Analysis of Nursing Students Learning Experiences …

1 Analysis of Nursing Students Learning Experiences in ClinicalPractice: literature ReviewN. C. Kaphagawani1 and U. Useh 21 Department of Nursing Sciences, School of Environmental and Health Sciences,Faculty of Agriculture Science and Technology, North West University Mafikeng Campus2 School of Research and Postgraduate Studies, Faculty of Agriculture Science and Technology,North West University Mafikeng CampusE-mail: Learning . clinical Learning Environment. clinical Education. Experiential Learning . Student NurseABSTRACT Learning in the clinical practice is an important component of Nursing education considering that Nursing ispractice-based profession. The importance of clinical practice cannot be overemphasized as it prepares nurses to becomecompetent practitioners. The aim of this study is to investigate Nursing Students Learning Experiences in clinical objectives of the study are to assess effective Learning in clinical Learning environment.

2 A review of literature wasperformed using electronic data bases of articles from 2003-2012 that were in English. The studies revealed that effectivelearning takes place in a clinical Learning in clinical practice occurs if Students are given opportunities to practice whatthey have learnt in the classroom and skills laboratory supervised and supported, provided with feedback in an environmentwhere there is good interpersonal relationships and communication. There is a need to use strategies that facilitate learningin clinical practice in addition to creating a conducive clinical Learning aim of this study is to explore nursingstudents Learning Experiences in the clinical prac-tice. Learning in the clinical practice is an im-portant component of Nursing education consid-ering that Nursing is practice-based quality of nurse education depends largelyon the quality of the clinical experience that stu-dent nurses receive in the clinical environment(Henderson et al.)

3 2006). The clinical practicetakes place in a dynamic social complex envi-ronment where patient care is provided as wellas Students Learning (Ip and Chan 2005). Stu-dents Experiences in a clinical Learning environ-ment may have profound impact on their learn-ing whether positively or negatively. Experiences ,including application of theory to practice, ef-fective mentoring and constructive feedbackpositively influence Learning (Ralph et al. 2009).Nonetheless, poor relationships with clinicalstaff, lack of support from educators and lack ofchallenging Learning opportunities are some ofthe negative Experiences that may affect Students Learning (Ip and Chan 2005). These experiencesmay differ from one clinical Learning environ-ment to another as organization of clinical edu-cation differs from place to place or country purpose of clinical practice has been il-lustrated in literature (Elcigil and Sari 2007;Mannix et al.

4 2006). Macfarlen et al. (2007) statethat clinical practice prepares Nursing studentsto become competent practitioners who will beable to provide quality health care and promotehealth of the people they serve (WHO 2005).Apart from Learning the skills, Students are ableto experience the real world of Nursing in addi-tion to the responsibilities of the nurse and de-velop interpersonal relationship with others(Benner et al. 2009; Sharif et al. 2005). Clinicalpractice allows Students to become socializedinto the norms and culture of the Nursing profes-sion (Fitzgerald et al. 2011). This indicates theimportance of clinical practice in Nursing educa-tion. Therefore, Learning in the clinical practiceshould be effectively facilitated in order to ad-equately prepare Nursing Students for the workthey do after takes place when Students applywhat they have learned in classroom situation andpracticed in a simulation laboratory into the re-ality of Nursing .

5 Evidence from literature sug-gest that there is a gap in integrating theory topractice which has been of concern for a longtime in Nursing education which have had animpact on Students Learning in clinical skills (Ipand Chan 2005; Sharif and Masoumi 2005; Kelly2007; Longley et al. 2007). Students becomeanxious and confused if they practice somethingdifferent from what they learnt in the classroom(Sharif and Masoumi 2005). Such emotions in Kamla-Raj 2013 Ethno Med, 7(3): 181-185 (2013) Students in addition to Learning on what may notbe ideal may negatively affect their performancein the clinical learningIn order to become competent practitioner,student nurses need to be guided and of Nursing Students in clinical prac-tice plays a significant role in Nursing professionas it has an influence on the Students Learning ofthe knowledge and skills (H ggman-Laitila et ).

