Nursing Education in the Clinical Setting Essay
Nursing Education in the Clinical Setting
Clinical nursing education represents one of the primary ways professionals are formed, as it is a period in which students bridge classroom experiences and patient care experiences. At this point, students must attempt to integrate complex theoretical knowledge while responding appropriately to the many fluid realities of clinical practice. The focus of the following essay will include five important factors: the sources of learner stress in clinical settings, the preceptor socialization strategies, the evaluation, and retention; the hazards and strategies associated with poor clinical role models; a comparison between concept mapping and traditional care planning; and an applied concept map for sepsis.
Sources of Learner Stress in Clinical Settings
Learners encounter concurrent stressors relating to academics, interpersonal relations, and performance in clinical environments. Academic stressors arise from the burden of coursework and the competing demands of clinical responsibilities and tests. In a nursing report, Labrague (2024) found excessive workload, lack of time, and fear of failure as significant stressors that negatively impacted well-being. Clinical stressors emerge when learners are in high-acuity environments, for example, feeling overwhelmed by a complex patient and fearing potential harm to patients. Aloufi et al. (2021) found that nursing students placed in intensive care units reported levels of anxiety were significantly higher than others and attributed their anxiety to unfamiliar equipment and responsibility. According to the study, interpersonal stressors were also common, often in cases where students were subjected to incivility or did not receive the expected support from staff or peers. In the same line, Toqan et al. (2023) found that learners often reported emotional turmoil with responses such as negative attitudes from staff and unclear expectations. These different stressors require complex and perseverant support.
Proactive measures have been shown to lessen the impact of clinical stress while managing student resilience. Preparation workshops prior to the clinical placement have helped students’ perceived readiness and reduce anticipatory anxiety. For example, students who completed pre-practicum orientation together with peer mentoring had greater psychological adjustment and confidence (Alkouri et al., 2025). Additionally, emotional regulation strategies, including mindfulness-based stress reduction (MBSR), have been associated with positive coping and reduced burnout outcomes among nursing learners. Students who received mindfulness intervention showed fewer cortisol levels and improved emotional regulation during their clinical placements (González-Martín et al., 2023). Faculty debriefings also provide opportunities for emotional processing and reflective learning. Labrague (2024) noted that structured reflection following clinical experiences could advance stress appraisal and promote improved coping strategies.
While clinical stress is most often discussed negatively, controlled stress levels are beneficial to outcomes. According to Chapter 20 by Bradshaw et al. (2021), students achieve optimal performance when manageable stress from challenges is scaffolded with support, feedback, and modeling. Opportunities for critical thinking, flexibility, and professional resilience can emerge from appropriately structured clinical placements. Stress can be a great driver to help foster personal and professional growth by creating learning-rich experiences when intentional preparation and mentorship practices support the transition in high-stress environments.
Preceptor Socialization, Evaluation, and Retention
The quality of nursing education in the clinical setting is largely contingent upon the abilities of preceptors. The socialization of preceptors into their educator role begins with an orientation program that articulates responsibilities, institutional values, and student learning outcomes. According to Mashayekh et al. (2024), structured preceptor orientations focused on communication skill development, reflective teaching, and managing conflicts successfully satisfied teacher and learner satisfaction. Bradley et al. (2021) use Chapter 22 to suggest that experiential learning strategies like role-play and simulation develop opportunities to model excellent teaching practices. In their writing, they conclude that preceptors value opportunities for continued learning that resemble typical clinical situations to practice some of the routine dilemmas they face in a low-risk environment.
Evaluation of precepting must utilize reliable assessment tools that enable feedback from multiple sources. Multi-source feedback systems that factor in student evaluations, peer observations, and self-reflections create a balanced perspective. Jan et al. (2025) established that consistently using the Clinical Teaching Behavior Inventory (CTBI-22) better fits learners’ needs and supervisor practices. In addition, feedback from faculty observations informs development in specific practice areas. These evaluations enhance individual practice, the overall culture of accountability, continued improvement, and shared values in systems of clinical education.
Retaining educators with expertise relies on acknowledging their accomplishments, educator roles, institutional factors, and opportunities for advancement. Substantial survey and trial evidence demonstrate that continuing education programs assist preceptors in keeping up with pedagogy and clinical practice developments. Hong and Yoon (2021) found that mentorship preceptors who participated in faculty development opportunities reported higher role satisfaction and commitment. Further, preceptors practicing in institutions that offered incentives via faculty clinical educator titles, peer recognition awards, and financial stipends had better preceptor retention. Bradshaw et al. (2021) noted the value of embedding preceptorship into a leadership trajectory within nursing career paths in Chapter 22. Overall, making sustained investments in preceptor development improves the quality of clinical education and advances the pursuit of excellence in nursing education.
