Relationship Between Nursing Students’ Emotional Intelligence and Their Clinical Performance During Obstetrics and Gynaecologic Nursing Practical Training

Abstract

Nursing and midwifery are stressful professions due to the requirements of patients’ care. They require a high degree
of self-regulation and emotional intelligence (EI). The aim of this study was to identify the relationship between nursing students'
EI and their clinical performance during obstetrics and gynecologic nursing practical training. A descriptive correlational
research design was utilized. The study was conducted at the faculty of nursing, Benha University. A convenience sample of all
third year female students (N=98) who were registered at reproductive health nursing course at the time of study was included.
Two tools were used for data collection; first tool is a structured interview schedule to collect data about the subjects'
demographic characteristics and the Schutte Self Report Emotional Intelligence Test. Second tool for clinical performance
evaluation it composed of performance checklist for different obstetrics and gynecologic nursing procedures and evaluation of
supportive clinical performance skills. There was a positive correlation (p˂0.05) between students' EI and their total clinical
performance skills. On the other hand, there was no statistically significant relation (p>0.05) between students EI and their
demographic characteristics. It can be concluded that there was a significant positive correlation between students' EI and their
clinical performance skills. The topic of EI should be included as a basic component of nursing curriculum in order to develop
students’ EI abilities. Furthermore, Training courses and seminars about EI should be conducted for the nursing educators in
order to develop and improve their own and students’ EI skills.
Keywords: Clinical Performance, Emotional Intelligence, Nursing Stud

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Relationship Between Nursing Students’ Emotional Intelligence and Their
Clinical Performance During Obstetrics and Gynecologic Nursing Practical
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American Journal of Nursing Science
2016; 5(6): 240-250
http://www.sciencepublishinggroup.com/j/ajns
doi: 10.11648/j.ajns.20160506.12
ISSN: 2328-5745 (Print); ISSN: 2328-5753 (Online)
Relationship Between Nursing Students’ Emotional
Intelligence and Their Clinical Performance During
Obstetrics and Gynaecologic Nursing Practical Training
Heba Abdel-Fatah Ibrahim1, Wafaa Taha Ibrahim Elgzar2, *, Rehab Elsayed Mohamed3,
Gihan Mohamed Mohamed Salem3
1Obstetrics and Woman Health Nursing, Benha University, Benha, Egypt
2Obstetrics and Gynaecologic Nursing, Damanhour University, El-Behira, Egypt
3Psychiatric Mental Health Nursing, Benha University, Benha, Egypt
Email address:
heba.abdelfattah@fnur.bu.edu.eg (H. Abdel-Fatah I.), Wafaa22006@yahoo.com (W. T. I. Elgzar)
*Corresponding author
To cite this article:
Heba Abdel-Fatah Ibrahim, Wafaa Taha Ibrahim Elgzar, Rehab Elsayed Mohamed, Gihan Mohamed Mohamed Salem. Relationship Between
Nursing Students’ Emotional Intelligence and Their Clinical Performance During Obstetrics and Gynaecologic Nursing Practical Training.
American Journal of Nursing Science. Vol. 5, No. 6, 2016, pp. 240-250. doi: 10.11648/j.ajns.20160506.12
Received: September 20, 2016; Accepted: October 7, 2016; Published: November 7, 2016
Abstract: Nursing and midwifery are stressful professions due to the requirements of patients’ care. They require a high degree
of self-regulation and emotional intelligence (EI). The aim of this study was to identify the relationship between nursing students'
EI and their clinical performance during obstetrics and gynecologic nursing practical training. A descriptive correlational
research design was utilized. The study was conducted at the faculty of nursing, Benha University. A convenience sample of all
third year female students (N=98) who were registered at reproductive health nursing course at the time of study was included.
Two tools were used for data collection; first tool is a structured interview schedule to collect data about the subjects'
demographic characteristics and the Schutte Self Report Emotional Intelligence Test. Second tool for clinical performance
evaluation it composed of performance checklist for different obstetrics and gynecologic nursing procedures and evaluation of
supportive clinical performance skills. There was a positive correlation (p˂0.05) between students' EI and their total clinical
performance skills. On the other hand, there was no statistically significant relation (p>0.05) between students EI and their
demographic characteristics. It can be concluded that there was a significant positive correlation between students' EI and their
clinical performance skills. The topic of EI should be included as a basic component of nursing curriculum in order to develop
students’ EI abilities. Furthermore, Training courses and seminars about EI should be conducted for the nursing educators in
order to develop and improve their own and students’ EI skills.
Keywords: Clinical Performance, Emotional Intelligence, Nursing Students
1. Introduction
Nursing is a deeply human practice, especially in obstetrics
and gynecologic branch. For any woman, it is extremely
difficult to share obstetrics and gynecology information with
anyone. However, in most circumstances she finds herself
obligated to talk about the most private information with a
nurse. At the same time, the nature of obstetric and
gynecologic examination is embarrassing and unfavorable.
