Health care industry is one of the rapidly growing industries in the world. The Covid-19 crisis made it even more evident that to carry health care delivery at its peak a huge number of efficient work force of health personnel is required. A need for large number of professional nurses was felt in the working area. This urgent need for large number of professional nurses required the professional nursing courses to yield work ready nurses (Kumar, 2012). The curricular nursing internship is a strategy taken up to help the student nurse transition to the role of a professional nurse. Though in reality the student nurses after completing their training felt they were stressed and not prepared to take the role of a professional nurse (Boyle et al, 1996). Hence it is essential that we identify the gap in the present strategy and plan on developing new strategies to facilitate the role transition of the new nurses.

Need for the Study
Nurses curricular internships are critical for gaining perspective on professional nursing and building competency in essential skills. Despite being a widely accepted strategy, developing a competent nursing workforce requires addressing the difficulties faced during internships. Identifying these challenges is vital for improving competency and facilitating smoother role transitions from students to interns. Insights from this study will guide strategies to support this transition and enhance patient care quality.

Objectives
The study was carried out with these objectives:
- To assess perception of nursing interns on role change.
- To identify the challenges faced by nursing interns.
- To determine the association between perception with the selected socio demographic variables.

Review of Literature
A study was done to analyse repercussions of the supervised curricular internship in the development of the ethical dimension of competency in undergraduate nursing students (Burgatti et al, 2013). An exploratory qualitative approach was taken. It was concluded that the phase that uses problem solving as a method of teaching and learning provides critical reflection about professional practice in the services and system of health. Hence Nursing Curricular Internship is an important strategy to build work ready nurses and focus has to be laid on successful implementation of this strategy.

A study was conducted to identify the perception of internship supervisors of the management process and the quality of the clinical supervision of students (Otti et al, 2013). The study used qualitative and quantitative descriptive crosssectional approach. The samples were interviewed to identify the perception of internship and given questionnaire to determine the quality of clinical supervision. The study found that 92 percent of supervisors had not received any specific training and regulatory framework conducive to coach. The results demonstrated low quality of clinical supervision. Thus the study shows there are gaps in the Nursing curricular internship strategy and the study only focused on supervisor perception and not the nursing students.

A study was conducted in Tanta University, Egypt to assess the nursing interns perception about role transition (Aldeeb et al, 2016). The study used a descriptive approach, employing an interview to collect data and concluded that the nursing interns perceived level of role transition was moderate; majority of them perceived role transition in the domain of role competency as high while almost half of the interns perceived the role transition in domains of role preparation and organisation support is low. The study did not focus on the challenges faced by the nursing interns.

Another study was conducted in Chennai in 2015 with the objective to assess the perception with regard to the level of preparation in three aspects: knowledge, skill and attitude as well as overall level of preparation, and correlate the extent of preparation for staff nurse position in knowledge, attitude and skill (Owen et al, 2012). Majority of students (96%) perceived that there was significant enrichment in preparation in the three aspects: knowledge, skill and attitude and that due to their learning in the internship period, they would confidently function independently in the ward in discharge of their duties. The study only focussed on the perception of preparedness of the students to take the role of staff nurse before they actually started it. Their perception may vary when they take the role. The later will be more fruitful in identifying gaps in present practice and help revise and improve the curriculum to facilitate the transition from nursing student to a professional nurse.

It was understood that the internship programme had many beneficial effects in building a competent workforce of nurses but focus should be laid on to identify the gaps in the present practice to take measures which will facilitate the role change of the nursing student to a nurse. This study focuses on the perception of role change of nursing interns and identifies the challenges faced by them during curricular nursing internship. The findings will guide in developing strategies to facilitate role change of nursing students.

Methodology
Approval was secured from the Principal of St John College of Nursing, Bengaluru, and the institutional ethics committee. Permission from class coordinators and name lists of all eligible students were also obtained. A descriptive research approach was taken. Proportionately stratified random sampling was employed, resulting in a sample size of 90 (69 BSc nursing interns and 21 GNM interns). Students were gathered in a common room on separate days for BSc and GNM interns. Data was collected during their free periods and after duty hours, with informed consent obtained prior to administering questionnaires. The entire process took approximately 30-40 minutes.

