesise existing evidence that identifies characteristics, behaviours or predictors of the struggling nursing student early on in their studies and the risk that this poses to vocational dissonance. DESIGN An integrative literature review. DATA SOURCES A search of the online databases CINAHL Plus, Medline and PsychINFO was conducted. METHODS Using predetermined inclusion and exclusion criteria, a systematic search across online databases was conducted for papers published between the years 2000 and 2018. Data were extracted using a standard proforma and evaluated for quality. Data were then categorised and compared until themes emerged that reflected the aim of this review. RESULTS From a total of 3024 studies, 14 papers were included in the review. Overall, this review indicates that it is challenging to identify the struggling nursing student early on in their education. Thematic analysis of the included studies identified three key themes: 1) defining the undefinable, 2) red flag characteristics of the struggling student; and 3) the power imbalance of student and educator. CONCLUSIONS There is limited evidence to define and describe the characteristics of the struggling nursing student. Future research should focus on describing and defining characteristics that are early markers of struggle and vocational dissonance.