Clinical learning challenges and associated factors among undergraduate nursing students at Wachemo University,...

Clinical practice is essential for developing competence, yet students in resource-limited settings often face multiple barriers. This study assessed the level of clinical learning challenges and associated factors among undergraduate nursing students at Wachemo University, Ethiopia.

An institution-based cross-sectional study was conducted from 18 February to 22 March, 2026. A census approach was used; all eligible regular undergraduate nursing students with clinical attachment were invited to participate. Data were collected via structured, self-administered questionnaires deployed through Kobo Toolbox. The tool incorporated a 9-item clinical learning challenge scale (5-point Likert), the Generalized Anxiety Disorder-2 (GAD-2) scale, the Patient Health Questionnaire-2 (PHQ-2) scale, and dedicated skill laboratory preparedness. High clinical learning challenge was defined as a total score[Formula: see text] percentile ([Formula: see text]. Data were analyzed using descriptive statistics and logistic regression analysis. Variables with p-value < 0.25 in Bivariable analysis were considered for multivariable logistic regression. Statistical significance was declared at p-value < 0.05.

A total of 280 nursing students participated (response rate 93.3% of 300 invited). The most prevalent challenges were overcrowding in the clinical ward (74.3%), inadequate clinical materials and equipment (69.9%), and a high student-to-patient ratio limiting hands-on practice (67.5%). Overall, 137 (48.9%) students experienced high clinical learning challenges. In multivariable analysis, third-year academic standing (AOR = 2.48, 95% CI: 1.36-4.52), moderate-to-severe anxiety (AOR = 2.58, 95% CI: 1.49-4.46), moderate-to-severe depression (AOR = 1.95, 95% CI: 1.14-3.33), and inadequate skill laboratory preparation (AOR = 2.18, 95% CI: 1.32-3.60) were independently associated with high clinical learning challenges.

Nearly half of nursing students experienced clinical learning challenges during clinical attachment. Poor skill laboratory preparation, psychological distress, and advanced academic year were key determinants. Strengthening skill laboratory training, improving clinical supervision, and providing psychological support services were recommended.