Laying the groundwork for clinical teaching in Bachelor of Science Nursing programs: findings from a grounded Delphi study

Abstract

Introduction: Bachelor of Science Nursing (BScN) students are exposed to clinical placements (CP) that are vital in advancing nursing competencies, but most of them attend the placements unprepared, thereby affecting learning, decision-making and safety. Even though, CPs are compulsory, preparation is often unstructured and not consistent across universities hence undermining theory-practice integration. The research objective was to formulate systematic strategies that would enhance BScN students´ readiness for clinical placements. Methods: a 15-month Grounded-Delphi study was conducted in three rounds: interviews with 13 professionals, followed by surveys with 103 and 75 participants (students, nurses, and lecturers). Thematic analysis and descriptive statistics were performed, and Kruskal-Wallis tests assessed differences in ratings of preparedness strategies across groups. Results: three key strategies emerged. The Theory-to-Practice Sequencing strategy emphasized acquiring theoretical knowledge before clinical exposure through coordinated instruction and essential skills training. The Goal-Oriented Learning Structures strategy focused on co-developed objectives and work plans using standard tools like rotation plans and logbooks. The Experiential Preparation approach highlighted simulations, mentorship, and practical training, though resource constraints remained a major challenge across universities and teaching hospitals. Conclusion: the academic-clinical interface in BScN programs can be strengthened with purposeful strategies aimed at preparing students with CPs by sequencing theory-practice, structured clinical learning with co-developed CP objectives, and experiential readiness through simulations. Nonetheless, the strategies must be implemented in a way that is viable to overcome the existing resource constraints.