Placing Learners with Less‑Than‑Ideal Role Models
Clinical contexts are not always the best sites for student learning, and students can be placed with role models who engage in problematic behaviors. The rationale for this placement can have ethical implications, including student internal conflict about acceptable or poor practices. Labrague (2024) distinguished that learners who experienced impoliteness or disregard for protocols reported increased stress levels or decreased motivation. This issue is compounded by the fact that students are often left unattended at clinical sites without supervision or a chance to debrief or process what they witnessed. The prospect of learning poor norms through silent and observational learning should not be minimized.
Nonetheless, placements such as this can still be educationally valuable if accompanied by guided reflective scaffolds, facilitator-guided reflections, peer reflections, or debriefings with practice educators, allowing the student to assess and discuss problematic behavior compared to what is considered good practice within a profession. Mashayekh et al. (2024) state that students benefit from structured discussions that prompt learning and thinking about the behaviors of role models. When students can describe the differences between “good” and “poor” practice they have seen, they show greater discernment about practice and enter the learning in a more ethically grounded space. Hong and Yoon (2021) illustrated that students who worked with a role model with mixed practice were offered guidance and opportunities to reflect on their work and displayed better judgment and resilience.
Facilitators must develop their clinical sites so that students do not passively observe unethical behavior and provide evaluative tools and an ethical framework. In chapter 23, Bradshaw et al. (2021) recommend developing self-awareness around values context and humanitarian reasoning for ethical reasoning. When students see that they have a framework and the opportunity to critique behaviors they see within a framework, even placements based on precarious role models can become rich, transcendent learning experiences.
Position on Concept Mapping vs. Traditional Care Plans
Although the nursing care plan has typically been the primary way to ensure nursing care accountability and approaches to care, it is often seen as limited now that it is seen as too linear in culture with its repetitious documentation. Conversely, concept mapping is a way to engage learners through the visual organization of patient data, pathophysiology, interventions, and outcomes in an organized framework. A path analysis by Dirgar et al. (2024), establishing the knowledge increase through concept mapping using undergraduate nursing students, found that students using concept mapping developed more critical thinking, clinical reasoning, and greater knowledge retention. Thus, concept mapping enhances cognitive engagement through its requirement for learners to engage across multiple layers of care.
Furthermore, concept mapping enhances metacognition and collaborative learning, which are also essential in 21st-century nursing education. Faraji et al. (2025) systematically reviewed the pedagogical process, finding that students using concept mapping recalled information slower and had better problem-solving abilities than students in traditional formats. Additionally, the collaborative nature of creating maps fosters collaboration and communication to demonstrate persuasiveness in clinical decision-making.
Theoretically, concept mapping is aligned with constructivist and student-centered learning models. In Chapter 26, Bradshaw et al. (2021) state that tools that foster reflective synthesis rather than passive recording allow learners to create meaning and ownership of knowledge. Therefore, concept mapping is aligned with pedagogical principles, evidence, and conceptual frameworks for practice to develop higher-order thinking that can be seen as more varied and flexible than a traditional care plan.
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Concept Map on Sepsis Management
Concept mapping improves clinical reasoning by visually linking related areas of patient care. The visual representation below represents an organized means of managing septic patients, providing clarity in instruction and continuity in decision-making. The concept map is evidence-based, practice-driven, and aligned with the educational principles set forth by Bradshaw et al. (2021).
The management of the sepsis content map follows a clear four-level structure to organize clinical priorities and facilitate a holistic approach to nursing care. Level 2 identifies four main domains: etiology, assessment, interventions, and monitoring, all aggregating under the lens of sepsis management. Each domain has identifiable clinical components at level 3: infection source, immunosuppression, and comorbidities under etiology; SIRS/qSOFA, blood cultures, and organ dysfunction under assessment; early antibiotics, fluid resuscitation, and source control under interventions; and vital signs with lactate, organ perfusion, and urine output with ScvO2 under monitoring. This sequence reflects the logic of evidence-based practice and promotes cognitive organization.
On the other hand, Level 4 establishes links to supports for practice under each domain: education under etiology, documentation under assessment, follow-up under interventions, and family support under monitoring. These domains signal the inclusion of psychosocial and communication aspects of clinical care. Bradshaw et al. (2021) emphasized the importance of multilayered concept maps in developing competency in synthesizing clinical reasoning with holistic patient-centered approaches, and Faraji et al. (2025) confirmed that visual content mapping improves retention, prioritization, and decision-making within the complexity of situations.
