December 2008

Document Type


Degree Name



Oregon Health & Science University


The purpose of this interpretive phenomenological study was to uncover and understand how nursing students learn in clinical settings. The central concerns of nursing students were examined, along with three areas of human learning and development: moral development, cognitive development, and skill acquisition. Twenty senior baccalaureate nursing students were interviewed in small groups and asked to talk about a challenging clinical experience in nursing school during which they felt stumped, worried or concerned about what to do. Themes, exemplars and paradigm cases were identified during data analysis and interpretation. Comparisons were made within and across semesters. Three central concerns of nursing student were identified: learning by doing, maintaining positive relationships with staff, and patient well-being. Their moral, cognitive and skill development were entwined within the central concerns. Although students experienced change in the areas of moral, cognitive and skill development as they progressed through nursing school, changes were subtle, and students did not all change equally or at the same pace. The findings of the study have implications for nursing education and can be used to inform clinical teaching strategies and curriculum planning. The implications include the importance of experiential teaching and learning, more thoughtful structuring of clinical experiences, addressing the mismatch between didactic and clinical learning, the applicability of Benner’s (1984) Novice to Expert model, the value of stress management and self-care for nursing students, and greater collaboration between education and practice. Limitations of the study included the position of the researcher and the lack of diversity of the sample. The researcher is a nurse educator, and may have been perceived by participants as being a person with power, and they may have been hesitant to share their stories and opinions. The participants were mostly Caucasian, and half of the sample came from two western states in the United States. The study should be replicated with a more diverse sample.




School of Nursing



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