Clinical teaching bases occupy a pivotal position in Chinese nursing education. Partner hospitals take formal responsibility for students’ clinical education, and during the final-year internship, students rotate through multiple specialty departments while simultaneously taking theoretical courses such as nursing management and professional development, delivered on site by hospital-based educators. This dual structure makes the base the environment where theoretical knowledge must be converted into clinical skill, and where the competence of the incoming nursing workforce is effectively shaped. Yet at the two hospitals studied, teaching quality had previously been judged mainly through supervisory inspection and instructor assessment, with no routine collection of structured student feedback.

The research team, led by Hao Zhang of Dianjiang People’s Hospital of Chongqing, designed a cross-sectional questionnaire to answer three questions: how much students actually participate in learning activities, how they perceive the effectiveness of teaching methods and content, and what improvements they would prioritize. The instrument combined three dichotomous participation items with five teaching-perception items, the last of which carried an open-ended field for improvement suggestions, plus a separate five-point overall satisfaction rating. Internal consistency was acceptable in the analytic sample, with a KR-20 of 0.71 for the participation items and Cronbach’s alpha of 0.75 for the teaching-perception ratings. A census approach was used, inviting every eligible student at both bases during the final month of the internship semester in May 2024.

Participation proved to be stratified less by the academic nature of an activity than by whether it was timetabled. Active participation in class discussions and activities, which is scheduled into the working day, reached 64.2 percent of students. By contrast, membership in self-organized study groups stood at just 28.0 percent, and participation in extracurricular academic activities such as lectures and competitions at 31.1 percent, roughly half the level of the timetabled option. Notably, study-group membership and extracurricular participation were moderately correlated at r = 0.56, a pattern consistent with both behaviours being constrained by a shared factor, most plausibly the demanding rotation schedules of interns, who work staggered shifts, are dispersed across departments, and move to a new department every few weeks.

Perceptions of teaching were less uniform than participation figures. Roughly two-thirds of students rated course content as comprehensive and aligned with the nursing discipline, at 68.6 percent, and expressed satisfaction with instructors’ teaching quality and attitude, at 64.5 percent. But only about half considered the teaching methods diverse, at 52.8 percent, and exactly half, 50.0 percent, felt that instructors actively encouraged student participation and expression of opinions. The remainder gave neutral or negative ratings on these interactive dimensions. Overall satisfaction with teaching at the base averaged 3.43 on the five-point scale, a middling score that reflects the split between strong content ratings and weaker delivery ratings.

The feedback process itself emerged as perhaps the most sobering finding. Although 61.0 percent of students said they were willing to comment on teaching, 39.0 percent declined outright, and among those willing, nearly half reported having no specific suggestion. Only 98 students, 30.8 percent of the full sample, provided at least one written improvement suggestion. Conventional content analysis of these responses identified five themes: interdisciplinary case teaching, cited by 28.6 percent of respondents; emergency care training, at 26.5 percent; diversified assessment methods, at 22.4 percent; technology integration, at 18.4 percent; and current-affairs topics, at 15.3 percent. The top two themes align with existing evidence that interdisciplinary case teaching supports integration of knowledge into comprehensive care plans, and that simulation-based emergency training improves nursing students’ knowledge and practical skills.

Why do so many students withhold feedback? The authors point to several features of the internship setting that could contribute, while cautioning that a cross-sectional design cannot distinguish among them. Students may doubt the anonymity of their responses, particularly since clinical instructors often also assess interns’ performance, creating an inherent conflict of interest. There may be no visible follow-up on earlier comments, leaving students unsure whether their input leads anywhere. Some may simply be unfamiliar with how to evaluate teaching. The finding extends prior work noting that nursing curriculum evaluation often lacks meaningful feedback, and that willingness and comfort with evaluation vary considerably among students.

An exploratory comparison between the two centres, located approximately 150 kilometres apart, found no significant differences on any categorical item, with all effect sizes negligible, and overall satisfaction differing only slightly, with a Cohen’s d of 0.20 whose confidence interval included zero. The similarity may reflect shared institutional features such as a common national curriculum framework, comparable accreditation standards and similar student populations. The uniformly small effect sizes are compatible with standardized practice supporting consistent educational quality across sites, although the study was not designed as an equivalence test, and identifying the specific mechanisms responsible would require purpose-built research.

