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A Dynamic Interaction: Supervisors' Reasoning About Nursing Students' Conditions for Learning and Development of Clinical Competence. A Focus Group Study
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0003-1522-275X
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0001-7140-625X
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0002-8842-7759
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0002-3400-323X
2025 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 12, no 3, article id e70176Article in journal (Refereed) Published
Abstract [en]

Aim: This study aimed to describe supervisors' reasoning about conditions for nursing students' learning and development of clinical competence during their clinical education.

Design: A qualitative design with an inductive approach.

Methods: This study used a focus group methodology. A total of 21 supervisors from various hospital wards in northern Sweden participated in six focus groups. The data were analysed according to Krueger and Casey's description of focus groups.

Results: The analysis resulted in one overarching theme with six subthemes that described the conditions during the final year of clinical education. Students' learning and development of clinical competence was seen as an ‘interplay developed over time’ between the supervisor and the student, a mutual give-and-take in the supervisory relationship where both parties were responsible for ensuring that it became a growth opportunity.

Conclusion: The major finding was that the learning and development of clinical competence in students was a result of a dynamic interplay between the student and supervisor. This process is time-dependent, and both the student and supervisor share responsibility for this progression.

Implications for the Profession and Patient Care: Active and conscious reflection is a crucial component in achieving clinical competence. Students should be taught and encouraged to apply and develop reflective skills throughout their education.

Reporting Method: The study adhered to the COREQ checklist for qualitative studies.

Patient or Public Contribution: Registered nurses contributed data for this study.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025. Vol. 12, no 3, article id e70176
Keywords [en]
clinical competence, clinical education, focus group, learning, nursing student, qualitative study, supervisor
National Category
Nursing
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-112087DOI: 10.1002/nop2.70176ISI: 001436661600001PubMedID: 40033606Scopus ID: 2-s2.0-86000099393OAI: oai:DiVA.org:ltu-112087DiVA, id: diva2:1946902
Note

Validerad;2025;Nivå 2;2025-03-24 (u5);

Full text license: CC BY-NC 4.0;

Available from: 2025-03-24 Created: 2025-03-24 Last updated: 2025-12-15Bibliographically approved
In thesis
1. The nursing process – A core structure for nursing students’ development of clinical competence: From the perspective of nursing students, supervisors and teachers
Open this publication in new window or tab >>The nursing process – A core structure for nursing students’ development of clinical competence: From the perspective of nursing students, supervisors and teachers
2026 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Clinical education is the part of the nursing education wherein students gain experiential and practical knowledge in real clinical settings. It is essential because it allows nursing students to develop clinical competence by applying and integrating theoretical knowledge through patient encounters. The nursing process is a component of clinical competence and a systematic approach to providing care which involves critical thinking. The overall aim of this thesis was to explore how the nursing process can support nursing students’ learning and development of clinical competence during clinical education. The thesis takes a qualitative research approach and consists of four interrelated studies, each designed to correspond to different aspects of the overall aim: qualitative descriptive design (I), focus group methodology (II), grounded theory (III) and qualitative longitudinal intervention study (IV). Data were collected through individual interviews (I, III, IV) and focus group discussions (II, III). The included participants were nursing students in their final year (I, III, IV), supervisors in clinical settings (II, III), clinical teacher (III) and teachers in nursing education from higher education (III). Data were analysed using qualitative content analysis (I), focus group methodology (II), constant comparative analysis (III) and pattern-oriented analysis (IV). For addressing the overall aim, an interpretative synthesis was conducted to form a comprehensive understanding of the findings from all the sub-studies. 

The overall findings show that the nursing process can provide a core structure for nursing students’ learning and development of clinical competence during their clinical education. The nursing process can serve as a framework for reflection and help students give meaning to theory in practice. Through reflection and a deeper understanding of the nursing process in practice, students can adopt a more structured approach to their clinical work, which strengthens their clinical competence. However, for learning based on the nursing process to be meaningful, students must receive sufficient support and experience the necessary prerequisites. A reciprocal relationship between the student and the supervisor is significant, as both have the responsibility to create conditions for learning and development. In addition, students’ understanding and holistic view of the patient were enhanced when they were given the opportunity to consider the entire nursing process. A clinical education grounded in person-centred learning and reciprocal supervisory relationship offers a conducive environment for students to grow and enhance their clinical competence in becoming a nurse. 

In conclusion, the nursing process appears to be a valuable structure in nursing students’ learning during clinical education. Nursing students need support from supervisors and teachers to make the process meaningful in practice. These findings have implications for educators in nursing programmes and supervisors in clinical practice with regard to structuring and improving clinical education. 

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2026
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
Keywords
clinical competence, clinical education, nursing, nursing education, nursing student, nursing process, supervision, qualitative research
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-115809 (URN)978-91-8048-970-6 (ISBN)978-91-8048-971-3 (ISBN)
Public defence
2026-02-27, A117, Luleå University of Technology, Luleå, 09:00 (Swedish)
Opponent
Supervisors
Funder
Luleå University of Technology, 622940
Available from: 2025-12-15 Created: 2025-12-15 Last updated: 2026-02-06Bibliographically approved

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Löfgren, UlrikaLindberg, BirgittaStrömbäck, UlricaWälivaara, Britt-Marie

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