{"id":{"repo_id":"oxford-brookes","oai_identifier":"tle:161182a7-65b2-4beb-bbdb-0d5836a0c20d:d6bd9758-527a-46cd-bfe2-c433766e8fca:1"},"canonical_url":"https://search.dev.ndltd.org/etd/oxford-brookes/tle:161182a7-65b2-4beb-bbdb-0d5836a0c20d:d6bd9758-527a-46cd-bfe2-c433766e8fca:1","repository":{"repo_id":"oxford-brookes","name":"Oxford Brookes University","base_url":"https://radar.brookes.ac.uk/radar/oai"},"display":{"title":"Experiences of final-year nursing students in clinical learning environments in the United Kingdom and in the Philippines : a comparative explanatory sequential mixed methods study","abstract":"Background The global nursing shortage poses a critical threat to healthcare systems worldwide, driven in part by high nurse attrition rates and persistent challenges in nursing education. Evidence suggests that where qualifying nursing students perceive strong continuity between the experience gained in theory and practice settings, they are more likely to persist in their professional preparation and succeed. Accordingly, this study examines and compares the clinical learning experiences of final-year nursing students in two healthcare systems where the theory and practice dimensions of nursing education are differently administered: the United Kingdom and the Philippines. Methods An explanatory sequential mixed methods design was used. Quantitative data were collected via an online survey using an adapted Clinical Learning Environment Inventory and the Generalised Self-Efficacy Scale. Descriptive statistical analysis was conducted using SPSS Version 29. In the second phase, semi-structured interviews were conducted with ten students, and data were analysed thematically using NVivo 14. Findings from both phases were integrated using the Pillar Integration Process and theorised with reference to experiential and social accounts of learning processes. Findings Sixty final-year nursing students participated in the study, with 15 from the UK site and 45 from the Philippines, yielding response rates of 18.52% and 17.24%, respectively. Under the theoretical lenses adopted in the study, four key themes emerged: (1) a sense of achieveme nt despite adversity, (2) feelings of unpreparedness for practice, (3) varied experiences of belonging within teams, and (4) a strong call for more student-centred clinical environments. Quantitative findings indicated that while over half of participants were satisfied with their clinical learning environments, less than one-third reported high self-efficacy. Conclusion While the study finds that the different organisation of educational roles and experiences across the theory and practice domains does indeed impact on student experience across the two cohorts, broader contextual, cultural, and institutional factors also play a critical role in shaping students' confidence and transition into practice. The study concludes that clinical satisfaction alone is not a reliable indicator of students’ professional readiness. In response, eight tentative recommendations and a novel reflective framework, the Reflexive Nursing Knowledge and Skills Framework, are proposed to enhance the quality of clinical education, bridge the theory–practice gap, and better support final-year nursing students in both national systems as they transition into the workforce.","abstract_html":"Background The global nursing shortage poses a critical threat to healthcare systems worldwide, driven in part by high nurse attrition rates and persistent challenges in nursing education. Evidence suggests that where qualifying nursing students perceive strong continuity between the experience gained in theory and practice settings, they are more likely to persist in their professional preparation and succeed. Accordingly, this study examines and compares the clinical learning experiences of final-year nursing students in two healthcare systems where the theory and practice dimensions of nursing education are differently administered: the United Kingdom and the Philippines. Methods An explanatory sequential mixed methods design was used. Quantitative data were collected via an online survey using an adapted Clinical Learning Environment Inventory and the Generalised Self-Efficacy Scale. Descriptive statistical analysis was conducted using SPSS Version 29. In the second phase, semi-structured interviews were conducted with ten students, and data were analysed thematically using NVivo 14. Findings from both phases were integrated using the Pillar Integration Process and theorised with reference to experiential and social accounts of learning processes. Findings Sixty final-year nursing students participated in the study, with 15 from the UK site and 45 from the Philippines, yielding response rates of 18.52% and 17.24%, respectively. Under the theoretical lenses adopted in the study, four key themes emerged: (1) a sense of achieveme nt despite adversity, (2) feelings of unpreparedness for practice, (3) varied experiences of belonging within teams, and (4) a strong call for more student-centred clinical environments. Quantitative findings indicated that while over half of participants were satisfied with their clinical learning environments, less than one-third reported high self-efficacy. Conclusion While the study finds that the different organisation of educational roles and experiences across the theory and practice domains does indeed impact on student experience across the two cohorts, broader contextual, cultural, and institutional factors also play a critical role in shaping students' confidence and transition into practice. The study concludes that clinical satisfaction alone is not a reliable indicator of students’ professional readiness. In response, eight tentative recommendations and a novel reflective framework, the Reflexive Nursing Knowledge and Skills Framework, are proposed to enhance the quality of clinical education, bridge the theory–practice gap, and better support final-year nursing students in both national systems as they transition into the workforce.","abstract_has_math":false,"creators":["Lanada, Jose Ariel"],"institution":"Oxford Brookes University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Davison-Fischer, Jan","Butcher, Daniel","Dalrymple, Roger"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":null,"date_issued":"","date_published":null,"updated_at":"2026-07-24T03:41:51Z","subjects":[],"languages":["en"],"rights":["All rights reserved"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://doi.org/10.24384/tkpb-3s22","outbound_label":"DOI","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Lanada, Jose Ariel","Davison-Fischer, Jan","Butcher, Daniel","Dalrymple, Roger"]},{"key":"dc:creator","label":"Author","values":["Lanada, Jose Ariel"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:publisher","label":"Institution","values":["Oxford Brookes University"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["All rights reserved"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://doi.org/10.24384/tkpb-3s22","https://radar.brookes.ac.uk/radar/file/161182a7-65b2-4beb-bbdb-0d5836a0c20d/1/Lanada2026Nursing.pdf","https://radar.brookes.ac.uk/radar/file/161182a7-65b2-4beb-bbdb-0d5836a0c20d/1/Jose Ariel Lanada Declaration form for final EdD Thesis submission.