This situation is exaggerated by two main factors inherited in
almost all Arabic countries. First: the culture of silence
surrounding the female complaints. Consequently, the
majority of women have fixed believe that obstetric
information should never be shared with anyone, even if she is
in pain and/or danger. Second, the health care system in the
majority of Arab countries does not support concepts such as
the named midwife or integrated midwife. This means that the
woman has to share her sensitive information with different

241 Heba Abdel-Fatah Ibrahim et al.: Relationship Between Nursing Students’ Emotional Intelligence and Their
Clinical Performance During Obstetrics and Gynaecologic Nursing Practical Training
staff each time she contacts health care. [1, 2]
This embarrassing situation for the female client requires
from the nurses and midwives to become competent at certain
skills that can help her to build trustful nurse patient
relationship. Building trustful relationship with the client is
the first and most important skill in successful care. These
skills include the aptitude to feel or imagine another persons'
emotional experience (empathy), understand and regulate own
emotions; acknowledge others' emotions, and the capability to
manage emotions of self and others. All these abilities known
as emotional intelligence (EI). [3, 4]
EI should be learned and developed during clinical training
in the undergraduate education Victoroff and Boyatzis 2013
urged that teachers in clinical professions as medicine, nursing
or dentists should consider EI as a key standard for student
selection. They additionally added that many professional
behaviors in health care may require abilities related to EI as:
putting the patient needs ahead of their individual interests,
fight to complete tasks at high standard nearly at all times,
frequently assess their knowledge and skills, be familiar with
their limitations and act with integrity. [5]
The psychologists Salovery and Mayer first used the word
EI in 1990. They defined it as "the ability to process
emotion-laden information competently and to use it to direct
cognitive behavior as problem solving and to spotlight energy
on requisite behaviors". [6] In other words, EI refers to "the
one's capability to recognize own feelings and those of others
and encompasses managing emotions effectively in ourselves
and in our relationships". [7] It also involves possessing the
capability for motivation, creativity and the aptitude to
perform at an optimal level when completing tasks. EI also
provides the ability to persist in face of setbacks and failures.
[8]
In midwifery and nursing, EI is appreciated as one of the
critical component of competency of care, which both
influences institutional work and the building of effective
nurse-patient relationships. These ultimately lead to more
patient-centered care. According to Bulmer-Smith et al (2009)
EI became popular within nursing literature but it is
sometimes inadequately defined, overestimated and has not
been actually measured. [9] In many circumstances EI is used
as a predictor of communication skills, professional
performance, team working as well as staff training. [10] It
enables individuals to deal with life events and be more
successful in personal relationships. This is particularly
relevant to nursing and midwifery students. EI ensures that
feelings are acknowledged and not dismissed or suppressed.
Consequently, effective understanding of self and others may
help the development of more insight in the complex
situations that professional relationships bring within nursing
and midwifery clinical training. [11]
Three main models have been proposed for EI. First,
Goleman, 1995 viewed EI as "a set of skills and personal
competences that enhance self-awareness, self-regulation,
empathy and success in human relationships" [12]. Second,
Mayer et al., 2003 defined EI-like academic intelligence "as
an ability that can be learned and occurs when an individual
can perceive, appraise and express emotions" [13]. Third,
Bar-On, 2006 conceptualizes EI "as being similar to a set of
personality traits and abilities". [14]
Mayer et al., 2003 had determined four main categories of
EI. These categories were perceive emotions, using emotions,
understanding emotions and managing emotions. [13] While
Schutte et al., 1998 has proposed EI scale that contain three
main categories. Namely, appraisal and expression of
emotions, regulation of emotion and utilization of emotional
information in thinking and acting. Each one of these three
categories is divided to subcategories. First, appraisal and
expression of emotions, which is the ability to detect and read
emotions in self and others. This detection of emotion can be
done in self through the ability to deeply recognize own
feeling and conflicts. Moreover emotions can be detected on
others through voices, pictures, facial expressions…etc.
Second, regulation of emotion which is the ability to regulate
and control emotion in both self and others. Therefore, the
emotionally intelligent person can control emotions, even
negative ones, and manage them to accomplish planned goals.
