Social Learning Dynamics in the Clinical Learning Environment(CLE) Experienced by Nursing Students in Two Kenyan Newborn Units (NBUs)

Background As global healthcare systems continue to suffer shortages in the nursing workforce, there is an increased need for well-rounded nurses. Professional socialisation which facilitates the journey to becoming a nursing professional, happens in the classroom and during clinical practicum, with substantial learning attributed to the training received at the clinical practicum. Various teaching and learning models are used in nursing education, most of them being formal and structured in nature. However, social learning which is informal and unstructured has been credited with having a greater impact on clinical learning for nurses. However, there is a gap in understanding how social theories of learning could help to enhance clinical teaching, especially in low-resource settings. This study explored the social learning dynamics of nursing students in two Newborn Units in Kenya. Methods This was an exploratory study where qualitative data were collected in two public hospitals. A total of 81 hours of non-participant observations were undertaken and 62 in-depth interviews were conducted. Staff and student interactions were observed as they delivered care to newborns. Staff, across cadres, and nursing students attending clinical practicum were interviewed thereafter using a semi-structured approach. Data were analysed thematically using Nvivo software. Two social learning frameworks informed data analysis: Communities of Practice and the Socio-cognitive Theory of Learning. Results Two main themes emerged: 1) opportunities for social learning and 2) influences on social learning. Opportunities for social learning in the clinical learning environment encompassed the sub-themes: conversational (ward teachers, meetings, group collaborations) and observational (role modelling). Influences on social learning were grouped into the following sub-themes: personality factors, environmental factors and structure of clinical placement. Discussion and Conclusions Social learning was a central learning avenue for nursing students in the clinical learning environment. Specific influences on social learning were identified, as well as measures to make social learning more successful for optimum learning outcomes. Recommendations from this study include the incorporation of social learning frameworks into nurse training, capacity building of ward staff as role models, and structuring the clinical placement and clinical learning environment for social learning to thrive. Clinical trial number: not applicable