Challenges faced during clinical placement among nursing students. A mixed study conducted at highest institutions in Addis Ababa city, Ethiopia, 2020

Abstract

Background The clinical learning environment is important to achieve the defined learning outcomes of the program, however nurse students face a multitude of challenges during their clinical placement. Objectives The objective of the study was to explore challenges experienced by nursing students during clinical placement with associated factors among highest institutions of Addis Ababa city, Ethiopia, 2020. Method A mixed method approach composed of cross sectional study and phenomenological method employed from February 15, to April 30, 2020 on 179 third- and fourth-year undergraduate nursing students selected using simple random sampling for the quantitative study and seven purposively selected students for qualitative study. Self-administered questionnaire and recording of telephone interview used to collect quantitative and qualitative data respectively. Logistic regression analysis carried out to identify the independent predictors, whereas the qualitative data analyzed using interpretation of the voice recorded during telephone interview, extracting significant statements, formulating meanings, and coding, categorizing into clusters of themes using the content analysis approach and using ATLAS ti.Version 7.5.16 software. Result the prevalence of challenge among nursing students was found to be 29 (16.9%).Consequently, in bivariate logistic regression, students’ religion, residence, entrance year, learning institution and substance use were found to have association with challenge among nursing student. However, in multivariable analysis only substance use and learning institution found to have significant association. Furthermore statistically significant negative moderate correlation between students total challenge score and their overall competency score were identified [r= -0.672, P value = < 0.001].In qualitative content regards student Nurses factors, lack of role model, instructors responsibilities, inadequate support structure & communication, lack of equipment and college responsibility were emerged. Conclusion It is essential to plan and improve students’ clinical supervision and support at clinical setting by their instructors and staff nurses to create skillful nursing students and minimize their challenge. Therefore there should be adequate orientation and ongoing follow-up for students before internship by principal instructors.

Investigating the challenges of clinical education from the viewpoint of nursing educators and students: A cross-sectional study

“…Based on the study results, prevalence of challenge of nursing students in their practical training was reasonable. 25 Nursing education is an ever-changing discipline, and as soon as it shifts from regular classes to web-based clinical guidelines, educators are required to guide, motivate, and coach students to gain a more technologically advanced experience in their field of study. 26 According to the results of the present study and other studies, for attracting the cooperation of the medical team it is necessary to provide better research facilities for their cooperation.…”

“…23 On the other hand, according to the results of another study, nursing students stated that they face challenges due to the absence of educators during essential hours. 25 Since learning and getting experience in the clinic have a direct relationship with clinical educators’ characteristics, the education-learning process through experienced educators would encourage students to use their capacity.…”

“…Also, based on the results of a study, some students stated that the field of clinical practice was stressful for us, because it was related to human life. 25 …”

“…In this regard, the results of the study showed that the lack of role model, educators responsibilities, insufficient support structure, lack of equipment, conditions related to the challenge of the faculty responsibility were the issues that nursing students faced in the clinical environment. 25 Therefore, the use of educational aids can be useful for better understanding educational materials. In particular, in the cases in which prevalence of a specific disease is low, educational goals of student will not be achieved; therefore, using educational aids can improve learning and accessibility to educational goals.…”

Nursing Clinical Instructors' Perspectives on Clinical Learning Environment Challenges: A Qualitative Study

“…Additionally, clinical instructors must be able to effectively manage clinical learning environment to ensure the safety of students and staff, as well as promote a meaningful learning experience (Soroush et al, 2021). The challenges faced by nursing clinical instructors in the clinical learning environment can be varied and complex, common issues include a lack of resources, a lack of support from administration, and an inability to effectively communicate with students (Addisie et al, 2022). Clinical instructors must also contend with the changing dynamics of the healthcare environment, as well as the need to remain current with changes in technology and medical practices (Dahlke et al, 2012).…”