Challenges in conducting clinical nursing skills education for the pre-qualified nursing students at the clinical environment of Hong Kong : a case study

Clinical practice is an integral component in nursing education. Pre-qualified nurse learners are required to work in different clinical settings to develop their skills competency. Conducting clinical skills education has always been a challenge to nursing teachers in Hong Kong and worldwide. This study adopts a case study methodology using three data collection methods including individual interviews, a focus group interview and the researcher's participant observation experience in a clinical visit and her skills laboratory teaching during a 3-month class in the teaching programme. Alongside inviting nursing student participants, this study also utilised the insights of nursing teachers, clinical nurses, and advanced practice nurses. Drawing upon the ideas from Vygotsky's Sociocultural Theory, this study engages with several Vygotskian concepts such as: "learning from the more knowledgeable others", "social interaction", "scaffolding" and "zone of proximal development". Through the collection of multiple sources of data, this case study favours a critical inquiry of the sociocultural factors and their relation to clinical education. It uses thematic analysis, synthesizing the findings, identifying four overarching themes namely the environment related sources, human-related sources, culture-related sources, skills-teaching-related sources along with eight sub-overarching themes have been generated. The findings reflect the dilemmas existing in clinical nursing education and uncovers the nursing students as well as the practitioners managing intense pressures which significantly affect the delivery of clinical skills education. The research study fronts the complex sociocultural context which influences the students' learning and teachers' mentoring, and it offers an important insight into the challenges of conducting clinical nursing skills education.