Document Type : Original Article

Authors

1 Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences

2 Department of Nursing, Faculty of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran

Abstract

Clinical education requires creating a supportive atmosphere for learners and nursing students, who
need support to be prepared for their future profession. The purpose of this study is to investigate
the challenges of supporting the nursing students in clinical education. This article reviewed studies
conducted between 2009 and 2019 with the keywords including support, challenge, students,
education, and nursing using SID, Magiran, IranMedex, Google Scholar, Elsevier, and PubMed as
databases. Among the 926 articles obtained during the two review stages, which were based on the
inclusion and exclusion criteria and the first one analyzed the title and the abstract and the second
one analyzed the whole article, ultimately 32 articles were selected for the study. The types of articles
used in this study are as follows: qualitative (16 articles), descriptive analytical and cross‑sectional (12
articles), review (3 articles), and mixed‑methods (1 article). The focus of all studies was on the
students’ clinical education environment. The participants of the studies were undergraduate nursing
students (in 22 articles), graduate students (in 2 articles), nursing instructors and students (in 4
articles), and nursing instructors and managers (in 1 article). Most of the challenges of supporting the
students included violence, fear, and anxiety; socio‑cultural challenges, environmental‑organizational
stresses; and ineffective clinical education. The findings of this study showed that nursing students
face many challenges in the clinical setting. Therefore, the managers of educational and health‑care
centers should give a high priority to their students’ support programs.

