Official Journal of the College of Nursing, University of Mosul

Document Type : Original Articles

Authors

1 Assistant Professor, Nursing Department, College of Health Sciences, University of Buraimi, Sultanate of Oman.

2 Professor, Department of Clinical Nursing Sciences, College of Nursing, University of Mosul, Iraq.

Abstract

 
Background: Clinical learning is a crucial aspect of nursing education, providing students with opportunities to develop essential skills and competencies. The nursing process serves as a systematic framework guiding nurses in delivering patient-centered care.
Objective: This qualitative study aims to explore nursing student experiences with the nursing process and its impact on their development during clinical learning.
Methods: The study adopts a qualitative approach, involving in-depth interviews, observations, focus groups, and document analysis to gather rich insights into nursing students' experiences with the nursing process. Thematic analysis is used to identify key themes and patterns in the data.
Results: The findings highlight the integration of theory and practice, enhancement of clinical reasoning and decision-making skills, emphasis on patient-centered care, promotion of interdisciplinary collaboration, and cultivation of continuous learning and improvement through the nursing process.
Conclusion: Integrating the nursing process into nursing curricula enhances students' clinical competencies, promotes patient-centered care, facilitates interdisciplinary collaboration, and fosters a culture of continuous learning. Recommendations are made for curriculum integration, educational strategies, faculty development, and future research directions.

Keywords

INTRODUCTION

 

Interact  with patients, healthcare teams, and diverse clinical scenarios, fostering their growth as future healthcare providers(Kestel & Korkmaz, 2023; Löfgren et al., 2023).

Central to clinical learning is the nursing process, a systematic and dynamic framework that guides nurses in delivering holistic, individualized patient care(Koy, Preechawong, et al., 2023). Comprising assessment, diagnosis, planning, implementation, and evaluation phases, the nursing process emphasizes a patient-centered approach, evidence-based practice, and continuous quality improvement(Ojo & Olaogun, 2023). This structured methodology not only enhances patient outcomes but also cultivates essential competencies in nursing students, such as clinical reasoning, therapeutic communication, and interdisciplinary collaboration(Demis & Munye, 2023).

Despite the recognized importance of the nursing process in nursing education, there exists a gap in the literature regarding its comprehensive exploration in relation to nursing student development(Koy, Yunibhand, et al., 2023). While numerous studies have investigated aspects of clinical learning and the nursing process separately, limited research delves into the nuanced interplay between these elements and their impact on nursing student learning outcomes, professional growth, and transition to practice(Tadzong-Awasum et al., 2022). This research lacuna highlights the need for a qualitative inquiry to gain deeper insights into how the nursing process serves as a framework for nursing student development during clinical learning experiences. By addressing this gap, this study aims to contribute valuable knowledge to the field of nursing education and inform evidence-based practices for optimizing clinical learning environments and enhancing student learning outcomes..

Methodology

Research Design: This study adopts a qualitative approach to explore nursing student experiences with the nursing process. Qualitative methods are chosen for their ability to capture rich, contextualized data, allowing for an in-depth understanding of participants' perspectives, attitudes, and experiences related to the nursing process in clinical learning environments. Through qualitative inquiry, this study seeks to uncover nuanced insights, patterns, and themes that may not be easily captured through quantitative measures alone, thereby enriching our understanding of the complex interplay between the nursing process and nursing student development.

Participant Selection: For this qualitative study, a purposeful sampling approach was employed to ensure the inclusion of participants with diverse perspectives and experiences related to clinical learning and the nursing process. A total of 8 nursing students were deliberately chosen to represent both undergraduate and graduate nursing students, aiming to capture a spectrum of educational backgrounds and experiences within the nursing program. This approach allowed for a comprehensive exploration of how the nursing process is perceived and applied across different educational levels, enriching the study with a range of insights from participants at various stages of their nursing education.

Data Collection Methods: Data collection for this study encompasses multiple methods to gather rich and comprehensive insights into nursing student experiences with the nursing process. These methods may include:

  • In-depth interviews: Conducted with individual nursing students to explore their perceptions, experiences, and reflections on using the nursing process in clinical practice.
  • Observations: Observational data gathered during clinical learning experiences to document how nursing students apply the nursing process in real-time patient care situations.
  • Focus groups: Group discussions involving nursing students to elicit collective perspectives, shared experiences, and group dynamics related to the nursing process and its impact on student development.
  • Document analysis: Review of relevant documents, such as clinical logs, reflective journals, or educational materials, to complement and triangulate data collected through interviews, observations, and focus groups.