Third, utilization of emotional information in thinking and
acting. It can be defined as the aptitude to connect emotions to
facilitate different cognitive activities. The emotionally
intelligent person can benefit from his or her changing moods
in order to best fit the duty at hand. This category can be
further divided into four subcategories (flexible planning,
creative thinking, motivation and redirected attention). [15,
16]
In nursing and midwifery practice, EI is acknowledged as
an essential attribute of the effective nurse student in clinical
training. [17] The difference in learning theoretical materials
and practical one has been highlighted by Begley, 2006. He
suggested that theoretical materials can be effectively
educated in class rooms where, practical aspect together with
its accompanied human skills including EI needs filed
experience together with role model. [18] Consequently,
nursing students need to be guided by good role model with
high level of EI in their practical training. This involves
approaching patients and colleagues in a constructive manner,
listening to them carefully, effective communicating of
information and giving skillful feedback to other team
members. Consequently, the relation between EI and clinical
performance is two-dimensional. On one hand, the student
needs EI to perform better in clinical training and gain the
client satisfaction. On the other hand, he needs to learn EI
from the training experience through good role model and
different training events. [17, 18]
Two studies had emphasized on the importance of EI in
clinical skills than intellectual intelligence, since people with
high EI work better within team, and demonstrate higher
interactive skills. They warning from nursing and midwifery
students who have affective neutrality. According to them
affective neutrality means lost ability to recognize the
importance of emotional aspects in women care. Accordingly,
they will be professionally disconnected and avoid emotions
in their practices. [19, 20]
Clinical performance is an important part of nursing

American Journal of Nursing Science 2016; 5(6): 240-250 242
education. It focuses on developing and applying the students’
knowledge, attitudes, and skills required for future
professional practice. [21] Clinical education provides
students with unique teaching opportunities in which skills
and theory are applied in the real life situations. Clinical
training have a great role in improving students' learning,
augments their sense of responsibility, bridging the theory
practice gap, and provides them with a great chance to
demonstrate nursing competences. [22] In clinical
performance evaluation, it must be confirmed that the students
have an effective professional and ethical conduct, establish
good relationship with the patients, have the basic knowledge
about clinical practice, prioritize the patients problems,
perform nursing skills correctly, and apply critical thinking
skill. [23]
EI also could help the midwife and nurse student to
overcome harmful emotions in training places. Deery, 2005
highlights the critical role of midwifery and nursing student's
supervisors in supporting them through emotional aspects of
practice. He reported that clinical supervision could be
successful in developing an increased self-awareness in nurse
student. They can facilitate and support the emotional needs of
their students. Accordingly, they can help their students in
developing EI. Studies have concluded that EI can be learned
later on life although it is developed early in childhood. They
can be developed and changed in later life. Undeniably, EI can
be developed with age and experience. Many students feel
poorly prepared for the interpersonal and emotional situations
that sometimes take place in their practice settings. Birth
experiences should be used to develop the nurse emotional
experience in the educational settings. Nursing educators also
need to re-skill them in areas of EI and communication to
deliver emotional sensitive care. [5, 20, 24]
1.1. Significance of the Study
Although extensive studies evaluating the role of EI in the
workplace exist, examining the influence and importance of
EI on the nursing performance is a more recent phenomenon.
[9] EI appears to be essential for midwifery and nursing
student because they need to learn how to manage their
emotions, how to support women and provide high quality,
satisfactory and women-centered care. Increasing EI will
strengthen the students’ capacity to deal with workplace
pressures and develop effective relationships with colleagues
and patients. Therefore, nursing educators should prepare
their students for not only the clinical and theoretical demands
of practice, but also the emotional challenges, which arise in
difficult clinical situations. It is expected that midwifery and
nursing students who are emotionally intelligent will manage
emotions in practice to enhance both the mother and midwife
experience. Therefore, today EI is acknowledged as an
important skill to present high quality women care.
Consequently, many midwifery schools have introduced some
subjects in their curriculums that help to develop the student
EI. However, in Egypt there is too little researches about the
importance of EI in midwifery and nursing education. This
have a negative impact on the quality of women care provided.
1.2. Aim of the Study
This study aimed to identify the relationship between
nursing students' EI and their clinical performance during
obstetrics and gynecologic nursing practical training.
1.3. Research Questions
Is there a relationship between nursing students' EI and their
clinical performance?
Is there a relationship between nursing students' EI and their
socio-demographic characteristics?
2. Subjects and Methods
2.1. Operational Definition
Clinical performance in this study refers to student
achievement during the clinical training. It can be measured
through two main items: First, assessment of the clinical
procedure skills using observational checklist during the final
practical exam. Second, assessment of the supportive clinical
skills including: nursing care plan, communication, clinical
reasoning/ problem solving, professional & ethical conduct
and oral/written presentations.
2.2. Research Design
Descriptive correlational research design was followed in
this study.
2.3. Setting
This study was conducted at the faculty of nursing, Benha
University, affiliated to ministry of higher education, Egypt.
2.4. Subjects
The study comprised a convenience sample of all third year
female students who were registered at reproductive health
nursing course at the time of study (first semester, academic
year 2015/2016) and agreed to participate in the study. Total
number was 98 female students, male students were excluded
from the study because they did not have actual training in the
hospitals they had only lab training.
