Challenges to clinical nursing education in the Middle East and North Africa: a systematic review and meta-synthesis of qualitative studies

BACKGROUND: Clinical learning is a vital component of nursing education, enabling the development of technical and non-technical skills. However, clinical training faces several challenges. This study aims to synthesize the main challenges that hinder clinical nursing education in the Middle East and North Africa. METHODS: A systematic review and meta-synthesis of qualitative studies conducted following the PRISMA guidelines. PubMed, Scopus, Web of Science, and ScienceDirect databases were searched for studies published in English or French from 1999 to 2024 in the MENA region. Two researchers independently assessed the retrieved papers using the Consolidated Criteria for Reporting Qualitative Research. Findings from primary studies were analyzed thematically using NVivo software following the Braun and Clarke's framework. RESULTS: Twenty-six studies were reviewed. A thematic analysis of the findings from the primary studies revealed four main themes synthesizing the main challenges faced by nursing students in clinical learning: (1) Unsupportive clinical environment, (2) Organizational and planning shortcomings, (3) Ineffective supervision and evaluation, and (4) Personal factors and students' attributes. CONCLUSIONS: Clinical education in the MENA region faces several challenges that could compromise the training of future nurses and, in turn, potentially affect the quality and safety of the care provided. It is recommended to strengthen academic and clinical partnerships, optimize mentoring, and upgrade clinical infrastructure.