Nursing students coping strategies to stressors in clinical learning environment: A systematic review and meta-synthesis

OBJECTIVES: The objective of this systematic review is to provide deeper understanding and insight through combining the results of qualitative research that reported on the effective coping mechanisms used by nursing students to deal with the pressure they face and support their adaptation in the clinical learning environment. METHODOLOGY: All primary qualitative research studies published in English that reported on the coping strategies adopted by nursing students in the clinical learning environment were included. In December 2024, electronic databases including Medline EBSCO, CINAHL, Embase Ovid, Web of Science, ProQuest, ClinicalKey, and Scopus were searched. Retrieved papers were independently reviewed by two authors for selection based on title, abstract, and full text, with both authors agreeing on the inclusion of the papers. The qualitative data were analyzed using thematic analysis, and all included reports were appraised using the CASP checklist. RESULTS: The review included 30 studies involving 573 nursing students from 15 countries. The coping strategies identified were problem-solving, sharing and seeking help, determination, giving up, confrontation, self-regulation, proactive coping, positive reframing, avoidance, adaptation to ward culture, and venting emotions. CONCLUSION: To optimize learning in the clinical setting, nursing instructors, clinical agencies, and curriculum designers must recognize the stressors the students face and help them develop effective coping strategies. Targeted interventions should be implemented to reduce stress and promote healthy coping while creating supportive environments that foster students' growth and provide timely assistance for the learning process.