2.5. Tools of Data Collection: Two Tools Were Used for Data
Collection
2.5.1. First Tool: Structured Interview Schedule
It encompassed two major parts:
i. Part 1: It was developed by the researchers to elicit
information about the socio-demographic characteristics
of the studied subjects such as students' age, residence,
marital status, parent education, and students' birth order.
ii. Part 2: The Schutte Self Report Emotional Intelligence
Test (SSEIT)
It was originally developed by Salovey & Mayer 1990 then
it was modified by Schutte et al., 1998. [15] SSEIT was
adapted and translated to Arabic language. The scale consists
of 33 items, which are rated on a five-point Likert scale that

243 Heba Abdel-Fatah Ibrahim et al.: Relationship Between Nursing Students’ Emotional Intelligence and Their
Clinical Performance During Obstetrics and Gynaecologic Nursing Practical Training
ranges from 1 (never) to 5 (always). SSEIT includes three
categories which are appraisal and expression of emotions (13
items), regulation of emotions (10 items) and utilization of
emotions (10 items). The total SSEIT score ranged from 33 to
165. The subject is considered to have low EI (33 to 77),
moderate EI (78 to 121) and high EI (122-165). The scale
items were randomly distributed in order to avoid leading
sentences. The items distributed according to table 1:
Table 1. Distribution of SSEIT categories and questions numbers.
Categories Questions number
Appraisal and expression of
emotions 2,4,5,9,15,18,19,22,25,26,29,32 and 33
Regulation of emotions 1,7,12,14,16,20,21,23,27 and 31
Utilization of emotions 3,6,8,10,11,13,17,24,28 and 30
2.5.2. Second Tool: Evaluation of Clinical Performance: It
Composed of Two Main Parts
i. Part I: Clinical/Procedural skills.
Performance checklist for different obstetrics and
gynecologic nursing procedures which is developed by
obstetrics and women health nursing department at faculty of
nursing/ Benha University. It contains checklists for all
obstetrics and gynecologic nursing procedures in (antenatal,
labor, post-partum, gynecology and family planning). Each
checklist contains detailed steps of the procedures then the
total score is calculated from 20. It was used to assess the
student procedural performance during the final practical
exam.
ii. Part II: Supportive clinical performance skills.
It was developed by the researchers after reviewing of the
related literature to evaluate students’ supportive clinical
performance skills. It includes five components, which are
nursing care plan (5 items), communication (4items), clinical
reasoning/ problem solving (5items), professional & ethical
conduct (8items), and oral/written presentations (7 items).
Each item rated on a five-point Likert scale that ranges from 1
(never) to 5 (always). The total score of 29 items ranged from
29 to 145. The higher grad indicate better performance.
2.6. Tools Validity and Reliability
All tools were tested for content validity by a jury of five
expertise in the obstetrics and gynecologic nursing as well as
psychiatric and mental health nursing and one expert from the
biostatistics field. Modifications were done accordingly based
on their judgment. Reliability was done by Cronbach’s Alpha
coefficient test which revealed that each of the two tools
consisted of relatively homogenous items as indicated by the
moderate to high reliability (internal consistency) of each tool
(SSEIT = 0.71 and clinical performance evaluation = 0.87).
2.7. Ethical Considerations
This research was conducted under the approval of Ethics
Committee/ faculty of nursing/ Benha University. Informed
oral consent was obtained from each student after explanation
of the study purpose and importance. They were reassured that
their responses would not affect their grades. They also were
informed that their information would be confidential and
would be used only for research purpose. In addition, they
were ensured that they had the right to refuse participation on
the study and that they had the right to withdraw from the
study at any time.
2.8. Field of Work
Official permissions were obtained from the responsible
authorities of the faculty of nursing, Benha University to
conduct the study after explaining its purpose.
Pilot study was carried out on randomly selected 10%
students not included in the actual study.
First tool was administered to the students at the beginning
of the semester. The students’ answering of the study tool was
attended by one of the researchers to ensure that all required
information in the sheets was completed. Second tool part I
was completed during the final practical exam. Part II was
completed during the practical training during the whole
semester. The data was collected from the beginning of the
first semester, academic year 2015/2016 until its end including
the examination period.
2.9. Statistical Analysis
The Statistical Package for Social Sciences (SPSS) version
20 was used for data analysis. Descriptive statistics and
correlation coefficients were used to answer the research
questions. Descriptive statistics (frequency, percentage,
arithmetic mean and standard deviation) were used to describe
characteristics of the subjects including: socio-demographic
and academic characteristics and the levels of EI. One sample
T-test was used to examine the differences between the
students. Monte Carlo test was used to examine the relations
between variables if there is small expected value. A
statistically significant difference was considered at p-value
p≤ 0.05 and a highly statistically significant difference was
considered at p-value p ≤ 0.001.
3. Results
Table 2. Demographic characteristics of the study subjects (n=98).
Items N %
Residence
Urban 44 44.9
Rural 54 55.1
Marital status
Single 86 87.8
Married 12 12.2
Mothers' level of education
Basic education 16 16.4
Secondary education 51 52.0
University education 26 26.5
Post graduate 5 5.1
Mothers’ job
House wife 67 68.4
Employee 31 31.6
Birth order
1-2 68 69.4

American Journal of Nursing Science 2016; 5(6): 240-250 244
Items N %
3-4 26 26.5
5 and more 4 4.1
Mean ± SD 2.08±1.24
Age in years
Mean ± SD 21.06 ± 0.78
Table (2) represents socio demographic characteristics of the
study subjects. It was clear that, 55.1% of the students were
rural areas residence. As regards to marital status, 87.8% were
single. Concerning their mothers’ level of education, 52 % of
them had secondary education. Also 68.4% of the students'
mothers were house wives. Moreover, 69.4% of them were born
first or second among their siblings. The students' mean age was
21.06 ± 0.78 years.
