Community-based learning and professional transformation in undergraduate nursing education: A multi-stakeholder qualitative study

Community-based and service-learning approaches are increasingly incorporated into undergraduate nursing curricula to equip students for complex demands of community health practice beyond traditional clinical settings.

This study examined community-based nursing education experiences structured within the SENSE model-a five-phase pedagogical framework consisting of societal exposure, empathic interpretation, nursing agency and advocacy, social responsibility enactment, and -emergent transformation-from the perspectives of three stakeholder groups: final-year nursing students, graduate nurses, and nongovernmental organization (NGO) representatives. It also introduced the model to the nursing education literature.

A qualitative descriptive design was used. Data were gathered through semi-structured interviews with 21 participants (9 final-year students, 6 graduate nurses, and 6 NGO representatives) engaged in a 14-week community-based nursing course in Türkiye (Community Awareness Project Course). Data were analyzed using reflexive thematic analysis, through abductive iteration between participant accounts and the SENSE framework that informed the interview guide.

The analysis produced five themes. Participants identified health inequities and recognized gaps in their professional knowledge, with this awareness extending to peers and communities. Direct interaction with disadvantaged individuals fostered emotional connections that shaped enduring professional attitudes. Advocacy, health education, and leadership roles were developed implicitly within the NGO context. Participants reported a transition from passive bystanders to active civic agents at individual and systemic levels. The course's impact extended beyond graduation through sustained volunteerism and career redirection. The five themes corresponded to the SENSE phases; given the SENSE-structured interview guide, this correspondence represents an empirical articulation of the model rather than independent confirmation. Gains at each phase appeared to reinforce subsequent development cumulatively.

Participants' accounts suggest that the SENSE model may offer an initial framework for understanding community-based nursing education as a sequential and cumulative process, with perceived relevance beyond the academic term to graduates' professional experiences. Nurse educators may consider integrating community-based learning across the curriculum; the model may be further evaluated in diverse contexts.