Key elements of a healthy clinical learning environment for undergraduate nursing students

Abstract

Nurse educators and clinical facilitators must understand how the clinical learning environment influences undergraduate nursing student’s development into competent, well rounded nursing practitioners. The purpose of this structured literature review was to identify elements of a healthy clinical learning environment. The guided research question was: ‘What is meant by a healthy clinical learning environment for undergraduate nursing students?’. The Population–Concept–Context framework was used to assist in a focused inquiry into the relevant population, concepts and context. To capture relevant literature, the search strategy included CINAHL, Medline, EBSCOhost, Academic Search Ultimate and LitMaps databases, using specific key terms aligned with the framework. Thematic coding was conducted inductively, followed by conceptualising and interpreting the themes. Proper orientation, clear expectations, structured clinical placements, active mentorship, emotional support well-being, effective communication, consistent feedback and a sense of belonging promote a healthy clinical learning environment. Stressors of clinical placement include inadequate support, ineffective feedback and a lack of psychological safety. These stressors influence the student’s ability to achieve learning outcomes. Contribution: This review synthesises the key elements of a healthy clinical learning environment, highlighting the relational, organisational and educational factors that support undergraduate nursing students’ learning and well-being. It provides evidence-informed recommendations to strengthen collaboration between NEIs and clinical placement sites, thereby enhancing student support, clinical learning experiences and successful achievement of learning outcomes.