The study carries clear practical implications for clinical teaching bases. First, collaborative learning could be timetabled directly into the internship, for example through a fixed weekly discussion slot, so that peer learning no longer depends on students coordinating around their own rotation schedules. This matters because collaborative learning develops the communication and teamwork skills that are core competencies for clinical nursing practice. Second, the feedback mechanism could be redesigned to lower the barrier to commenting, by separating, as far as practical, the staff who collect feedback from those who assess interns’ performance, and by issuing a written response after each round so students can see where their input leads. Third, because the interactive dimension of teaching was rated below content delivery, preceptor training could target participatory skills specifically, including structured questioning, case-based discussion and techniques for eliciting student contributions, addressing a known weakness in how clinical preceptors are prepared for the teaching component of their role.

The authors acknowledge limitations: all participants were female associate degree students from two centres in one region during a single academic year, self-selection and response bias cannot be excluded, the scheduling explanation for lower participation remains untested, and the questionnaire was developed on small preparatory samples. Even so, the overarching pattern is compelling and hypothesis-generating: students’ learning behaviour tracked the institutional scaffolding available to them, with participation substantially higher wherever the school or hospital organized the activity than where it was left to students themselves. Future research could follow participation longitudinally across an internship, examine its association with licensure performance and workforce retention, and pair questionnaires with interviews to establish why students withhold feedback. For nursing programmes worldwide, the message is that building routine, responsive collection of student feedback into curriculum design may do more to raise engagement than exhorting individual students to participate, and could better prepare students for the complexity of clinical work.

Subject of Research: Nursing students' participation and perceptions of teaching effectiveness at clinical teaching bases in China

Article Title: Nursing Students' Participation and Perceptions of Teaching Effectiveness at Clinical Teaching Bases: A Cross‐Sectional Survey

Article References: Zhang, H., Mei, Y., Zhang, C.-L., Liu, J., & Ma, X.-J. (2026). Nursing Students' Participation and Perceptions of Teaching Effectiveness at Clinical Teaching Bases: A Cross‐Sectional Survey. Nursing Open, 13(10), Article e70824. https://doi.org/10.1002/nop2.70824

Image Credits: AI Generated

DOI: 10.1002/nop2.70824

Keywords: nursing education, clinical teaching bases, student engagement, student feedback, teaching effectiveness, clinical internship, cross-sectional survey, China, preceptor training, collaborative learning, nursing students, teaching quality

The research team, led by Yuqing Zhao of Tianjin Medical University Cancer Institute and Hospital together with colleagues from Tianjin Second People’s Hospital, Tianjin University of Traditional Chinese Medicine, and Tianjin Medical University, set out to answer a deceptively simple question: what kind of clinical teaching do nursing interns actually want? The question carries considerable weight. Undergraduate nursing interns are becoming an increasingly vital component of the nursing workforce in China and internationally, and the quality of the clinical internship, the critical transition from classroom theory to bedside practice, has emerged as a pressing concern for nursing educators worldwide.

Methodologically, the study took the form of a descriptive qualitative investigation. The researchers used purposive sampling to recruit 21 undergraduate nursing interns, aged between 20 and 23, all of whom were in the clinical practice phase of their training in July 2025. Each participant took part in a semi-structured interview, a format that gives respondents room to speak in their own words while ensuring that key topics, anticipated influencing factors, preferred teaching methods, mentor behaviors, expectations about the structure and current state of clinical placements, and additional educational needs, were systematically explored. The interview transcripts were then analyzed using Colaizzi’s seven-step method, a well-established approach to thematic analysis in nursing research that moves from careful reading of raw text through extraction of significant statements, formulation of meanings, clustering of themes, and eventual validation of the resulting thematic structure against the original data.

What emerged from that analysis were three primary themes describing the clinical teaching traits preferred by undergraduate nursing students. The first, which the researchers describe as relational pedagogy as motivational catalyst, captures the interns’ desire for teaching grounded in personal connection, encouragement, and emotional support rather than command and correction. The second theme, experiential integration of knowledge, reflects a strong preference for learning that fuses doing with knowing: interns valued mentors who could translate abstract theoretical content into concrete bedside moments and, conversely, who used real clinical events as springboards for deeper conceptual understanding. The third theme, expanding the learning ecology beyond skills, points to an appetite for growth in dimensions that traditional skills checklists do not touch, including professional identity, communication, ethical judgment, and the psychological demands of caring work.

