Study on challenges faced by Nursing students at Eastern University, Sri Lanka in transitioning from classroom learning to clinical practice

Abstract

The transition from classroom learning to clinical practice is a critical phase in nursing education that poses significant challenges for students. Although theoretical knowledge in subjects like pharmacology and anatomy provides a strong foundation, the dynamic and unpredictable nature of real-world clinical settings demands adaptability, critical thinking, and resilience qualities that are not fully cultivated in traditional academic environments. Students often face gaps between classroom instruction and clinical realities, limited supervision, emotional stress, all of which can hinder skill development and confidence. Recognizing and addressing these challenges is vital to producing competent, confident, and adaptable nurses who can thrive in complex healthcare systems. This study aimed to explore the challenges faced by nursing students at Eastern University, Sri Lanka, in transitioning from classroom learning to clinical practice. Qualitative research with phenomenological approach was used to explore the clinical learning experiences of third and final-year nursing students at Eastern University. Purposive sampling was used. Data were collected through four in-depth interviews and three focus group discussions, supplemented by observational field notes. Thematic analysis, facilitated by NVivo software (version 1.7.2), was used to code the data and interpret key themes from participants' experiences. The study identified several major themes impacting students' clinical learning experiences. Key findings revealed significant gaps in clinical education, characterized by inadequate orientation, a profound theory-practice disconnect, insufficient bedside teaching, and inconsistent supervision from faculty and staff. Students reported substantial psychological and emotional distress, stemming from negative interactions including public criticism, perceived examiner bias, and high levels of stress and anxiety. Systemic and organizational barriers were prominent, with students citing resource shortages, a lack of financial stipends, and inequitable treatment compared to diploma nursing students, which fostered feelings of injustice and demotivation. Communication difficulties with both patients and staff further complicated their learning environment. In response to these multifaceted challenges, students primarily relied on peer support as a crucial coping mechanism. The study concludes that undergraduate nursing students face significant, multifaceted challenges that impede their clinical learning and professional development. The pervasive theory-practice gap, inadequate supervision, and negative psychological experiences, compounded by systemic resource and policy deficiencies, create a formidable barrier to effective education. Addressing these deep-rooted issues requires a comprehensive, multi-pronged reform. Key recommendations include curriculum modernization, enhanced faculty supervision, and fostering a supportive, equitable learning environment to ensure the development of competent and confident nursing professionals.