Keywords

  1. Nabolsi M, Zumot A, Wardam L, Abu‑Moghli F. The experience
    of Jordanian nursing students in their clinical practice. Procedia
    Soc Behav Sci 2012;46:5849‑57.
    2. Dadgaran I, Parvizy S, Peyrovi H. Nursing students’ views of
    sociocultural factors in clinical learning: A qualitative content
    analysis. Jpn J Nurs Sci 2013;10:1‑9.
    3. Firoozehchian F, Ezbarmi ZT, Dadgaran I. Nursing‑midwifery
    students and teachers’ views of effective factors in clinical
    education. Procedia Soc Behav Sci 2012;47:1832‑7.
    4. Aghamohammadi‑Kalkhoran M, Karimollahi M, Abdi R. Iranian
    staff nurses’ attitudes toward nursing students. Nurse Educ Today
    2011;31:477‑81.
    5. Cheraghi MA, Salasli M, Ahmadi F. Factors influencing the clinical
    preparation of BS nursing student interns in Iran. Int J Nurs Pract
    2008;14:26‑33.
    6. Berntsen K, Bjørk IT. Nursing students’ perceptions of the
    clinical learning environment in nursing homes. J Nurs Educ
    2010;49:17‑22.
    7. Gidman J, McIntosh A, Melling K, Smith D. Student perceptions
    of support in practice. Nurse Educ Pract 2011;11:351‑5.
    8. Jokelainen M, Turunen H, Tossavainen K, Jamookeeah D, Coco K.
    A systematic review of mentoring nursing students in clinical
    placements. J Clin Nurs 2011;20:2854‑67.
  2. 9. Ooms A, Fergy S, Marks‑Maran D, Burke L, Sheehy K. Providing
    learning support to nursing students: A study of two universities.
    Nurse Educ Pract 2013;13:89‑95.
    10. Msiska G, Smith P, Fawcett T. Exposing emotional labour
    experienced by nursing students during their clinical learning
    experience: A Malawian perspective. Int J Afr Nurs Sci
    2014;1:43‑50.
    11. Banks P, Kane H, Rae C, Atkinson J. Support for nursing
    and midwifery students: A special case? Nurse Educ Today
    2012;32:309‑14.
    12. Williamson GR, Callaghan L, Whittlesea E, Heath V. Improving
    student support using Placement Development Teams: Staff and
    student perceptions. J Clin Nurs 2011;20:828‑36.
    13. Price L, Hastie L, Duffy K, Ness V, McCallum J. Supporting
    students in clinical practice: Pre‑registration nursing students’
    views on the role of the lecturer. Nurse Educ Today 2011;31:780‑4.
    14. Broome ME. Integrative literature reviews for the development
    of concepts. IN: Concept Development in Nursing: Foundations,
    Techniques and Applications. Philadelphia: WB Saunders
    Company; 2000. p. 231‑50.
    15. Whittemore R, Knafl K. The integrative review: Updated
    methodology. J Adv Nurs 2005;52:546‑53.
    16. Dinmohammadi M, Peyrovi H, Mehrdad N. Undergraduate
    student nurses’ experiences in clinical environment: Vertical
    violence. Iran J Nurs 2014;27:83‑93.
    17. Rassouli M, Zagheri Tafreshi M, Mohammadnejad E. Challenges
    in clinical nursing education in Iran and strategies. Clin Excell
    2014;2:11‑22.
    18. Cheung K, Ching SS, Cheng SHN, Ho SS. Prevalence and impact
    of clinical violence towards nursing students in Hong Kong:
    A cross‑sectional study. BMJ Open 2019;9:e027385.
    19. Tee S, Üzar Özçetin YS, Russell‑Westhead M. Workplace violence
    experienced by nursing students: AUK survey. Nurse Educ Today
    2016;41:30‑5.
    20. Magnavita N, Heponiemi T. Workplace violence against nursing
    students and nurses: An Italian experience. J Nurs Scholarsh
    2011;43:203‑10.
    21. Clarke CM, Kane DJ, Rajacich DL, Lafreniere KD. Bullying
    in undergraduate clinical nursing education. J Nurs Educ
    2012;51:269‑76.
    22. Oikarainen A, Mikkonen K, Tuomikoski AM, Elo S, Pitkänen S,
    Ruotsalainen H, et al. Mentors’ competence in mentoring culturally
    and linguistically diverse nursing students during clinical
    placement. J Adv Nurs 2018;74:148‑59.
    23. Joolaee S, Jafarian Amiri SR, Ashghali Farahani MA, Varaei S.
    Iranian nursing students’ preparedness for clinical training:
    A qualitative study. Nurse Educ Today 2015;35:e13‑7.
    24. Pourghane P. Nursing students’ experiences of clinical teaching:
    A qualitative study. J Holistic Nurs Midwifery 2013;23:16‑26.
    25. Haghani F, Farzi S. The challenges of nursing procedures training
    from the perspective of nursing students: A qualitative study.
    SDMEJ 2016;12:745‑52.
    26. Killam LA, Heerschap C . C h a l l e n g e s t o s t u d e n t
    learning in the clinical setting: A qualitative descriptive
    study. Nurse Educ Today 2013;33:684‑91.
    27. Mckenna L, Plummer V. Indonesian student nurses’ perceptions
    of stress in clinical learning: A phenomenological study. J Nurs
    Educ Pract 2013;3:56‑65.
    28. Arieli D. Emotional work and diversity in clinical placements of
    nursing students. J Nurs Scholarsh 2013;45:192‑201.
    29. Fazel N, Yazdi MH, Elhani F, Pejhan A, Koshan M, Ghasemi M,
    et al. The nursing experiences regarding to clinical education in
    emergency department: A qualitative content analysis in 2012.
    J Sabzevar Univer Med Sci 2017;24:97‑106.
    30. Shadadi H, Sheyback M, Balouchi A, Shoorvazi M. The barriers
    of clinical education in nursing: A systematic review. Biomed Res
    2018;29:3616‑23.
    31. Buthelezi SF, Fakude LP, Martin PD, Daniels FM. Clinical learning
    experiences of male nursing students in a Bachelor of Nursing
    programme: Strategies to overcome challenges. Curationis
    2015;38:1517.
    32. Heydari K, Ali‑Sheykhi R, Shahbazi S, Heydari M. Nursing
    students’ viewpoints about problems of clinical education.
    J Health Care 2013;13:18‑23.
    33. Shirazi M, Akbari L, Babaee M. Assessment of the condition of
    clinical education from the viewpoints of undergraduate nursing
    students: Presentation of problem‑oriented strategies. J Nurs Educ
    2013;2:30‑8.
    34. Komeili Sani H. Analysis of nursing education challenges in the
    clinical field. Educ Dev Judishapur 2015;6:277‑84.
    35. Abazari P, Namnabati M. Restrictive and facilitating factors of
    nursing students clinical education effectiveness. Iran J Med Educ
    2017;17:494‑503.
    36. Saleh AS, Golafrooz SM, Nasrollahi S, Akbarzadeh M,
    Mirchouli N. Clinical education problems and ways of enhancing
    its quality from the perspective of clinical instructors and students
    of nursing and midwifery at Sabzevar University Medical Sciences
    in 2008. J Sabzevar Univer Med Sci 2014;20:539‑46.
    37. Rikhotso SR, Williams MJ, de Wet G. Student nurses’ perceptions
    of guidance and support in rural hospitals. Curationis
    2014;37:e1‑6.
    38. Papathanasiou IV, Tsaras K, Sarafis P. Views and perceptions of
    nursing students on their clinical learning environment: Teaching
    and learning. Nurse Educ Today 2014;34:57‑60.
    39. Qanbari Qalehsari M, Khaghanizadeh M, Ebadi A. Lifelong
    learning strategies in nursing: A systematic review. Electron
    Physician 2017;9:5541‑50.
    40. Fotoukian Z, Hosseini S, Beheshti Z, Zabihi A, Aziznejad P,
    Ghaffari F. Clinical education status according to the nursing
    students’ point of view, Babol Medical Sciences University. Bian
    J Med Educ Dev Cent 2013;1:26‑33.
    41. Joolaee S, Ashghali Farahani M, Jafarian Amiri SR, Varaei S.
    Support in clinical settings as perceived by nursing students in
    Iran: A qualitative study. Nurs Midwifery Stud 2016;5:e31292.
    42. Baraz S, Memarian R, Vanaki Z. Learning challenges of nursing
    students in clinical environments: A qualitative study in Iran.
    J Educ Health Promot 2015;4:52.
    43. Zolfaghari M, Bahramnezhad F, Asgari P, Shiri M. Challenge of
    clinical education for critical care nursing students: Qualitative
    content analysis. J Clin Nurs Midwifery 2016;4:57‑67.
    44. Asadizaker M. The present challenges in clinical education of
    fundamentals to undergraduate nursing. Educ Dev Judishapur
    2015;6:74‑84.