Struggles and adaptive strategies of prelicensure nursing students during first clinical experience: A metasynthesis

Abstract

Background: Nursing students' first clinical experience can be a challenging. Reviews focused on student struggles about readiness, ethical decision making, gender discrimination, and challenges to transcultural care. However, no reviews synthesized students' struggles and strategies during their first clinical experience.

Purpose: The purpose of this review was to develop an in-depth understanding of prelicensure nursing students' struggles and adaptive strategies during their first clinical experience.

Methods: A metasynthesis was conducted. Peer-reviewed qualitative studies were searched in CINAHL, PubMed, Scopus, Science Direct, and ProQuest Central. In total, 22 studies published from January 2010 to December 2021 were critically appraised and synthesized. Literature summary tables were used for data extraction and thematic synthesis for data synthesis.

Results: Nursing students encountered an array of affective and relational struggles from preparation to adaptation stage of their first clinical experience. Marginalization and incivility, powerlessness, and mentorship neglect were prominent struggles. Students used peer support, capacity building, and supportive resources as strategies to address their struggles.

Conclusions: Prompt and early collaboration of multiple stakeholders such as nursing students, frontline nurses, clinical educators, nursing schools, and managers of clinical placement settings can facilitate a smooth transition of nursing students into their first clinical experience.

Keywords: Clinical education; Clinical learning environments; First clinical experience; Nursing education; Nursing students.