The challenges encountered by Chinese nursing students during their clinical practicums: A critical incident analysis approach

Abstract

This paper explores the difficulties and challenges during clinical practicums among Chinese nursing students in Hong Kong and identifies strategies to maximize student learning. By using critical incident case study, interviews of 3 focus groups with 20 nursing instructors (i.e. 5-9 persons in a group) were conducted in 2018. The group discussions were facilitated by the same moderator and observed by two academic staff. Each interview lasted for an hour and they were audio-taped and transcribed for analysis. The interviewees were assigned to three groups according to their teaching experiences in higher education, i.e. six members in the experienced group (>2 years), nine in the intermediate experienced group (1-2 years), and five in the non experienced group (0-1 year). Three themes that reflected students’ challenges included: Interpersonal inadequacy: A failure to commit to nursing professionalism, codes of ethics, and the practice of safe procedures; previous traumatized experience in clinical practicum; the lack of confidence and insights into the ‘do’s and ‘don’ts; Intrapersonal conflict: discord created by overly dominant students in skill practice, and inadequate and ineffective communication; and extrapersonal influences from the hospital environment. The strategies that were identified to maximize students’ learning experiences were: For example, maintaining standards and supervising practices throughout, partnering with clinical staff to monitor student’s learning, instigating disciplinary system to assess fitness for practice, using multiple teaching methods, channels and platforms, motivating and backing up students and providing feedback, teacher’s self-reflection and sharing of personal experiences, checking students’ performances from academic records, etc.