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UBC Theses and Dissertations

The nature of learning from the clinical experience of nursing students Goldie, Norma Elizabeth


This research project began with a discussion of the centrality of the clinical learning experience in nursing education. It went on to discuss the literature that identified the need for a better understanding of learning from this experience. This research project was designed to address that need. It attempted to describe conceptions of learning from clinical experience. The questions posed by this research project were: What are nursing students' conceptions of learning from clinical experience, and what is the relationship between the different conceptions of learning? The subjects were 13 nursing students in the fifth semester of a two year nursing program in a large urban centre. A qualitative methodology called phenomenography was used to systematically examine conceptions of learning from clinical experience. The data base were transcriptions of taped interviews of students' descriptions of learning. The analysis of data proceeded inductively through the reduction of unimportant differences in expressions in the interviews to the identification of a core of elements that represented the process and content of learning. These elements were then grouped according to similarities and delimited according to differences. The findings were the identification and description of three qualitatively different conceptions of learning. These conceptions of learning from clinical experience were: Conception A - Learning as reproducing facts and procedures, Conception B - Learning as an interpretive process, and Conception C - Learning as the discovery of relativism. The main difference between these conceptions was between Conception A where learning was seen as reproducing facts and procedures and between Conception B and C, where understanding was achieved. In Conception A learning is characterized by a quantitative view of knowledge, dualistic thinking, attention to parts rather than wholes, and repetition. In Conception B, learning is described as qualitative, analytical and concerned with a way of knowing. Learners use a physiological framework in understanding and seeing relationships. In Conception C, learning is focused on interpreting the person-in-situation as a basis for decision-making. Thinking in this conception is relativistic and contextual. The difference between conception B and C results in a difference in the quality of interpretation achieved. Conceptions of learning are tools that can be used when planning learning and teaching activities, when communicating with students about learning, and when evaluating the success of teaching. The findings of this research project suggest the benefits of modification of the clinical learning environment. This research project suggests the need for further studies of conceptions of learning from clinical experience including longitudinal studies and studies in which nursing students from different types of programs are used as subjects.

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