Understanding undergraduate nursing students' clinical experience: An integrative review

Abstract

Background and objective: Clinical education is a cornerstone of undergraduate nursing programs, providing students with hands-on experiences essential for developing clinical judgment, professional identity, and confidence. Despite its central role, limited research explores how students experience clinical learning or how these experiences are structured and delivered. This integrative review explored and critically analyzed the clinical experiences of undergraduate nursing students in generalist nurse clinical placements in the United States.

Methods Design: The review followed the Whittemore and Knafl integrative review framework and adhered to the PRISMA 2020 reporting guidelines. A comprehensive search of PubMed, CINAHL Complete, APA PsycINFO, and Web of Science identified peer-reviewed studies published between 2014 and 2024. Inclusion criteria focused on primary research involving undergraduate nursing students in U.S.-based generalist clinical experiences. Nine studies met the inclusion criteria and were included in the integrative review. These studies were comprised of five mixed-methods, two qualitative, one retrospective, and one cross-sectional study.

Results Four themes emerged: (1) student emotional responses to clinical experiences, (2) the influence of clinical instructors or preceptors, (3) student confidence and sense of belonging, and (4) clinical skill development. Emotional responses and instructor influence were most frequently studied, while psychomotor skills acquisition received minimal attention.

Conclusions Emotional and relational dimensions of clinical education are well represented in the literature; however, evidence related to skill development, instructional models, and faculty preparation remains limited. Further research should identify and test best practices that enhance student competence, confidence, and readiness for professional practice.

Keywords

Clinical education / Clinical placement / Experiential learning / Nursing education / Undergraduate nursing student

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