Nursing students’ learning dynamics and influencing factors in clinical contexts

Clinical placements are essential for students to develop clinical skills to qualify as nurses. However, various difficulties encountered by nursing students during their clinical education detract from developing clinical competencies. This constructivist grounded theory study aims to explore nursing students' experiences in clinical nursing education, and to identify the factors that influence the clinical education students receive. Twenty-one individual and six group semi-structured interviews were conducted with sixteen fourth year nursing students and four registered nurses. This research identified six factors that influence nursing students' clinical education: interpersonal, socio-cultural, instructional, environmental, emotional and physical factors. The research has developed a dynamic model of learning in clinical contexts, which offers opportunities to understand how students' learning is influenced multifactorially during clinical placements. The understanding and application of the model can improve nursing instructional design, and subsequently, nursing students’ learning in clinical contexts. •Nursing students have difficulties learning effectively in clinical environments.•Six factors that influence nursing students' clinical education are identified.•There is a lack of institutional support for nursing students' clinical placements.•Social hierarchy and norms within clinical contexts affect the students' learning.•Nursing students undergo emotional distress during their clinical placements.