These data collection methods are designed to provide a comprehensive and multi-dimensional understanding of nursing student experiences with the nursing process, capturing both individual perspectives and group dynamics within clinical learning contexts.

Data Analysis: Data analysis in this study involves thematic analysis, a qualitative analysis method that identifies, analyzes, and interprets patterns, themes, and categories within the data. Thematic analysis allows for a systematic and rigorous exploration of participants' narratives, experiences, and perceptions related to the nursing process and its role in nursing student development. Through iterative coding, pattern recognition, and theme development, this analysis aims to uncover key themes, insights, and implications that contribute to a deeper understanding of how the nursing process shapes nursing student learning experiences and professional development in clinical settings.

RESULTS

In analyzing the data gathered from interviews, observations, focus groups, and document analysis, several key themes emerged regarding how nursing students perceive and experience the nursing process in clinical learning. These themes provide valuable insights into the impact of the nursing process on nursing student development and professional growth.

  1. Integration of Theory and Practice: Nursing students highlighted the importance of the nursing process in bridging theoretical knowledge with practical application. They described how learning about the nursing process in classrooms and simulation labs facilitated their ability to apply theoretical concepts to real patient care scenarios during clinical rotations. One participant stated, "The nursing process taught in classes became real for me during clinicals. It's like connecting the dots between theory and practice."
  2. Clinical Reasoning and Decision-Making: Participants emphasized the role of the nursing process in enhancing their clinical reasoning skills and decision-making abilities. They described how systematically following the nursing process helped them prioritize patient care tasks, identify patient needs, and formulate appropriate nursing interventions. A participant shared, "Using the nursing process helps me think critically and make informed decisions about patient care. It's like having a roadmap for providing comprehensive care."
  3. Patient-Centered Care: Nursing students emphasized the patient-centered nature of the nursing process and its emphasis on holistic care. They discussed how applying the nursing process allowed them to consider not only the physical needs of patients but also their psychosocial, emotional, and spiritual well-being. A participant mentioned, "The nursing process encourages us to see patients as whole individuals, not just a list of symptoms. It helps us provide personalized and compassionate care."
  4. Interdisciplinary Collaboration:

 Participants highlighted the collaborative aspect of the nursing process, particularly in interdisciplinary healthcare teams. They discussed how collaborating with other healthcare professionals, such as physicians, therapists, and social workers, within the framework of the nursing process enhanced communication, coordination, and continuity of care. One participant stated, "The nursing process promotes teamwork and collaboration. It's about working together with other healthcare providers to achieve the best outcomes for patients."

  1. Continuous Learning and Improvement: Nursing students expressed the value of the nursing process in fostering a culture of continuous learning and improvement. They discussed how reflecting on their experiences, evaluating outcomes, and revising care plans based on feedback contributed to their professional growth and development. A participant reflected, "Using the nursing process taught me the importance of continuous learning and adapting to changes in patient conditions. It's about always striving to provide better care."

Quotations from Participants:

  • "The nursing process taught in classes became real for me during clinicals. It's like connecting the dots between theory and practice."
  • "Using the nursing process helps me think critically and make informed decisions about patient care. It's like having a roadmap for providing comprehensive care."
  • "The nursing process encourages us to see patients as whole individuals, not just a list of symptoms. It helps us provide personalized and compassionate care."
  • "The nursing process promotes teamwork and collaboration. It's about working together with other healthcare providers to achieve the best outcomes for patients."
  • "Using the nursing process taught me the importance of continuous learning and adapting to changes in patient conditions. It's about always striving to provide better care."



Figure 1: impact of the nursing process on nursing student development and professional growth

 

 

 

 

 

 

DISCUSSION

Interpretation of Results: The findings of this study have significant implications for nursing education and practice. By highlighting the role of the nursing process in nursing student development, the study underscores the importance of integrating this systematic framework into nursing curricula. The interpretation of results emphasizes several key implications:

  • Enhanced Clinical Competencies: Integrating the nursing process into nursing education can enhance students' clinical competencies, including critical thinking, clinical reasoning, and decision-making skills.

