Strategies to Moderate Effects of Difference (e.g., Age, Culture, Language) in Nursing Students in the Clinical Environment

Wednesday, 1 August 2012

Jane Koch, RN, RNT, MA
Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia
Bronwyn Everett, PhD, RN, BAppSc (Nurs), MSc
Faculty of Nursing, Midwifery & Health, University of Technology Sydney & University of Western Sydney, Broadway, Australia
Jane L. Phillips, PhD
School of Nursing, The University of Notre Dame Australia, Darlinghurst, Australia
Yenna Salamonson, PhD, RN, BSc, CCUCert, GDNEd, MA
School of Nursing and Midwifery, University of Western Sydney, Penrith South DC NSW, Australia
Patricia Mary Davidson, RN, BA, MEd, PhD, FRCNA
Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Broadway, NSW, Australia

Learning Objective 1: 1. appreciate how diversity may affect the experiences of nursing students whilst on clinical placements

Learning Objective 2: 2. appreciate strategies that may moderate the effects of difference from a theoretical perspective


Increasing globalisation and cultural pluralism has resulted in diverse nursing student cohorts, who ultimately help to develop a health workforce able to meet the needs of a diverse population. Despite the promotion of ethno-cultural knowledge in nursing research, education, and practice and the common use of inclusive terms like ‘celebrating’ and ‘embracing’ diversity, ‘difference’ can create opportunities for marginalisation and discrimination. Studies also indicate reduced effectiveness of diverse work groups (Qin, 2009). In the clinical learning environment these factors may lead to adverse effects for client groups and negatively impact on the learning experiences of nursing students. The study aims to explore stories told by nursing students, facilitators and academics about clinical placements using a diversity framework.  

Methods: A mixed method design, including surveys with closed-and open-ended questions and focus groups, was used. The sample included undergraduate students enrolled in Bachelor of Nursing programs and facilitators at seven universities in Australia.  In addition to demographic data, the surveys also collected stories about which aspects of diversity impact on nursing students’ clinical experience and their consequences. To date a total of a 533 nursing students and 164 facilitators have been recruited to participate in the study by completing the survey.


Emerging data suggests age, maturity and difficulties communicating are creating intolerance, tensions and conflict between students and facilitators in the clinical learning environment.


Quality care involves effective team work and communication and thus providing strategies to moderate the effects and impact of diversity within the clinical learning environment is essential. 


Qin, J., O’Meara, B., McEachern, S. 2009. The need for an integrated theoretical framework for researching the influence of group diversity on performance. Management Research News, 32(8), 739-750