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Challenges in the clinical learning environment: experiences of final-year nursing students in a tertiary institution in Ghana
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DOI：10.1186/s12912-026-05146-1.png)
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Abstract
En 中文
Clinical practicum is central to nursing education, yet suboptimal Clinical Learning Environments can hinder competence development and readiness for practice. Evidence from sub-Saharan Africa remains limited, particularly on final-year students approaching transition to practice. This study explored final-year nursing students’ experiences of clinical practicum in Ghana and the strategies they use to navigate learning constraints. An exploratory qualitative design was used. Twenty-four final-year nursing students from a Ghanaian tertiary institution were purposively recruited. Data were collected through twelve individual interviews and two focus group discussions, audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Reflexivity, collaborative coding, and an audit trail supported rigor. Two themes were generated: challenges in the Clinical Learning Environment and coping strategies. Reported challenges included poor mentorship, limited hands-on opportunities, restricted access to protective equipment, theory–practice gaps, and language barriers. These constraints undermined confidence and perceived readiness. Students demonstrated resilience through self-directed learning and supportive staff relationships, with positive feedback fostering confidence and professional identity. Clinical Learning Environments function as both barriers and formative spaces for learning. Strengthening mentorship, resource availability, and psychologically safe supervision is essential to optimizing students’ transition in resource-limited contexts.
Keywords:
Clinical learning environment
Nursing students
Nursing education
Clinical practicum
Theory–practice gap
Ghana
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