Clinical nursing competency is influenced by a range of factors, including education, training, experience, professional development, clinical judgment, decision-making skills, and communication (Gardulf et al., 2016). In line with this understanding, the International Competency-Based Medical Education (ICBME) Collaborators have been actively working since 2009 to advance competency-based medical education (Carraccio et al., 2016). Moreover, nursing competency is also shaped by interpersonal skills, technical proficiency, emotional intelligence, ethical and legal considerations, as well as the work environment and support provided by healthcare organizations (Feliciano et al., 2019). Additionally, researchers have emphasized the significance of the nurse-patient interaction in fostering nursing competency, particularly highlighting the crucial role of interpersonal skills in achieving positive outcomes (Meretoja & Koponen, 2012).

  • Promotion of Patient-Centered Care: Emphasizing the nursing process fosters a patient-centered approach to care, ensuring that nursing students consider holistic patient needs and provide individualized, compassionate care.
  • Facilitation of Interdisciplinary Collaboration: Utilizing the nursing process promotes interdisciplinary collaboration and communication, preparing students to work effectively within healthcare teams.

Both the National League for Nursing Accreditation Commission (NLNAC) and the Commission on Collegiate Nursing Education (CCNE) emphasize the importance of demonstrating interprofessional collaboration within nursing programs, particularly in interprofessional teams and during patient care activities. The American Association of Colleges of Nursing (AACN) recommends a collaborative approach with other professions, such as sharing simulation centers and their resources, as a means of fostering interprofessional collaboration (AACN, n.d.).(Dashti-Kalantar et al., 2023)

  • Cultivation of Continuous Learning: Incorporating the nursing process encourages a culture of continuous learning and improvement among nursing students, leading to professional growth and development.

Caring is a fundamental core value in nursing education and should permeate all aspects of the undergraduate nursing program's content and activities. Students can effectively demonstrate caring behaviors by embodying five key values, namely human dignity, integrity, autonomy, altruism, and social justice (Fahrenwald et al., 2005). Students' perceptions of expressing caring behaviors encompass a range of actions, including providing assistance, offering support, maintaining health, preventing disease, promoting wellness, delivering services, and offering both biological and psychological support (Petrou et al., 2017).

Limitations: Despite the valuable insights gained from this study, several limitations should be acknowledged:

  • Sample Size: The study's sample size may limit the generalizability of findings to broader nursing student populations. Future research with larger samples could enhance the study's external validity.
  • Contextual Specificity: Findings are based on specific clinical learning contexts and may not fully capture variations in nursing education programs or healthcare settings.
  • Potential Biases: Participant biases or social desirability effects in self-reported data could impact the study's results.

Recommendations: Based on the study's findings and limitations, several recommendations are proposed for integrating the nursing process into nursing curricula, improving clinical learning experiences, and guiding future research directions:

  • Curriculum Integration: Incorporate the nursing process as a foundational framework throughout nursing curricula, emphasizing its relevance to clinical practice and patient care.
  • Educational Strategies: Implement active learning strategies, case-based learning, and simulation experiences that integrate the nursing process into clinical learning environments.
  • Faculty Development: Provide faculty development opportunities to enhance educators' understanding and implementation of the nursing process in teaching and assessment practices.
  • Research Directions: Encourage further research on the longitudinal impact of the nursing process on nursing student outcomes, explore variations in nursing process implementation across different healthcare settings, and investigate innovative approaches to teaching and assessing the nursing process in nursing education.

ETHICAL CONSIDERATIONS COMPLIANCE WITH ETHICAL GUIDELINES

Ethical considerations in this study included obtaining written informed consent from each student after explaining the study's aims. Participants were informed of their right to withdraw from the study at any time, and confidentiality of the collected data was ensured. Moreover, students' privacy and anonymity were maintained throughout the study for all participants.

FUNDING
There is no funding. 

AUTHORS CONTRIBUTIONS

RAR designed the study, collected data, interpreted the results, prepared all tables and figures, wrote the manuscript, and reviewed it before submission. Read and approved the final manuscript.

DISCLOSURE STATEMENT

The author declares no competing interest

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