6 Lack of supervision may lead Nursing stu-dents Learning incorrect procedures as they lackguidance become incompetent and lose interestin Nursing profession as they feel frustrated intheir work due to is suggested that Students have to be givenopportunities to practice different tasks to gainconfidence, become perfect and learn from themistakes they will make (L fmark and Wikblad2001). As much as this suggestion is ideal, thenumber of Students in the Nursing colleges hasincreased in such that Students are not given ad-equate opportunities to learn. The increase ofstudents numbers may lead to Students not be-ing competent to some tasks when completingtheir training hence unable to provide quality care(Heller et al. 2005). Learning in clinical practice takes place if stu-dents know what they are doing is right or is done through feedback that is providedto Students from clinical nurses.

7 Mentors, pre-ceptors and nurse educators during clinical learn-ing (Clynes and Raftery 2008) Feedback helpsstudents to gain confidence as through feedbackstudents know their progressFurthermore, good interpersonal relationship,communication and support between staff andstudents create a conducive environment whichis essential for Students Learning in the clinicalsetting. Such behaviours reduce anxiety and fos-ter socialisation process, confidence and self-esteem thus promoting wide range of data search was conductedby the authors to identify studies on Nursing stu-dents Experiences of Learning in the clinical prac-tice. Electronic data research was done data en-gines included; Academic research premier,CINAHL, ERIC, Health source/ Nursing / aca-demic edition, Master file premier, Medline,Psych Articles and Psycinfo, thesis and disserta-tions.

8 The inclusion criteria were research articlesand reviews published in English in scholarlypeer reviewed journals with abstracts and fulltexts published from 2003 to 2012. The searchincluded studies with all types of methods andyielded 58 of literature was done by answeringthe following question. What are the Nursing stu-dents Learning Experiences in the clinical prac-tice? Key words used in the search were: Learn-ing, clinical practice, clinical education, clinicallearning environment, experiential Learning andstudent AND DISCUSSIOND espite a wealth of research on clinical edu-cation Learning in clinical practice is still a prob-lem (Croxon and Maginnis 2008). The studieshad different purposes and used different meth-ods making Analysis and comparison , findings from the studies providedinsight into the Experiences of Nursing studentslearning in the clinical practice on what impactseffective clinical Practice GapThe theory-practice gap has been describedas the disparity between what has been learnt inthe classroom setting and what is practiced inthe clinical environment.

9 Evidence from litera-ture suggest that there is a gap in integratingtheory to practice which has been source of con-cern for a long time in Nursing education. Ac-cording to Sharif and Masoumi (2005) in Iran,Elcigil and Sari (2007) in Turkey and Safadi etal. (2012) in Jordan, Students reported dispari-ties between what was learnt in class and simu-lation laboratory and the actual practice in clini-cal practice. Theory forms a basis for learningwhich Students have to apply in the clinical prac-tice in order to make meaning from the practices between the ideal nursingtaught and that of clinical setting results instudents being confused, stressed and anxiousmay indicate that Students are not effectivelylearning to prepare them for work they do afterqualifying (Evans and Kelly 2004; Sharif andMasoumi 2005).

10 Learning takes place whenstudents apply what they have learned inclassroom situation and practiced in a simulationlaboratory into the reality of studies have illustrated measures totry and close the theory-practice gap. Studiessuggest the use of pedagogical approaches suchN. C. KAPHAGAWANI AND U. USEH182as guided reflection and Problem Based Learn-ing can close the gap (PBL) (Sharif and Masoumi2005; Ehrenberg and H ggblom 2007; Dlamni2011). PBL and Reflective process which focuseson both cognitive and affective aspects allow stu-dents to learn from their practice experiencethrough discussions and meetings with other stu-dents under the guidance of the preceptor. Stu-dents become independent self-learners therebydeveloping the critical thinking and problemsolving skills (Ehrenberg and H ggblom 2007).