Tools Used
The data collection tool comprised three sections: socio-demographic variables, perception of nurse interns on role change, and challenges faced during the internship. Section A featured a selfadministered questionnaire that collected data on educational qualifications, area of posting, duration of the internship, and the presence of a nurse in the family. Section B utilised a three-point Likert scale to gauge the interns perceptions of role change across three domains - role preparation, role competence, and organisational support, with a total of 45 items. Respondents rated their agreement with each statement on a scale from 1 (not at all) to 3 (great extent), with some statements requiring reverse scoring. Section C also used a three-point Likert scale to identify the challenges faced by nursing interns, categorised into five domains: direct patient care, teamwork, ward administration, education, and personal attributes. Interns rated their agreement with the challenges using the same scale: 1 (disagree), 2 (not sure), and 3 (agree).

Results
Section A: Selected socio-demographic variables

It was found that 76.7 percent of the interns were having the educational qualification of BSc Nursing; most of them had completed 8 weeks of internship at the time of data collection; 41.1 percent of the interns were posted in common ward and 54.4 percent of the interns had nurse as family member.

Section B: Perception of nurse interns on role change

In relation to the domains of perception i.e. role preparation, role competence and organisational support, the perception of role change for majority of the samples in terms of role preparation, role competence and organisational support belong to the category of great extent which indicates higher perception of the samples and among all the three domain the perception of role change related to role competence high among 91.1 percent.

Table 1: Range, mean, mean percentage and standard deviation of subjects related to perception score (n = 90)

Section C: The challenges faced during internship
The challenges faced were studied under 5 domains.

Direct patient care
Table 2: Frequency and percentage distribution of subjects for challenges related to direct patient care (n = 90)

Teamwork
Table 3: Frequency and percentage distribution of subjects for challenges related to team work (n = 90)

Ward Administration
Table 4: Frequency and percentage distribution of subjects for challenges related to ward administration (n = 90)

Education
Table 5: Frequency and percentage distribution of subjects for challenges related to education (n = 90)

Personal Attributes
Table 6: Frequency and percentage distribution of subjects for challenges related to personal attributes (n = 90)

Association of socio-demographic variables with perception of role change of nursing interns
Table 7: Association between perception score as related to role preparation, role competence, organizational support and duration of internship (n = 90)

There was only weak positive relation found between perception of role change related to role preparation and duration of internship that was statistically significant.

Discussion (Tables 1 to 7)

In this study, a majority of the nursing interns had a high perception of role change. It was found that 85.6 percent of interns felt well-prepared for their new roles, 91.1 percent believed they were competent in clinical judgment, communication, time management, skills, and knowledge application; 77.8 percent found the work environment supportive. The study findings were similar to a study done in Chennai to assess the perception of nursing students of internship (Suresh, 2012). The study aimed to identify challenges faced by nursing interns, categorised into five domains, in direct patient care, 62.2 percent found prioritising care and organising workload challenging. In teamwork, 61.1 percent had difficulty communicating with supervisors. In ward administration, 55.6 percent struggled with ward activities. In education, 54.4 percent found managing academic requirements challenging. In personal attributes, 65.6 percent had difficulty taking up new responsibilities due to lack of experience. Open-ended feedback revealed additional challenges: workload, duty timings, less support from staff, fewer equipment, and difficulty correlating theory with practice.

Studies in Europe and Canada found similar challenges emphasising the need for shift in strategies at personal and organisational levels, including empowerment programmes, to aid role transition (Owen et al, 2012). The study examined the association between selected sociodemographic variables and perception of role change among nursing interns and a statistically significant positive correlation was found between duration of experience and perception of role change in relation to role preparation.

Limitations of the study:
The study had several limitations; the structured tool restricted indepth information collection, the research was conducted within a limited timeframe, and it was carried out in a specific setting, thereby limiting the generalisability of the findings to the broader population.

Implications for Nursing
The study findings offer valuable insights across various aspects of nursing.

Nursing education: Understand interns perceptions and challenges, assess current practices, and design or modify curriculum programmes to facilitate role transition.
Nursing administration: Plan induction programmes, select strategies to improve the work environment, and facilitate role transitions.Nursing practice: Identify and address factors affecting interns performance, and enhancing their ability to provide quality care.
Nursing research: Develop strategies like empowerment programmes, and repeat similar studies to assess the effectiveness of internships.

Conclusion
In this study the perception of nursing interns were assessed and the challenges they face were identified. Most of the interns had a good perception of the role change though they were facing many challenges. By gaining knowledge of these challenges one can develop strategies to facilitate the transition of the nursing students to their new role.

Acknowledgement: I sincerely thank my guide Prof Susan Kumar, Dept of Medical Surgical Nursing, St John College of Nursing, and my co-guide Dr Kimneihat Vaiphei, Asst Lecturer, Dept of Psychiatry, St John Medical College Hospital, Bengaluru for their valuable guidance and suggestions. I thank my head of institution, all the faculty and the interns for their support and cooperation.