Conclusion
This paper considered aspects of clinical nursing education through the lens of evidence and best practice. The learner’s stress in the clinical context is a multifaceted challenge that can be alleviated with proactive orientation, supportive approaches, and critical process reflection. The precepting approach is guided by carefully structured socialization, meaningful assessment, and retention in the context of institutional rewards. In learners interacting with dysfunctional socialization roles, formalized reflection and ethics provide an opportunity for invention and to learn from experience. Concept mapping is an alternative to traditional nursing care plans and provides an alternate approach to the learning experience that is enriched and integrated. It is possible to demonstrate through a sample map a patient sepsis learning example how this concept mapping process can enable the learner to transform patient assessment observations into synthesized plans for patient care. Using socialization principles and the support of peer-reviewed literature has and can continue to support clinical education in developing skilled, reflective, and resilient nursing professionals.
References
Alkouri, O., Al-Bashaireh, A. M., Aljawarneh, Y., Albikawi, Z., & Saifan, A. R. (2025). Perceived stress, coping mechanisms, and influential factors among undergraduate nursing students during ICU clinical placements: A cross-sectional study. PLOS One, 20(5). https://doi.org/10.1371/journal.pone.0323406
Bradshaw, M. J., Hultquist, B. L., & Hagler, D. (2021). Innovative teaching strategies in nursing and related health professions (8th ed.). Jones & Bartlett Learning.
Dirgar, E., Berşe, S., Bor, N. A., & Tosun, B. (2024). The effect of concept mapping in nursing education on critical thinking motivation: A path analysis. Nurse Education Today, 143, 106386–106386. https://doi.org/10.1016/j.nedt.2024.106386
Faraji, A., banafshi, Z., Jalali, R., & Jalali, A. (2025). Concept mapping teaching method and nursing education: A systematic review and meta-analysis. BMC Medical Education, 25(1). https://doi.org/10.1186/s12909-025-07392-4
González-Martín, A. M., Aibar-Almazán, A., Rivas-Campo, Y., Castellote-Caballero, Y., & Carmen, del. (2023). Mindfulness to improve the mental health of university students. A systematic review and meta-analysis. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1284632
Hong, K. J., & Yoon, H.-J. (2021). Effect of nurses’ preceptorship experience in educating new graduate nurses and preceptor training courses on clinical teaching behavior. International Journal of Environmental Research and Public Health, 18(3), 975. https://doi.org/10.3390/ijerph18030975
Jan, A., Asmat, K., Yasir, S., & Raheel, S. (2025). Clinical teaching behaviors of preceptors of undergraduate nursing students at a private teaching hospital in Islamabad, Pakistan: A convergent mixed-methods study protocol. BMJ Open, 15(5), e099313. https://doi.org/10.1136/bmjopen-2025-099313
Labrague, L. J. (2024). Umbrella review: Stress levels, sources of stress, and coping mechanisms among student nurses. Nursing Reports, 14(1), 362–375. https://doi.org/10.3390/nursrep14010028
Mashayekh, R., Ebadi, A., Nehrir, B., & Moayed, M. S. (2024). The effect of the preceptorship training program on the participation of clinical nurses in training nursing internship students: A quasi-experimental study. BMC Nursing, 23(1), 395. https://doi.org/10.1186/s12912-024-02034-4
Toqan, D., Ayed, A., Malak, M. Z., Hammad, B. M., ALBashtawy, M., Hayek, M., & Imad Thultheen. (2023). Sources of stress and coping behaviors among nursing students throughout their first clinical training. SAGE Open Nursing, 9. https://doi.org/10.1177/23779608231207274
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Write a 1500-1750 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) sources in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.
- What are the sources of learner stress in the clinical setting? How can they be reduced? Can the stress ever have a positive aspect?
- How would you socialize, evaluate, and retain a preceptor?
- Should you place learners in a clinical setting that has less-than-desirable staff role models? What are the risks and how can they be mitigated?
- Do you agree or disagree with the following statement? Defend your position.
“…concept mapping has found a useful place in nursing education as an alternative strategy to the linear, rote organization of information in the traditional nursing care plan. …” - Develop a concept map on a health-related topic of your choice
- Bradshaw, M. J., Hultquist, B. L., & Hagler, D. (2021). Innovative teaching strategies in nursing and related health professions (8th ed.). Jones & Bartlett. ISBN: 978-1284204728. Review Chapter 15. Read Chapter 20, 21, 22, 23, 25, & 26.