The nursing process – A core structure for nursing students’ development of clinical competence : From the perspective of nursing students, supervisors and teachers

Clinical education is the part of the nursing education wherein students gain experiential and practical knowledge in real clinical settings. It is essential because it allows nursing students to develop clinical competence by applying and integrating theoretical knowledge through patient encounters. The nursing process is a component of clinical competence and a systematic approach to providing care which involves critical thinking. The overall aim of this thesis was to explore how the nursing process can support nursing students’ learning and development of clinical competence during clinical education. The thesis takes a qualitative research approach and consists of four interrelated studies, each designed to correspond to different aspects of the overall aim: qualitative descriptive design (I), focus group methodology (II), grounded theory (III) and qualitative longitudinal intervention study (IV). Data were collected through individual interviews (I, III, IV) and focus group discussions (II, III). The included participants were nursing students in their final year (I, III, IV), supervisors in clinical settings (II, III), clinical teacher (III) and teachers in nursing education from higher education (III). Data were analysed using qualitative content analysis (I), focus group methodology (II), constant comparative analysis (III) and pattern-oriented analysis (IV). For addressing the overall aim, an interpretative synthesis was conducted to form a comprehensive understanding of the findings from all the sub-studies. The overall findings show that the nursing process can provide a core structure for nursing students’ learning and development of clinical competence during their clinical education. The nursing process can serve as a framework for reflection and help students give meaning to theory in practice. Through reflection and a deeper understanding of the nursing process in practice, students can adopt a more structured approach to their clinical work, which strengthens their clinical competence. However, for learning based on the nursing process to be meaningful, students must receive sufficient support and experience the necessary prerequisites. A reciprocal relationship between the student and the supervisor is significant, as both have the responsibility to create conditions for learning and development. In addition, students’ understanding and holistic view of the patient were enhanced when they were given the opportunity to consider the entire nursing process. A clinical education grounded in person-centred learning and reciprocal supervisory relationship offers a conducive environment for students to grow and enhance their clinical competence in becoming a nurse. In conclusion, the nursing process appears to be a valuable structure in nursing students’ learning during clinical education. Nursing students need support from supervisors and teachers to make the process meaningful in practice. These findings have implications for educators in nursing programmes and supervisors in clinical practice with regard to structuring and improving clinical education.