Challenges Impacting Clinical Placement Quality: Insights From Nursing Undergraduates in Sri Lanka - A Mixed Methods Study |Biomedgrid

Introduction: Clinical experience plays a crucial role in nursing education programs, enhancing the clinical competence of nursing undergraduates. The research aimed to understand how nursing undergraduates perceive their clinical experiences and gather insights on the topic, as this area lacks research evidence. Methodology: The study used a mixed method, including a descriptive quantitative design with qualitative inputs (n=78) and Focus Group Discussions (FGDs) (n=42). The sample consisted of nursing undergraduates in their 2nd, 3rd, and 4th years at the University of Sri Jayewardenepura. Self-administered questionnaires with open-ended questions and focus group discussions were employed for data collection. Results: A total of 78 participants completed the self-administered questionnaire. Most participants were females (79.5%), and 4th-year students represented 46.2% of the sample. The quantitative analysis of the data showed that most participants agreed that clinical appointments were sufficient to enhance their knowledge and skills. However, they expressed dissatisfaction with aspects such as the availability of equipment, facilities in hospitals and universities for clinical practice, and guidance from hospital nursing staff. On the other hand, participants found the clinical supervision guidance provided by academic staff from the university to be adequate. Participants also reported positive experiences in clinical placements at certain hospitals, with Paksha Hospital being the best. Issues highlighted include transportation problems, lack of sufficient room and meal facilities, and the need for clearer objectives and procedure books for clinical placements. Participants also recommended improving facilities in changing rooms, assigning a graduate nurse or clinical instructor for support, and tailoring assessments to each placement. A descriptive qualitative study was conducted with an exploratory design and an inductive approach. Five FGDs (n= 42) were conducted until data saturation using a focus group guide, a trained note taker and a moderator. The qualitative analysis from the focus group discussions revealed four themes: inadequate resources, negative attitudes toward nursing undergraduates, motivations with support, and suggestions for improvement. It was observed that physical and human resources need to be improved, attitudes toward nursing undergraduates should be more positive, and staff nurses should be more aware and supportive of clinical placements. Conclusions and Recommendations: In conclusion, the study suggests that enhancing nursing undergraduates' clinical experience requires addressing resource inadequacies, fostering positive attitudes, and improving support and supervision. Recommendations include providing adequate physical and human resources, raising awareness among staff nurses, and developing strategies to enhance undergraduate clinical competencies in Sri Lanka.