Cant Robyn, Ryan Colleen, Hughes Lynda, Luders Elise, Cooper Simon
School of Health, Federation University Australia, Berwick, VIC, Australia.
School of Nursing, Midwifery, and Social Sciences, CQ University, Brisbane, QLD, Australia.
SAGE Open Nurs. 2021 Sep 14;7:23779608211035845. doi: 10.1177/23779608211035845. eCollection 2021 Jan-Dec.
Clinical placements are a mandatory component of nursing students' education internationally. Despite clinical education being a key to nursing students' achievement of nursing competencies, few studies have reviewed students' narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys.
A ystematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students' experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research.
Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as "Preparation," "Welcomed and wanted" and "Supervision experiences". A conceptual model of clinical placement elements conducive to nursing students' learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed.
The conceptual model presents positive elements that influence students' clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strategies to support students and supervisors alike, an important step forward in moving beyond the current clinical placement rhetoric.
临床实习是国际上护理专业学生教育的必修组成部分。尽管临床教育是护理专业学生获得护理能力的关键，但很少有研究回顾学生的叙述以描述他们在临床实习期间的学习经历。此类研究对于比定量调查更深入地洞察临床学习经历可能很重要。
对2010年至2020年6月期间的定性研究进行了系统的主题综合分析。寻找对本科护理专业学生实习期间学习经历进行主题分析的英语语言研究。在五个数据库（PubMed、Ovid Medline、CinahlPlus、SCOPUS和谷歌学术）中进行了检索。该研究以ENTREQ声明为指导，以提高定性研究综合报告的透明度。
该综述纳入了27项定性研究。主题综合分析显示，各项研究中有100多个主题和子主题。聚类分析揭示了积极因素以及在研究中被视为临床学习障碍的其他因素。积极因素包括支持性的指导教师、密切监督和归属感（团队中的）。不支持的指导教师、缺乏监督和未被接纳被视为障碍。揭示了可以描述成功实习的三个关键总体主题，即“准备”、“受到欢迎和需要”以及“监督体验”。开发了一个有助于护理专业学生学习的临床实习要素概念模型，以增强对与监督相关的复杂性的理解。展示并讨论了研究结果和模型。
该概念模型呈现了影响学生临床实习学习体验的积极因素。该模型可能提供一个框架，以指导专业发展计划和策略，以支持学生和指导教师，这是超越当前临床实习言辞的重要一步。
