Undergraduate nursing students' clinical adaptation: a qualitative journey mapping study from student and clinical preceptor perspectives

Abstract

Clinical adaptation is shaped by students' readiness, precepting arrangements, patient responses, and ward conditions. Previous studies have usually examined student and preceptor experiences separately. This study aimed to explore undergraduate nursing students' adaptation to clinical practice from student and clinical preceptor perspectives and to identify key touchpoints, differences in focus, and support needs through journey mapping. A descriptive qualitative study was conducted. Sixteen undergraduate nursing students and 11 clinical preceptors from a tertiary teaching hospital in Anhui Province, China, were purposively recruited. Individual face-to-face semi-structured interviews were analysed using Braun and Clarke's thematic analysis. Student and preceptor data were analysed separately and then compared at the thematic level. Journey mapping was then used to organise the findings across the clinical adaptation process and to present students' experiences and clinical preceptors' observations within the same journey map. Three themes and seven subthemes were identified: Positioning and Participation, Interaction and Adjustment, and Readjustment and Identity. Students judged their adaptation mainly by whether they could take part in patient care and whether their involvement was accepted by preceptors and patients. Preceptors adjusted participation and supervision according to observed performance, task risk, patient preferences, and safety requirements. Feedback, procedural setbacks, and ward rotations could interrupt participation, and previously established progress and support did not always carry over. Clinical adaptation was described as involving repeated adjustments as opportunities to participate were gained, interrupted, and re-established. Clinical education should support continuity of participation, provide specific feedback and opportunities to re-engage after setbacks, and improve the transfer of learning information across ward rotations while maintaining patient safety.