Date of Award

10-13-2025

Degree Type

Thesis

Degree Name

MSc in Nursing

First Advisor

Dr Salma Rattani

Second Advisor

Dr Saima Sachwani

Third Advisor

Ms Saira Lalani

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: The quality of clinical placements is fundamental to nursing education, bridging theoretical knowledge with practical competence. In Karachi, Pakistan, numerous private nursing colleges lack affiliated teaching hospitals, necessitating the placement of students in resource-constrained public healthcare facilities. This arrangement creates a challenging learning environment characterized by a potential theory-practice gap, inadequate supervision, and high student stress, which may compromise the development of competent future nursing professionals.
Purpose: This study aimed to explore and describe the clinical experiences of third- and fourth-year undergraduate nursing students from private colleges in Karachi. It focused on their perspectives regarding the challenges, learning opportunities, and overall satisfaction during clinical placements in public tertiary care hospitals, and how these experiences contributed to their professional development.
Method: An exploratory descriptive qualitative design was employed. Data were collected through eight semi-structured focus group discussions involving 59 Bachelor of Science in Nursing (BSN) students from three private nursing colleges. The data were analyzed using reflexive thematic analysis to identify recurrent themes and patterns within the participants' narratives.
Findings: The analysis revealed a profound disconnect between academic training and clinical reality. Five major themes were constructed: (1) systemic and environmental deficiencies, including institutional neglect and severe resource scarcity; (2) a culture of supervisory neglect and hostility, leaving students feeling abandoned, exploited, and devalued; (3) a pervasive theory-practice chasm where evidence-based protocols were ignored; (4) a crucible of confidence, detailing the psychological toll on students alongside their remarkable resilience and agency in self-directed learning; and (5) a unified call for systemic reform.
Conclusion: The current model of clinical education for these students is unsustainable and detrimental, relying on student resilience rather than structured institutional support. The findings underscore an urgent need for comprehensive reform in nursing education, practice, and policy to create safe, supportive, and pedagogically sound clinical learning environments that can effectively prepare a competent and confident nursing workforce for Pakistan.

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1

Last Page

154

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