Narratives of nursing students and educators on clinical environment and culture in the context of community of practice: a narrative study

Nursing students, nurse educators, and nurses engage in clinical practice education and healthcare services through experiences within the complex clinical environment, and culture, in interaction with other healthcare professionals. During this process, learners and nurses become part of the community of practice, experiencing a socialization process where they develop both their individual growth and professional identity. Therefore, addressing the experiences of nursing students and educators regarding the clinical environment, and culture as a component of the community of practice is crucial for clinical education. The purpose of this study is to identify the contextual components related to the unique clinical environment and culture that shape the experiences of nursing students and educators in clinical education. Through the narratives of students and educators, this study aims to highlight how they engage with these contextual components and the consequences of these patterns of engagement for their experiences. The study was designed as a qualitative research with a narrative design. Narrative interviews were conducted to collect narratives, which were analysed using the ‘three-stage contextual analysis framework’, followed by contextual reading and thematic analysis. The participants of the study were 15 nursing students from the second, third and fourth grades who were receiving clinical practice training in the surgical clinic of a university hospital and their three instructors (N = 18). A contextual analysis of nursing students’ and educators’ narratives regarding the clinical environment and culture identified two main contexts: “Clinical system, structure, and functioning context” and “Socio-cultural, emotional interaction context of the clinic.” In relation to the first context, one main theme, “Possibility of clinical training and healthcare experience,” and five sub-themes derived. Regarding the second context, three main themes were derived: “Clinical community of practice and interactions,” “Professional role modeling of clinical nurses,” and “Emotionally challenging encounters.” Furthermore, the participants’ narratives contained rich metaphorical expressions. Our findings indicate that, within nursing education, the unique environment and culture of the surgical clinic, together with the local socio-cultural context and interactive dynamics, can develop students’ professional identities and intervention skills, and provide a foundation for more emotionally human encounters. The study emphasizes the importance of creating an emotionally supportive and interactive clinical environment that incorporates contextual, reflective, and narrative educational practices.