The framing of that first theme is perhaps the study’s most striking finding, because it signals what the authors call a shift from hierarchical to relational pedagogy. In many clinical settings, including those shaped by longstanding cultural traditions of deference to senior clinicians, the teaching relationship has historically flowed in one direction: the expert speaks, the novice complies. The interns in this study described something else. They described teaching that works as a catalyst for motivation, in which the educator’s personal qualities, their warmth, their patience, their visible enthusiasm for the profession, ignite the student’s own desire to learn. In this view, the clinical teacher is not merely a transmitter of technique but a role model whose character itself functions as a pedagogical instrument.

The second theme, experiential integration, speaks directly to one of the oldest problems in health professions education: the persistent gap between what students learn in lectures and what they encounter at the bedside. The interns participating in the study indicated that they learn best when knowledge and experience are deliberately intertwined, when a mentor pauses at the bedside to connect a textbook principle to the patient in front of them, or when a post-procedure debrief converts a hands-on moment into durable understanding. This preference aligns with a broad body of educational theory holding that learning is most effective when it is situated in authentic practice, but the study grounds that abstraction in the specific voices and priorities of Chinese nursing interns navigating their formative clinical months.

The third theme broadens the frame considerably. The interns reported unmet multidimensional learning needs that extend well beyond technical competence. They wanted support in developing as professionals, in understanding the ethical texture of nursing work, in communicating with patients and families, and in managing the emotional labor inherent in caring for people at vulnerable moments of their lives. This finding suggests that clinical placements, as currently structured, may be underdelivering on dimensions of professional formation that interns themselves consider essential. The learning ecology of the clinical environment, the study implies, should be deliberately expanded to cultivate these capacities rather than left to chance.

The implications reach into the practical machinery of nursing education. The authors conclude that the cultivation of nursing professionals depends fundamentally on clinical educators, whose personal qualities can stimulate student enthusiasm for learning, and that this motivational potential must be channeled through progressive teaching methods while attending to the multidimensional clinical learning needs of students. Done well, they argue, this combination helps interns build a coherent professional knowledge system during clinical practice, allowing clinical education to transcend traditional frameworks and achieve deeper integration. More concretely, the findings are intended to provide a theoretical basis for designing selection, training, and management programs for clinical teaching nurses, calibrated to the Chinese cultural context in which those programs will operate.

The study’s timing matters. Health systems across the globe are grappling with nursing shortages, and undergraduate nursing interns are shouldering a growing share of frontline care capacity. At the same time, the internship represents the single most consequential phase of nursing education, the point at which theoretical knowledge either solidifies into professional competence or frays under the pressures of real practice. If the quality of that transition depends heavily on the relational and pedagogical skills of clinical teachers, then investing in those teachers, choosing them well, training them deliberately, and managing their teaching roles thoughtfully, becomes a strategic priority rather than an administrative afterthought.

The research also carries a methodological contribution. By applying Colaizzi’s seven-step analysis to a purposively sampled cohort and reporting the work in line with qualitative research conventions, the team offers a replicable template for exploring learner preferences in other institutions, other regions, and other healthcare cultures. The picture that emerges is of a generation of nursing students who respect expertise but respond most powerfully to educators who teach as relationships first and hierarchies second, who turn every clinical encounter into an integrated learning opportunity, and who take seriously the full breadth of what it means to become a nurse. For educators and hospital administrators, the message is clear: the future of clinical nursing education may belong less to the loudest authority in the room than to the most motivating presence at the bedside.

Subject of Research: Clinical teaching preferences of undergraduate nursing interns in China

Article Title: Clinical teaching preferences of undergraduate nursing interns in China: a descriptive qualitative study

Article References: Zhao, Y., Zhao, S., Zhang, W., Huo, Q., Wang, M., Sun, X., Li, H., Zhao, Y., & Lu, Q. (2026). Clinical teaching preferences of undergraduate nursing interns in China: a descriptive qualitative study. BMC Nursing. https://doi.org/10.1186/s12912-026-05346-9

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05346-9

Keywords: nursing education, clinical teaching, undergraduate nursing interns, qualitative research, mentorship, China, nursing workforce, relational pedagogy, clinical internship, teaching methods, nurse mentors, health professions education