title: Perceived clinical constraints in the nurse student-instructor interactions: a qualitative study.
abstract: Effective student-instructor interactions impact the quality of nursing clinical education. There are a myriad of different factors related to clinical settings that affect these interactions and they have received less attention in nursing studies. Identifying clinical constraints that impact the nursing student-instructor relationships will help nursing instructors to manage clinical learning situations in a more effective manner.
  
  
  OBJECTIVE
  The goal of this study was to identify the primary factors that influence the student-instructor interactions within clinical settings.
  
  
  METHODS
  A purposeful sampling strategy was applied to recruit 18 nursing students and instructors to participate in qualitative, semi-structured interviews. In order to identify relevant themes of transcribed interviews, qualitative content analysis was utilized.
  
  
  RESULTS
  Data analysis resulted in the development of five main themes that represent essential interaction constraints in clinical contexts. These themes include: outsiders' eyes, dominance of act, close contact, clinical workplaces' disputes, and instability and uncertainty.
  
  
  CONCLUSIONS
  The results of this study can serve to improve the understanding and practice of international clinical nursing instructors within the clinical education context. The behaviors that emerged were based on clinical constrains and an awareness each can serve to enhance the instructor-student relationship.
authors.affiliation: Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tohid Sq., Tehran, Iran. Electronic address: h_shahsavari@razi.tums.ac.ir.
authors.forename: Hooman
authors.initials: H
authors.lastname: Shahsavari
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Parsa Yekta
authors.forename: Marian L
authors.initials: ML
authors.lastname: Houser
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Ghiyasvandian
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004506:Education, Nursing / Q000458:organization & administration*; D005181:Faculty, Nursing / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D036301:Qualitative Research; D013338:Students, Nursing / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Clinical education; Constraints; Nursing; Student–instructor relationship