What Helps, What Hinders? Undergraduate Nursing Students’ Perceptions of Clinical Placements Based on a Thematic Synthesis of Literature

Abstract

Introduction Clinical placements are a mandatory component of nursing students’ education internationally. Despite clinical education being a key to nursing students’ achievement of nursing competencies, few studies have reviewed students’ narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys. Methods A systematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students’ experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research. Results Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as “Preparation,” “Welcomed and wanted” and “Supervision experiences”. A conceptual model of clinical placement elements conducive to nursing students’ learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed. Conclusion The conceptual model presents positive elements that influence students’ clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strategies to support students and supervisors alike, an important step forward in moving beyond the current clinical placement rhetoric.

An evaluation of professional development for staff working with nursing students in distress

“…2021; Singh 2020), our intervention could provide valuable insights for those wishing to increase mental health knowledge of clinical facilitators and preceptors, or to assist them to identify appropriate pathways to provide support to students in preparation for clinical learning (Cant et al . 2021).…”

“…Regarding self-care interventions, Moscaritolo (2009) suggested nursing students could benefit from learning mindfulness techniques in preparation for clinical learning experiences. Recent reviews have recommended students learn, and practice, positive thinking and self-affirmations before the clinical placement (Cant et al 2021) after several nursing students reported the strategies assisted them to cope more effectively with their anxiety during clinical learning (Sun et al 2020). Emerging works recommend universities better prepare nursing academics, and students for their clinical learning experiences by introducing them to well-being and anxiety management strategies such as the notion of regular practice of selfcare activities (Cleary et al 2020).…”

Upskilling Australian registered nurses to enhance students’ clinical placement experiences: a contemporary discussion

“…7 Students believed that a lack of supervision and not being included were factors that negatively impacted their learning. [8][9][10] An Australian qualitative study exploring student clinical learning experiences found students felt clinical learning was stressful because it is unpredictable, and they needed to be included to learn. 8 A separate Australian study further added students were bewildered and confused by university teaching and what eventuates in supervisory practice.…”

“…9 Further, a 2021 review reported indifferent staff attitudes detracted from students' learning experiences. 10 An earlier report on the future of nursing education in Australia indicated a need for education providers, placement organisation staff and RNs supervising students, to focus on prioritising planning and preparation of staff and students for clinical placements. 11 In Australia, the Nursing and Midwifery Board Standards for Registered Nurse Practice, 12 and Code of Conduct for Nurses, 13 prescribe education elements related to RNs being prepared to educate, supervise, and assess others: Standard 3.3: "uses a lifelong learning approach for continuing professional development of self and others".…”

The Clinical Environment as a Source of Stress Among Bachelors of Medical Specialties

“…This in turn, requires teachers to provide an effective set of methods to empower students to deal with the stress during their learning process and in their future careers. Placing students in a clinical setting aims to prepare them for professional situations and to facilitate the socialisation required in their professional careers (Cant R et al, 2021). Building humane relationships in the system teacher-student as a condition and factor for establishing the behavioral model of humane treatment of the patients by these future medical professionals: in providing medical help and care; in the implementation of the preventive, promotional, pedagogical, and social functions and activities of the medical specialist (Terzieva, 2009).…”