An assessment of factors influencing clinical learning among diploma nursing students at Moi Teaching and Referral Hospital Eldoret, Kenya

Abstract

Whereas clinical learning is a vital aspect in nursing education, enabling students to gain practical skills and experience under supervision, several factors can promote or hinder its effectiveness. This study assessed factors influencing clinical learning among diploma nursing students at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. This mixed-methods cross-sectional study combined a quantitative survey of 304 nursing students and 4 qualitative focus groups of 6 - 8 participants. Quantitative data were analyzed using SPSS version 27 for descriptive, bivariate, and multivariate statistics, while qualitative data underwent thematic analysis. Results indicated that 48.03% of students strongly agreed they effectively applied theoretical knowledge during placements ( x = 4.27, SD = 0.95). Confidence in managing complex cases was moderate ( x = 3.99, SD = 0.93), while anxiety negatively impacted 22.04% of students ( x = 2.90, SD = 1.37). Institutional challenges such as inadequate supervision (37.83% disagreement, x = 2.37) and resource shortages (36.51% disagreement, x = 2.43) significantly hindered learning outcomes (χ2 = 66.000, p < 0.001). Regression analysis identified key predictors: student-related factors (B = 0.124, p = 0.023), training institution factors (B = −0.148, p = 0.003), and clinical factors (B = −0.112, p = 0.034), explaining 12.5% variance (R2 = 12.5%). Thematic findings emphasized supportive preceptorship, adequate resources, and alignment between theory and practice. These insights highlight the need for enhanced mentorship, resource investment, and improved institutional practices to optimize clinical learning and graduate competencies.