Abstract

Background: Nursing students spend a substantial proportion of their education in clinical practice; hence, the quality of these environments plays a critical role in shaping students’ learning outcomes. While research finds that nursing students often encounter bullying and harassment during clinical placement, the characteristics of positive and high-quality learning situations during these placements are less clearly described in the literature. Methods: A convergent, quantitative-dominant mixed-methods study was conducted between April and June 2024. Quantitative and qualitative data were collected concurrently; statistical analysis described prevalence and associations, while thematic analysis explored students’ experiences and contextualised the quantitative findings. Results: Statistical and thematic analyses indicated that high-quality learning emerged from the interplay of inclusion, mastery and active participation. A gradual transition from observation to independent practice, combined with appropriate challenges and opportunities for reflection, characterised the most effective learning situations. Approximately 50% of the students perceived themselves as victims of bullying or harassment, which impaired learning and prompted some to consider leaving nursing programs. The juxtaposition of positive and negative experiences highlighted team inclusion as the pivotal factor for both enhancing learning and preventing bullying. Conclusions: Being included as part of the team emerged as the main driver of positive clinical learning, whereas feeling isolated from the team was interpreted as bullying or harassment. These results indicated that well-prepared students, empowered supervisors, and inclusive organisational cultures supported by transparent reporting and response systems can provide the foundation for both high-quality learning and the prevention of bullying and harassment in clinical education.

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