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Background The global nursing shortage poses a critical threat to healthcare systems worldwide, driven in part by high nurse attrition rates and persistent challenges in nursing education. Evidence suggests that where qualifying nursing students perceive strong continuity between the experience gained in theory and practice settings, they are more likely to persist in their professional preparation and succeed. Accordingly, this study examines and compares the clinical learning experiences of final-year nursing students in two healthcare systems where the theory and practice dimensions of nursing education are differently administered: the United Kingdom and the Philippines. Methods An explanatory sequential mixed methods design was used. Quantitative data were collected via an online survey using an adapted Clinical Learning Environment Inventory and the Generalised Self-Efficacy Scale. Descriptive statistical analysis was conducted using SPSS Version 29. In the second phase, semi-structured interviews were conducted with ten students, and data were analysed thematically using NVivo 14. Findings from both phases were integrated using the Pillar Integration Process and theorised with reference to experiential and social accounts of learning processes. Findings Sixty final-year nursing students participated in the study, with 15 from the UK site and 45 from the Philippines, yielding response rates of 18.52% and 17.24%, respectively. Under the theoretical lenses adopted in the study, four key themes emerged: (1) a sense of achieveme nt despite adversity, (2) feelings of unpreparedness for practice, (3) varied experiences of belonging within teams, and (4) a strong call for more student-centred clinical environments. Quantitative findings indicated that while over half of participants were satisfied with their clinical learning environments, less than one-third reported high self-efficacy. Conclusion While the study finds that the different organisation of educational roles and experiences across the theory and practice domains does indeed impact on student experience across the two cohorts, broader contextual, cultural, and institutional factors also play a critical role in shaping students' confidence and transition into practice. The study concludes that clinical satisfaction alone is not a reliable indicator of students’ professional readiness. In response, eight tentative recommendations and a novel reflective framework, the Reflexive Nursing Knowledge and Skills Framework, are proposed to enhance the quality of clinical education, bridge the theory–practice gap, and better support final-year nursing students in both national systems as they transition into the workforce."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Experiences of final-year nursing students in clinical learning environments in the United Kingdom and in the Philippines : a comparative explanatory sequential mixed methods study"]}]}],"canonical_facts":{"dc:contributor":["Lanada, Jose Ariel","Davison-Fischer, Jan","Butcher, Daniel","Dalrymple, Roger"],"dc:creator":["Lanada, Jose Ariel"],"dc:description":["Background The global nursing shortage poses a critical threat to healthcare systems worldwide, driven in part by high nurse attrition rates and persistent challenges in nursing education. Evidence suggests that where qualifying nursing students perceive strong continuity between the experience gained in theory and practice settings, they are more likely to persist in their professional preparation and succeed. Accordingly, this study examines and compares the clinical learning experiences of final-year nursing students in two healthcare systems where the theory and practice dimensions of nursing education are differently administered: the United Kingdom and the Philippines. Methods An explanatory sequential mixed methods design was used. Quantitative data were collected via an online survey using an adapted Clinical Learning Environment Inventory and the Generalised Self-Efficacy Scale. Descriptive statistical analysis was conducted using SPSS Version 29. In the second phase, semi-structured interviews were conducted with ten students, and data were analysed thematically using NVivo 14. Findings from both phases were integrated using the Pillar Integration Process and theorised with reference to experiential and social accounts of learning processes. Findings Sixty final-year nursing students participated in the study, with 15 from the UK site and 45 from the Philippines, yielding response rates of 18.52% and 17.24%, respectively. Under the theoretical lenses adopted in the study, four key themes emerged: (1) a sense of achieveme nt despite adversity, (2) feelings of unpreparedness for practice, (3) varied experiences of belonging within teams, and (4) a strong call for more student-centred clinical environments. Quantitative findings indicated that while over half of participants were satisfied with their clinical learning environments, less than one-third reported high self-efficacy. Conclusion While the study finds that the different organisation of educational roles and experiences across the theory and practice domains does indeed impact on student experience across the two cohorts, broader contextual, cultural, and institutional factors also play a critical role in shaping students' confidence and transition into practice. The study concludes that clinical satisfaction alone is not a reliable indicator of students’ professional readiness. In response, eight tentative recommendations and a novel reflective framework, the Reflexive Nursing Knowledge and Skills Framework, are proposed to enhance the quality of clinical education, bridge the theory–practice gap, and better support final-year nursing students in both national systems as they transition into the workforce."],"dc:format":["application/pdf"],"dc:identifier":["https://doi.org/10.24384/tkpb-3s22","https://radar.brookes.ac.uk/radar/file/161182a7-65b2-4beb-bbdb-0d5836a0c20d/1/Lanada2026Nursing.pdf","https://radar.brookes.ac.uk/radar/file/161182a7-65b2-4beb-bbdb-0d5836a0c20d/1/Jose Ariel Lanada Declaration form for final EdD Thesis submission.pdf"],"dc:language":["en"],"dc:publisher":["Oxford Brookes University"],"dc:rights":["All rights reserved"],"dc:title":["Experiences of final-year nursing students in clinical learning environments in the United Kingdom and in the Philippines : a comparative explanatory sequential mixed methods study"],"dc:type":["thesis"]},"updated_at":"2026-07-24T03:41:51Z"}