Clearer structure in nursing strengthens student nurses’ clinical competence

A clear structure during clinical education can help student nurses feel more confident in their professional role and, ultimately, contribute to safer patient care. This is shown in a new doctoral thesis by Ulrika Löfgren at Luleå University of Technology, in which she explores how structure, reflection and supervision interact in students’ learning.

Lack of experience and feelings of uncertainty are common when student nurses enter healthcare settings during their clinical education. At the same time, they are expected to make well-considered decisions in complex situations. In her thesis, Ulrika Löfgren, doctoral student in nursing at Luleå University of Technology, has examined how nursing education can provide students with better conditions to develop the clinical competence required in the profession. At the heart of the research is the so-called nursing process.

The nursing process is a structured approach used by nurses to plan and deliver care. It involves systematically assessing the patient’s needs, planning interventions, implementing them and subsequently evaluating the outcomes. The process is intended to ensure that care is well considered and based on a holistic view of the patient.

In the thesis, the nursing process is examined as a pedagogical tool specifically during clinical education, not merely as a working method in healthcare practice. By clarifying how the nursing process can function as a core structure in education, the thesis contributes new knowledge about how future nurses can be prepared for an increasingly complex healthcare environment — something that may ultimately strengthen both patient safety and quality of care.

"The nursing process provides students with a clear structure for how to think and act in encounters with patients during clinical education. It creates a coherent link between theory and practice," says Ulrika Löfgren, doctoral student in nursing at Luleå University of Technology.

Making a difference in practice

The research shows that when supervisors and students use the same structure in discussions about real care situations during clinical education, students’ clinical reasoning develops. They become better at analysing situations, prioritising interventions and justifying their decisions. It is not about following a checklist, but about developing a professional way of thinking in real-life care situations.

"When the nursing process is used jointly in supervision during clinical education, students’ independence and their professional reasoning about patients’ needs are strengthened," says Ulrika Löfgren.

An important conclusion is that the model does not work on its own. For it to contribute to learning during clinical education, a learning environment is required in which supervisors actively use the structure and encourage reflection.

"It is the interplay between the model, the supervision and the learning environment during clinical education that makes the difference. This enables students to develop the confidence needed in complex care situations," says Ulrika Löfgren.

Ulrika Löfgren defended her thesis, The nursing process – a core structure for nursing students’ development of clinical competence, at Luleå University of Technology. The opponent was Professor Mia Berglund, Department of Health Sciences, University of Skövde.