Table 3. Mean and standard deviations of the students' emotional intelligence main categories (n=98).
Categories Maximum score Mean standard deviation
t P
Appraisal and expression of emotions 65 43.57 6.63 65.04 <0.001**
Regulation of emotions 50 33.84 6.69 50.07 <0.001**
Utilization of emotion 50 33.76 6.60 50.57 <0.001**
Total score of emotional intelligence 165 110.5 17.46 62.68 <0.001**
The test used is one sample t test
**A highly statistical significant difference (p ≤ 0.001)
Table (3) displays that, the mean score of students' EI main categories were (43.57±6.63, 33.84±6.69, and 33.76 ± 6.60) related
to appraisal and expression of emotions, regulation of emotions and utilization of emotions respectively. In addition, the total EI
mean score was 110.5±17.46. It is observed that, there was a highly statistical significant difference between the students in all
categories of their EI (p<0.001).
Figure 1. Distributions of the students according to their total emotional intelligence (n=98).
Figure: (1) reveals that 70.40% of the students had moderate level of emotional intelligence. Where, only 2% of them had low
level of emotional intelligence.
Table 4. Mean and standard deviations of the students' clinical performance skills (procedural and supportive clinical skills) (n=98).
Item Maximum score Mean Standard deviation t P
Clinical/Procedural skills 20 15.25 3.77 97.3 <0.001**
Supportive clinical skills
Nursing care plan 25 18.83 3.62 78.52 <0.001**
Communication 20 15.04 2.37 66.79 <0.001**
Clinical reasoning and problem solving 25 18.04 3.58 80.67 <0.001**
Professional and ethical conduct 40 33.61 4.79 95.5 <0.001**
Presentation 35 25.79 3.85 71.40 <0.001**
Total Supportive clinical skills 145 110.73 9.95 92.19 <0.001**
Total clinical performance score 165 117.98 18.86 98.92 <0.001**
The test used is one sample t test
**A highly statistical significant difference (p ≤ 0.001)

245 Heba Abdel-Fatah Ibrahim et al.: Relationship Between Nursing Students’ Emotional Intelligence and Their
Clinical Performance During Obstetrics and Gynaecologic Nursing Practical Training
Table (4) clarifies that; the mean score of students’ clinical/procedural skills was (15.25±3.77). Regarding to supportive
clinical skills, the mean score were (18.83 ± 3.62, 15.04± 2.37, 18.04±3.58, 33.61±4.79, 25.79±3.85 and 110.73±9.95) related to
nursing care plan, communication, clinical reasoning and problem solving, professional and ethical conduct, presentation and
total supportive clinical skills respectively. Finally, the total clinical performance mean score was 117.98±18.86.
Table 5. Correlation coefficient between students' emotional intelligence and their clinical performance skills (n=98).
Clinical skills
Emotional intelligence categories
Appraisal and expression of
emotions
Regulation of
emotions
Utilization of
emotions
Total emotional
intelligence
r P r P r P r p
Clinical/Procedural skills 0.15 >0.05 0.21 <0.05* 0.24 <0.05* 0.23 <0.05*
Supportive clinical skills
Nursing care plan 0.005 >0.05 0.007 >0.05 0.20 <0.05* 0.09 >0.05
Communication 0.21 <0.05* 0.07 >0.05 0.24 <0.05* 0.23 <0.05*
Clinical reasoning and problem solving
0.01 >0.05 0.21 <0.05* 0.04 >0.05 0.07 >0.05
Professional and ethical conduct 0.20 <0.05* 0.01 >0.05 0.05 >0.05 0.24 <0.05*
Presentation 0.23 <0.05* 0.008 >0.05 0.14 >0.05 0.01 >0.05
Total Supportive clinical skills 0.05 >0.05 0.14 >0.05 0.r22 <0.05* 0.23 <0.05*
Total clinical skills 0.04 >0.05 0.01 >0.05 0.20 <0.05* 0.225 <0.05*
*A statistical significant difference (p ≤ 0.05)
Table (5) portrays that; there was a positive correlation
coefficient between students' total clinical performance skills
and their total EI and utilization of emotions(r= 0.22, p<0.05,
r=0.20, p<0.05) respectively, as well as between total
supportive clinical skills and total EI and utilization of
emotions (r= 0.23, p<0.05, r=0.22, p<0.05) respectively. In
addition, there was a positive correlation coefficient between
communication and appraisal, utilization of emotions and total
EI (r= 0.21, p<0.05, r=0.24, p<0.05, r=0.23, p<0.05)
respectively. Where, professional and ethical conduct was
significantly correlated with appraisal and expression of
emotions (r= 0.20, p<0.05) as well as total clinical
performance skills (r= 0.24, p<0.05). Presentation skills was
significantly correlated with appraisal and expression of
emotions (r=0.23, p<0.05) respectively. Finally, clinical
reasoning and problem solving was significantly correlated
with regulation of emotions (r= 0.21, p<0.05).
