Strategies for Preventing Workplace Bullying in Clinical Learning Environments: Perspectives of Nursing Students in Sri Lanka

Abstract Background: Workplace bullying in clinical learning environments is a global concern that negatively affects nursing students' Psychological well-being and clinical performance. Although the prevalence of workplace bullying among nursing students has been widely documented, limited attention has been given to students' awareness of institutional policies and their own recommendations for preventing bullying during clinical education. Objective: This study aimed to explore nursing students' awareness of existing institutional policies related to workplace bullying during clinical placement and to elicit strategies suggested by nursing students for preventing workplace bullying in clinical learning environments in Sri Lanka. Methods: A qualitative descriptive study was conducted among second- and third-year nursing students enrolled at a government nursing education institution in Sri Lanka. A total of 166 students participated. Data were collected using a self-administered open-ended survey that explored students' awareness of institutional policies related to workplace bullying and invited recommendations for prevention based on their clinical placement experiences. The qualitative responses were analysed using inductive thematic analysis. Ethical approval was obtained from the Ethical Review Committee of KIU University, Sri Lanka. Participation was voluntary, and confidentiality and anonymity were maintained throughout the study. Results: The majority of participants were female (96.8%), with a mean age of 25.5 years (SD = 1.2). Most students reported limited or no awareness of existing institutional policies related to workplace bullying. Thematic analysis revealed five key student-recommended prevention strategies: promoting respectful communication, strengthening clinical supervision, establishing confidential reporting mechanisms, enhancing staff awareness of nursing students' roles and responsibilities, and strengthening institutional leadership and accountability. Conclusion: The findings highlight an important gap in nursing students' awareness of institutional policies addressing workplace bullying. Creating safer clinical learning environments requires a comprehensive approach that strengthens policy awareness, promotes respectful communication, improves clinical supervision, provides accessible and confidential reporting mechanisms, clarifies students' roles to clinical staff, and reinforces institutional leadership and accountability. Implementing these strategies may help create more supportive, respectful, and psychologically safe clinical learning environments for nursing students in Sri Lanka.