title: Passing through a rocky way to reach the pick of clinical competency: A grounded theory study on nursing students' clinical learning.
abstract: BACKGROUND
  Clinical learning is one of the important issues that helps the perception of nursing students' practice in a clinical setting and its effect on their professional development. The aim of this study is to describe and state the manner of clinical learning in nursing students.
  
  
  METHODS
  This qualitative study was conducted as a grounded theory. The individual semi-structured interviews and participants' observations were taken into account with a purposive and theoretical sample of 27 participants. The data were analyzed using the grounded theory approach and the constant comparison analysis method.
  
  
  RESULTS
  The results showed that students use two approaches of Micro- and Macrolearning. The first includes learning conditions and situations that act like a foundation for the second one (Macrolearning). Macrolearning is a continuous process including all categories of "Facing unfavorable clinical facts", "Clinical situation and appropriate decision making", "Bridging the gap between practice and theory", "Struggle for clinical independence", and "Dynamism" in a continuum reflecting the struggle to obtain clinical competency (core variable).
  
  
  CONCLUSIONS
  Through provision of such conditions as students' gradual acquaintance with real situations, selection of more resistant students, use of mentorship and preceptor ship in clinical learning, enhancement of educational standards in hospitals, handling collaborative learning methods to make a cooperation spirit in internship environment, and so on, students can be helped to obtain clinical competency.
authors.affiliation: Tehran University of Medical Sciences, Nursing and Midwifery faculty, Nursing PhD department, Tehran, Iran ; Guilan University of Medical Sciences, Department of Medical-Surgical Nursing, Rasht, Iran.
authors.forename: Seyedeh Ameneh
authors.initials: SA
authors.lastname: Dadgaran
authors.forename: Soroor
authors.initials: S
authors.lastname: Parvizy
authors.forename: Hamid
authors.initials: H
authors.lastname: Peyrovi
keywords: Clinical nursing research; Iran; education; learning; nursing; qualitative research