Background The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. This study aimed to assess the student nurses and midwives’ experiences and perception of the clinical learning environment in Malawi. Methods A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = < 0.001), and task orientation (β =0.16 p = < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment. Conclusion Although satisfaction with clinical learning environment subscale had the highest mean score, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that negatively impacted on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement.

Purpose: Fears of the Covid-19 pandemic have brought additional psychological pressure among nursing students. Nursing students at Mzuzu University in Malawi resumed clinical practice amidst the first wave of the pandemic and completed their rotation from September to December 2020. However, it was not known how they were coping with fears of the Covid-19 pandemic during clinical practice and this had set the impetus for conducting this study. Methods: The study used qualitative approach employing a descriptive phenomenological design. Four focus group discussions (FGDs) were conducted on students who had completed a clinical rotation during the first wave of the Covid-19 pandemic. Results: Four themes emerged from the data analysis, and these were staying positive amidst the Covid-19 pandemic; applying the Covid-19 preventive measures; the role of religion and use of avoidance strategies. Conclusion:Students should be encouraged to use coping strategies that have been proven to promote psychological well-being in times of crisis such as the Covid-19 pandemic.

BackgroundThe clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. The aim of this study was to assess the experiences and perception of nursing and midwifery students of their clinical learning environment in Malawi.Methods A mixed-methods approach was used to collect data from nursing and midwifery students. Data were collected using a questionnaire and focus group discussions. Questionnaire data were collected using the Clinical Learning Environment Inventory (CLEI). Data from focus group discussions were collected using an interview guide which had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression while qualitative data were analysed by thematic analysisResults A total of 126 participants completed the questionnaire data while 30 students participated in the focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while Individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed statistically significant association between Satisfaction with clinical learning environment and Personalization (β = 0.50, p = < 0.001), and Task orientation (β =0.16 p= < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment.Conclusion The findings of this study show that although satisfaction with clinical learning environment had the highest scores, students encountered multifaceted challenges in their clinical learning environment. A collaborative effort from training institutions and hospitals is needed to better support students with their clinical learning.

Purpose: Clinical practice during pandemics is known to bring additional fears to nursing students. The purpose of this study was to explore fears of Mzuzu University's nursing students nurses regarding resumption of clinical practice amidst the Coronavirus disease (COVID-19) pandemic. Methods: The study used a qualitative approach employing a descriptive phenomenological design. Mzuzu University Research Ethics Committee (MZUNIREC) approved the study and issued MZUNIREC/DOR/20/06 as approval number. An independent person collected data through four focus group discussions with a purposefully selected sample of 40 consented nursing students who had completed clinical practice during the first wave of the COVID-19 pandemic. Data analysis was done manually using content analysis. The analysis started with transcription of the interviews. Following this, data were coded and categorized into themes and subthemes were established from participants' significant statements. Results: Four major themes about the fears amongst the student nurses emerged. These were as follows: equipment and supplies; increased perceived risk for acquiring and transmitting COVID-19; stigma and discrimination and perceived fear of not having adequate learning. Conclusion: Clinical practice during the COVID-19 pandemic brings fear among nursing students and requires that implementers of nursing and midwifery programs prioritize ascertaining student's skill, emotional wellbeing and provision of adequate resources before deploying them to clinical areas.

Background The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. The aim of this study was to assess the experiences and perception of the clinical learning environment by nursing and midwifery students in Malawi.Methods A concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed. Results A total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = < 0.001), and task orientation (β =0.16 p= < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment.Conclusion Although satisfaction with clinical learning environment had the highest scores, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that impacted negatively on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement.