Embracing a constraints-led approach for skills acquisition in nursing education: Insights from a focus group study

Introduction: Nursing education traditionally teaches skill acquisition in isolated practice drills and guided by step-by-step protocols. While these approaches may seem to provide a solid foundation, they do not adequately bridge the gap between a controlled learning environment and the reality of nursing practice. The constraints-led approach (CLA) is an applied theory, which explains that skill acquisition is a process of adjusting to the characteristics of a situation, instead of reproducing isolated, “ideal” movements out of context. Given that CLA has gained recognition as an effective learning method in various fields, it is worth investigating how CLA can be implemented for skill acquisition in nursing education. Methods: To gain insight into student experiences of several CLA-exercises, an explorative qualitative design was used. Ten longitudinal focus groups with nursing students (n = 11) were performed to gain deeper understanding of students' experiences with an education course in which several “CLA-exercises” were integrated. In addition, the teachers (n = 3) involved were interviewed after the course was completed. Results: The students experienced the education course as enjoyable, challenging and reality-based. Also, the exercises motivated students to keep practicing. The students further appreciated the room for autonomy and self-organization. The teachers expressed enthusiasm for CLA-inspired education, noting the benefits of varied methods and the need for expert feedback and well-working practice materials. Conclusion: Both students and teachers felt confident that the students who completed this course were ready to apply the learned skills under supervision in clinical practice.