Table 6. Correlation coefficient between students' total emotional
intelligence and their clinical performance score, age and birth order
(n=98).
demographic
characteristics
Total emotional
intelligence
Total clinical
performance
r P r P
Age 0.06 >0.05 0.06 >0.05
Birth order 0.08 >0.05 0.09 >0.05
Table (6) illustrates that; there was no significant
correlation coefficient between students' age and\or birth order
and total EI (r =0.06, p >0.05) and (r =0.08, p >0.05)
respectively.
Table 7. The relationship between the students' demographic characteristics and their total emotional intelligence (n=98).
Item
Total emotional intelligence
M c P Low (n= 2) Moderate(n=69) High(n=27)
N % N % N %
Residence
Urban 1 50.0 31 44.9 12 44.4 0.02 >0.05
Rural 1 50.0 38 55.1 15 55.6
Marital status
Single 2 100.0 61 88.4 23 85.2 3.41 >0.05
Married 0 0.0 8 11.6 4 14.8
Mother' level of education
Basic education 1 50.0 13 18.8 2 7.4
Secondary education 0 0.0 37 53.6 14 51.9 12.12 >0.05
University education 1 50.0 14 20.4 11 40.7
Post graduate 0 0.0 5 7.2 0 0.0
Mother' job
House wife 2 100.0 50 72.5 15 55.6 3.08 >0.05
Work 0 0.0 19 27.5 12 44.4
Mc= monte carlo test

American Journal of Nursing Science 2016; 5(6): 240-250 246
Table (7) shows that; there was no a statistically significant
relation between students EI and their residence, marital status,
mothers education and job.
4. Discussion
Nursing and midwifery is a stressful profession due to
requirements of patients’ care. It requires a high degree of
self-regulation and EI. Especially when this care is provided
to the women during the stress of pregnancy and childbirth.
Nursing students work as caregivers in clinical areas early in
their education. Therefore, EI is required to help them to
control their emotions; as inability to control emotions can
lead to increase anxiety, stress and negatively affect the
quality of care. [25] Emotion is fundamental to nursing and
midwifery practice consequently, EI is considered as an
important skill for nurses. It can affect the quality of their
work including clinical decision-making, critical thinking,
implementation of nursing care plan, communication and
knowledge use in practice. Teaching staff in nursing schools
should know that nursing students have different levels of
emotional maturity that help them to overcome a lot of stress
present in this profession. They should also consider that the
way to deal with emotions is attainable to a noticeable extent
through learning. [26]
The present study has revealed that, the mean score of
students’ EI was 110.5±17.46 indicating moderate EI. This
finding is in the same line with Rice, 2015, Codier and Odell,
2014, Mahmoud et al., 2013, Beauvais et al., 2013, and
Beauvais et al., 2011. [27, 28, 29, 30, 31] Where the first, had
studied "predictors of successful clinical performance in
associate degree nursing students. The second, had measured”
EI ability and grade point average in nursing students". The
third, had studied “EI among baccalaureate students at the
faculty of nursing, Alexandria University". The fourth had
studied "the factors related to academic success among
nursing students". The fifth, studied “EI and nursing
performance among nursing students". They stated that, the
mean score for EI among their study participants was within
moderate level. This agreement between the present study
result and this group of studies may be due to the fact that, all
of them were carried out on students with limited clinical
experience and young age. It is strongly acknowledged that
EI as human attribute improves through experience and age.
[32]
On the contrary, at least three studies found to disagree
with the present study result. First, that of Al-Tamimi and
Al-Khawaldeh, 2016 [33] who studied “EI and its relation
with the social skills and religious behavior of female
students at Dammam University in the light of some
variables". They reported that the average grade for the EI
among arts faculty female students was in high level. Second,
that of Mohzan et al., 2013 [34] who studied "the influence
of EI on academic achievement". He found that the students
of the faculty of education, technology MARA University
had high level of EI. Third, that of Singaravelu, 2007 [35]
who had studied" EI of education students at primary level".
He had reported that the EI of education students was high.
This discrepancy between the present study and the latter
three studies might be attributed to the educational
differences in the present study and the contrary group.
Where, the present study deals with nursing student, the other
three studies deal with Arts and education students, whose
respondents are future educators, with different age groups
and different educational courses. Education and arts students
mostly learn pedagogical courses which may include some
topics on how to be emotionally intelligent. In addition,
Mohzan et al., study deals with both male and female
students, while the present study deals with female students
only.
