Nursing home management and clinical learning environments: A qualitative study

For their health and well-being, nursing home residents increasingly depend on appropriate basic nursing care that requires certain clinical skills. In our study, we examined how the managers of nursing homes facilitate appropriate clinical learning environments to promote basic nursing skills. Following a qualitative design and with reference to complexity theory, we probed multiple sources of data in a reflexive thematic analysis. The results revealed the NH managers adopt a holistic approach balancing a complexity of interests: maintaining effective oversight, supporting staff in delivering high-quality care, and providing learners with valuable learning experiences and guidance. They recognised that integrating these complex interests was best achieved by empowering the caring staff and supported them in doing so. Clinical learning environments have inherent self-organizing capacities, where staff can autonomously manage their tasks and collaborate effectively. This self-organization is a powerful aspect that complements the managerial authority. Facilitating learners' insight into the power of the caring staff's self-organizing capacities is important for basic nursing competencies The managers' understanding of how the caring staff naturally organise their work represents a resource for both maintaining and enhancing the quality of both care and clinical learning. Thus, their contribution and involvement are vital for the success of any initiative aimed at enhancing the clinical learning environment.