Agents of innovation? Institutional conditions shaping nurse students’ positions in practice development

Abstract

This study investigates how institutional conditions shape nurse students' possibility to contribute to the development of clinical practices by applying the results of their bachelor thesis. The empirical context is a novel educational organization of the final study year, where the bachelor thesis is integrated with clinical placement and includes a mandatory bachelor conference, where students discuss the results from their bachelor thesis with clinicians at their clinical placement for the purpose of enhance innovative ideas for practice development. Drawing on institutional ethnography, the research adopts a mixed-method design, where data were collected via field observations of the bachelor conferences, focus group interviews with students who had held the conference, and a comparative questionnaire with 56 nurse students participating in the intervention and 48 completing existing educational format. The analysis reveals that the conference serves as a pivotal space for professional dialogue with different patterns of reactions. Students reported feelings of professional recognition, but also expressed concern about presenting critical reflections on clinical practice. The relational dynamics—such as fear of exposing poor care or not having enough knowledge themselves—highlight the complexity of embedding innovation within real-world healthcare environments. The findings suggest that integrating bachelor thesis with clinical practice enhances students’ innovation competencies and development of practice. However, the increased complexity calls for deliberate pedagogical strategies that support relational and communicative skills essential for sustainable practice development.

Keywords

Bachelor thesis / Innovation / Institutional ethnography / Nurse education / Nurse students / Practice development

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