Regarding research question 1, the present study results
revealed a positive correlation between students' total EI and
their clinical performance skills. These results indicate the
necessity and importance of emotions in decision-making for
proper clinical performance and the effectiveness of EI in
enhancing skills necessary for obstetrics and gynecologic
nursing students. The results of the present study agree with
at least five other researches. First, Rankin 2013 [36] who
had studied " EI: enhancing values-based practice and
compassionate care in nursing". Second, Tafazoli et al., 2012
[37] who investigated "the relationship between EI and
clinical performance in training field in midwifery students".
Third, Por et al., 2011 [25] who studied " EI: Its relationship
to stress, coping, well-being and professional performance in
nursing students". Fourth, Beauvais et al., 2011 [31] who had
studied "the EI and nursing performance among nursing
students". Fifth, Codier et al., 2008 [38] who measured "the
EI of clinical staff nurses". The five studies had found
significant positive correlations between clinical performance
and EI although different measuring tools were used to
measure EI and clinical performance. This result seems to be
logic because emotional intelligence by definition deals with
appraisal and expression of emotions, regulation of emotion
and utilization of emotional information in thinking and acting.
[15] Consequently, students with high EI are expected to
demonstrate higher levels of interactive skills, are more
co-operative and work more effectively within team. They
also expected to be more successful in nurse –patient
relationship. [19, 20]
Both of Gordon-Handler, 2009 and Talarico et al., 2008
[39, 40] findings had contradicted the present study finding.
The former had investigated "the relationship between EI and
clinical performance in an occupational therapy training
program". The latter had studied “EI and its correlation to
performance as a resident, on medical college students".
Their results indicated that there were no significant
correlation between the students’ EI s and their clinical
performance. The cause of the difference in findings between
these studies and that of the present research is probably due
to the difference in the comparative educational program.
While the medical and occupational therapist students
depend on their hands in their clinical performance skills

247 Heba Abdel-Fatah Ibrahim et al.: Relationship Between Nursing Students’ Emotional Intelligence and Their
Clinical Performance During Obstetrics and Gynaecologic Nursing Practical Training
rather than social and communication skills. However,
nursing students depend on interpersonal relationship and
social communication skills, as they are the milestone of their
clinical performance.
The results of this study also showed that, of the three
sub-scales of EI (appraisal and expression of emotions,
regulation of emotions and utilization of emotions); there was
a significant correlation between utilization of emotions and
total clinical performance. This result is congruent with
previously mentioned Beauvais et al., 2011 study. [31] In his
study, of the four EI subscales, (receiving emotions,
understanding emotions, using emotions, and managing
emotions) the only significant correlation found was between
understanding emotion and total clinical performance. The
researchers of the present study urged that utilization of
emotions is the most important aspect in clinical training
because how to use emotions will affect all aspects of clinical
training competencies as: communication, presentation,
problem solving and gaining patients' cooperation. On the
other hand, Al-Hamdan et al., 2016 and Bakr and Safaan,
2012 [41, 42] checked the relationship between EI and nurses
performance. Both of them demonstrated a significant
positive relationship between all subscales of EI and nurses
performance. This discrepancy between the present study and
the latter studies might be related to the age and experience
differences between the studies subjects. Where, the present
study deals with student nurses with young age and limited
experience, the latter studies deals with mature registered
nurses with long experience. It is strongly acknowledged that
age and experience play an important role in EI acquisition.
The findings of the present study also revealed that there
was positive correlation between communication as an
integral part of supportive clinical skills and appraisal of
emotions, utilization of emotions and total EI. This result was
consistent with the researches conducted by Cherry et al.,
2014, Hacettepe and Kose, 2013 and Lee and Ok, 2013. [43,
44, 45] The first had studied "validating relationships among
attachment, EI and clinical communication". The second had
studied "evaluation of EI and communication skills of health
care manager candidates". The third had studied "The
relationship between EI and communication skill, clinical
competence & clinical practice stress in nursing students".
They found a significant positive relationship between
communication skills and total EI among study participants.
In addition, nursing instructors make stress on
communication and social skills as important factor in
acquiring clinical performance skills. This result is seems to
be convincing because prerequisite for effective
communication is appraisal of own and others emotions.
The findings of this study indicated that, clinical reasoning
and problem solving was significantly correlated with one
component of EI (regulation of emotions). This result is
consistent with Mi-Ran and Su-Jeong, 2015 [46] who had
studied " nursing students’ EI and coping strategies" and with
that previously mentioned Por et al., 2011study. [25] Both of
them demonstrated a significant positive relationship
between problem solving coping and EI. The findings
suggest that regulation of own and others’ emotions assist
nursing students to adopt active and effective coping
strategies when dealing with problems.
Regarding to professional and ethical conduct, the present
study reported that EI were significantly correlated with
professional and ethical conduct. This finding is in the same
line with Cabral and Carvalho, 2014 and Angelidis and
Ibrahim, 2011. [47, 48] The former had studied " EI and
ethics on organizations". The latter had studied "the impact
of EI on the ethical judgment of managers". They concluded
that EI was significantly correlated with individual ethics,
perceptions of other’s ethics and ethical judgment. Also
Agarwal and Chaudhary, 2013 [49] who studied " role of EI
in ethical decision making”, stated that EI enhance our
personality and moral reasoning to figure out what is right
and wrong for the human being. EI help in the personality
maturation, consequently, it directs the person to take moral
decisions and act professionally regardless of his own
interests.
