Experiences Of Ghanaian Student Nurses In The Clinical Learning Environment: Implications For Nursing Education And Practice

ABSTRACT Learning environments are relevant in adult education as they serve to facilitate acquisition of relevant knowledge, skills and attitudes for one to be well educated. The Clinical Learning Environment (CLE) has been identified as a complex network of forces that work together in the learning of clinical skills for student nurses in addition to classroom learning (Flott & Linden, 2016). Student nurses are placed in the Clinical Learning Environment to acquire the requisite skills needed for future professional practice on graduation. The experiences of student nurses during this placement are varied and have implications for nursing education and practice. This study aimed at exploring the experiences of student nurses in their Clinical Learning Environments and described how these influence and impact on their acquisition of the requisite skills for professional practice which is foundational to nursing science. Using Heideggerian phenomenology qualitative approach, the study explored the lived experiences of student nurses in the Clinical Learning Environment guided by the Learning Environment and Learning Processes and Learning Outcomes Framework (LEPO Framework) (Phillips, McNaught & Kennedy, 2010) and Quality of the Clinical Learning Environment Conceptual Framework (D’Souza, Karkada, Parahoo & Venkatesaperumal, 2015). A total of six (6) focus group interviews were conducted with seventy-five (75) student nurses from the School of Nursing and Midwifery, University of Ghana. Only student nurses from Levels 200 to 400 were recruited for the study. Data was analysed using Colaizzi’s 7-Step strategy of descriptive phenomenological data analysis method to elicit an exhaustive description and interpretation of the phenomenon of experiences in the Clinical Learning Environment. Seven themes and sixteen sub-themes emerged from the data. The themes were description of the Clinical Learning Environment, nature of the ward atmosphere, supervisory relationships on the ward, leadership style of the ward manager, iii pedagogical atmosphere on the ward, supervision by clinical teachers, and challenges with clinical learning. Explanations were provided for each theme and sub-theme with relevant supporting quotes presented to offer an in-depth understanding of the phenomenon under study. The findings showed that the Clinical Learning Environment is a complex one in which stakeholders interact as community of practice. The student nurses indicated that the leadership style of the ward mangers impacts on their learning outcomes either positively or negatively. They indicated that the pedagogical atmosphere on the ward contributes to their acquisition of the requisite nursing skills for practice as professional nurses. Clinical supervisors need to be present on the wards engaging the student nurses in nursing procedures to translate theory into practice. Student nurses experiences in the Clinical Learning Environment showed that the efforts of all stakeholders are necessary to ensure that effective teaching and learning takes place for student nurses. It was recommended that there must be collaboration among student nurses, ward managers and staff nurses, and clinical instructors to assist with acquisition of requisite clinical skills in nursing.