Exploring the clinical learning experience: voices of Malawian undergraduate student nurses.
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Very little has been done to define the process of clinical learning in Malawi and yet anecdotal observations reveal that it is more challenging than classroom teaching and learning. This set the impetus for this hermeneutic phenomenological study, the aim being to gain an understanding of the nature of the clinical learning experience for undergraduate students in Malawi and to examine their clinical experiences against some experiential learning models (Kolb 1984; Jarvis et al 1998). The study setting was Kamuzu College of Nursing (KCN) and the sample was selected purposively and consisted of 30 undergraduate students who were recruited through volunteering. Conversational interviews were conducted to obtain students’ accounts of their clinical learning experience and an eclectic framework guided the phenomenological analysis. The study raises issues which relate to nursing education and nursing practice in Malawi. From an experiential learning perspective, the study reveals that clinical learning for KCN students is largely non-reflective. The study primarily reveals that the clinical learning experience is enormously challenging and stressful due to structural problems prevalent in the clinical learning environment (CLE). In some clinical settings the CLE appears hostile and oppressive due to negative attitudes which some of the clinical staff display towards KCN students. Consequently, students’ accounts depict emotionally charged situations which confront them and this illustrates that clinical learning for KCN students is an experience suffused with emotions. In literature issues on emotions are commonly discussed under emotional labour (Hochschild 1983) and I used the concept as a basis for my pre-understandings and interpreted the students’ accounts of their clinical learning experience against such a conceptual framework. What resonated from their narratives was the depth of the emotion work they engage in. This enabled me to arrive at a new and unique conceptualisation of clinical learning redefined in terms of emotional labour within the perspective of nurse learning in Africa. The findings are a unique contribution to the literature on emotions and provide essential feedback which forms the basis for improving clinical learning in Malawi.