Regarding research question 2, the findings of this study
indicated that, there was no significant correlation between
the students' demographic characteristics including birth
order and their total EI. This result is similar to the results of
two studies. First, Miri et al., 2013 [50] who had studied "the
relationship between EI and academic stress in medical
sciences students". Second, is the previously mentioned study
of Tafazoli et al., 2012 [37]. Both studies indicated that, there
was no significant relationship between the birth order and EI
level. The result of this group of studies may be justified by
the theory postulated that EI is a mental ability to implicate
and apply the emotional information which is partly intrinsic
and partly acquired during life experiences. [50]
Additionally, the current study results confirmed that there
was no significant relationship between students' age and
their total EI. The results of the present study agree with the
results of Ghanimat et al., 2013, Saeed et al., 2013 and
Adeyemo, 2008. [51, 52, 53] The first had analyzed "the
relationship between demographic characteristics and EI in
female student at Islamic Azad University of Tabriz" . The
second had studied “EI of nurses in general and intensive
care units". The third had studied "demographic
characteristics and EI among workers in some selected
organizations" .This group of studies found no significant
relationship between the age of the studied subjects and their
total EI score.
On the other hand both Snowden et al., 2015 and Ungur
and Karagozoglu, 2013 [32, 54] had reported different results.
Where, the first had studied the relationship between EI,
previous caring experience and mindfulness in student nurses
and midwives. The second had studied “the relationship
between EI, social physique anxiety and life satisfaction in
physical education and sports students". Both studies
emphasized that the age of the student has significant relation
with total EI. Furthermore, a very recent study conducted by
Srinivasan and Umesh Samuel, 2016 [55] had studied "EI of
staff nurses working in Villupuram district". Emphasized that
EI increased with age. The difference between the present

American Journal of Nursing Science 2016; 5(6): 240-250 248
study findings and the latter group studies might be related to
the fact that all the studied subjects in the current study had
close or the same age, as all of them were third year students.
Therefore, there is no clear age variation that can clarify the
correlation between the students' EI and their age.
Regarding to marital status no significant difference was
found between married and unmarried students and their total
EI score. In this regard Saeed et al., 2013 and Saeid et al.,
2013 [52, 56] checked the relationship between this variable
and the total score of EI. They found no significant
relationship between these two variables. On the contrary
with the present study result; Ealias and George, 2012 [57]
who had studied the EI and job satisfaction. They found a
significant difference on the EI between married and
unmarried study subjects in which 75% of the married
respondents having high EI. In another study, Pande, 2010
[58] had evaluated "the characteristics and EI among workers
in organizations in Rajasthan state". He reported that, married
respondents had higher level of EI than unmarried ones. The
difference between the present study’s findings and the latter
two studies might be attributed to the fact that the current
study included a small percentage of married respondents,
which represent only 12% of the total respondents, while in
the contradictory studies more than 50% of the respondents
were married and in different age groups.
Based on the present study findings, there was no
statistically significant relation between students EI and their
residence. This result is in line with the studies of Gangal and
Singh, 2012. [59] They had studied “EI of teacher trainee of
Meerut city" and found out that the rural and urban studied
subjects do not differ significantly in relation to their EI. The
finding is also in agreement with the findings of the
previously mentioned Singaravelu, 2007 [35] study. He
found no significant difference in the EI of urban and rural
studied respondents.
On the other hand, at least two studies found to be in
contrary with the present study result. First, that of Adsul,
2013 [60] who had studied "a comparative study of urban
and rural students on EI and adjustment". He found a
significant difference between urban and rural students on the
different areas of EI, Where urban students had better EI than
rural students. Second that of Punia and Sangwan, 2011 [61]
who had studied “EI and social adaptation of school
children". He stated that urban children comparatively had
better EI against rural children. This discrepancy between the
present study and the latter two studies might be attributed to
the cultural and age group differences in the present study
and the contrary group.
5. Conclusion
Based on the results of the present study, and answering of
research questions it can be concluded that, obstetrics and
gynecologic nursing students at the Faculty of Nursing,
Benha University had moderate levels of EI. Furthermore,
there was positive correlation between students' EI and their
clinical performance skills. In addition, there is no
statistically significant relation between students EI and their
demographic characteristics.
Recommendations
 Training courses and seminars about EI should be
conducted for the nursing educators in order to develop
and improve their own and students’ EI skills.
 The topic of EI should be included as a basic
component of nursing curriculum in order to develop
students’ EI abilities
 Replication of the present study on larger sample,
different settings and courses
 Further study is required to evaluate the effect of
implementing intervention programs to develop and
enhance nursing students’ EI abilities.
Acknowledgment
The researchers would like to express gratitude and
appreciations to the students who participated in this study
for their effective cooperation.
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