Abstract:

Clinical learning is integral to nursing education, essential for the competence development required in a three-year diploma program. This research aimed to investigate factors affecting skill acquisition during clinical learning among preservice Registered Nursing students at Levy Mwanawasa Medical University in Lusaka, Zambia. A cross-sectional descriptive design, employing a self-administered adapted questionnaire pretested for reliability in the UK and Swaziland (Cronbach’s alpha: 0.77–0.96, correlation: 0.74) was used. Stratified random sampling based on training level selected 80 participants meeting inclusion criteria through a random sampling method.  Data analysis included descriptive statistics, chi-square tests, and binary logistic regression using SPSS version 26, with a 95% confidence interval and 5% significance level. The study identified four predictors significantly correlated with skill acquisition during clinical learning: inadequate supportive learning environment (100%, n=80, p=0.003), inadequate Student-Patients allocation (83.75%, p=0.048), and inadequate Resources (56.25%, p=0.002), and inadequate motivation to learn (51.25%, p=0.037). Incompetence of clinical instructors and mentors (57.5%, p=0.233) and mild Anxiety (85%, p=0.762). Binary Logistic Regression, adjusted for independent variables, indicated that an improved supportive learning environment decreased skill acquisition odds (Odds Ratio=0.049, p=0.025), while increased resource availability raised odds (Odds Ratio=3.338, p=0.01) for students who perceived these variables as inadequate. The omnibus test was significant (chi-square=14.095, p=0.015), accurately classifying 72.5% of cases. Collaboration among educators, clinical staff, and policymakers is crucial for enhancing nursing education quality by addressing factors affecting clinical skills acquisition.

Keywords: Anxiety, clinical learning, competence of clinical instructors and mentors, resources, skill acquisition, supportive learning environment.

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