Abstract
Critical care nursing (CCN) students develop their professional competence within
complex and demanding clinical learning environments (CLEs) where theory and
practice converge. Within these high-acuity settings, effective learning depends on
supportive relationships among key stakeholders such as unit managers, clinical
facilitators, and clinical supervisors, whose roles intersect at the service–education
interface. However, inconsistent support, staff shortages, and poorly defined
supervisory structures continue to compromise student learning and psychological
safety. This study sought to explore the lived experiences of these stakeholders in
providing support to CCN students and to develop a model to facilitate student support
in the critical care CLE.
The study was conducted within an interpretivist–constructivist paradigm, guided by
the philosophical assumptions of interpretive phenomenology. A theory-generative,
qualitative, exploratory, descriptive, and contextual design was used. Seventeen
participants, comprising unit managers (UMs), clinical facilitators (CFs), and clinical
supervisors (CSs), were purposively selected from critical care units in a private
healthcare institution in South Africa. Data were generated through semi-structured
phenomenological interviews and analysed using Braun and Clarke’s reflexive
thematic analysis (RTA) approach. Trustworthiness was ensured through reflexivity,
independent coding, and adherence to ethical principles.
Three overarching themes emerged during the empirical phase of the study: student
support was viewed as a valued and meaningful part of participants’ roles; structural
and operational barriers constrained their ability to provide support; and student
engagement significantly influenced the effectiveness of support. Through concept
analysis and the construction of relational statements, the central concept of ‘fostering
collaborative student support through commitment and empowerment’ was identified.
These insights informed the development of the integrated spiral partnership model
(ISPM), which illustrates how collaboration, commitment, and empowerment interact
dynamically to sustain multidimensional student support within the critical care CLE...