How do nursing students experience the clinical learning environment and respond to their experiences? A qualitative study

INTRODUCTION: On entry into the clinical environment, nursing students are confronted with many challenges. It is a common problem throughout the world, including Iran. Although many studies have been conducted on the problems of nursing students in the clinical environment, limited information is available on nursing students’ experiences of the clinical learning environment and the way they respond to these experiences. Identifying nursing students’ experiences is essential to develop interventions to reduce challenges. OBJECTIVE: This study aimed to explore nursing students’ experiences in a clinical learning environment and the way they responded to these experiences. DESIGN: The present study was conducted based on the qualitative research design of the grounded theory methodology. SETTING: This study was conducted at schools of nursing in academic settings in Iran. PARTICIPANTS: The participants included 19 nursing students, 4 nursing instructors and 3 clinical nurses. METHODS: The data were collected using semistructured interviews, field notes and observation, and were analysed using Strauss and Corbin’s approach. RESULTS: Students, as a result of the inadequacy of the educational environment, were faced with ‘confusion of identity’, stating this as their main concern. When confronted with this concern, they employed specific strategies, some of which prevented them from getting into unpleasant conditions. These strategies did not help students solve their problems and also prevented them from accepting their professional roles and responsibilities. Conversely, some other strategies led them to advanced professional development and enabled them to accept their role and the clinical environment. CONCLUSION: According to the results of this study, educational policymakers should focus on improving the clinical environment. Identifying professional models and increasing their influence on management, education and clinical education, as well as teaching positive and constructive strategies, will promote positive strategies in coping with inadequate educational contexts. This is necessary for the professional development of nursing students.