Developing effective strategies for nursing care : the learning process of Thai undergraduate nursing students : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
The low average pass percentages in the Thai licence test of newly graduating nurses from the nursing college programmes has been recognised as a critical problem in Thailand for a significant period of time. There are many studies about conditions and strategies to improve the student nurses‘ competence. However, which teaching and learning strategies should be used, and when they should be applied in the process of learning had not been fully investigated. In this study, a grounded theory approach was used to explore the learning process of nursing students developing their nursing skills to become professional nurses. Thirty-two nursing students were interviewed individually about their learning in clinical situations. The main early emerging category in the study was continuing practical studies, which was based on two sub-categories: namely attending to procedure training, and seeking case problems and how to provide nursing care. The second main category, learning how to provide nursing care, emerged later, and supplied another two sub-categories: modifying strategies for case learning, and discovering how to understand case conditions. The main findings were that having enough learning opportunities and willing supervision develops the nursing students‘ self-confidence in practising and their learning motivation. Feelings of worry and fear, a sense of professional responsibility and supervisors‟ expectations are important influences that motivate nursing skill development of the participants. The ability of some students to transition from learning in order to meet supervisors‟ expectations to an internal desire to learn marked those students as successful adult learners who demonstrated critical thinking skills and the ability to integrate theoretical knowledge into the care planning for their patients. These students were able to transfer their knowledge to other nursing care situations, to develop effective strategies for nursing care and to pass the external registration exams. The findings from this study could be used to guide nursing instructors about how to enable the students to successfully integrate theory into clinical practice.