Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/locate/nedt Undergraduate nursing students' strategies for coping with their first clinical placement: Descriptive survey study Yousef Alshahrani ⁎ , Lynette Cusack, Associate Professor (A/Prof.), Philippa Rasmussen, Doctor (Dr) The University of Adelaide, Adelaide Nursing School Level 4, Adelaide Health and Medical Sciences Building, Corner of North Terrace and George Street, Adelaide, SA 5000, Australia ARTICLE INFO Keywords: Nursing students Clinical placement Coping Clinical lecturer Anxiety ABSTRACT Background: Clinical placement is an essential component in academic nursing programs to provide nursing students with an opportunity to apply theoretical knowledge to practice. The first clinical placement can be an extremely stressful experience for some nursing students, which may affect their decision to be a nurse. Objective: The aim of this study was to identify factors and strategies that enable a positive experience of the first clinical placement for first year nursing students. Design: Mixed methods descriptive survey design. Settings: The study was conducted in a nursing school at one university in South Australia. Respondents: Respondents were all first year undergraduate nursing students at a higher education facility in South Australia. Methods: Data collection tool was an online questionnaire including quantitative and qualitative questions. Coping strategies framework informed qualitative analysis. Results: Respondents identified a range of strategies that had enabled them to positively cope with their first clinical placement experience. Strategies included use of debriefing sessions with their clinical lecturers and seeking-out their friends and family to talk about their first clinical placement experiences. Other strategies included being adequately prepared before the clinical placement, identifying and seeking advice from sup- portive nursing staff and effective communication between nursing schools and clinical institutions about pla- cement arrangements and expectations. Conclusions: It must not be forgotten how stressful first clinical placements are. This experience will leave a lasting impression on students' introduction to the nursing profession. Sharing coping strategies used by nursing students will assist to provide a positive introduction to nursing practice. 1. Introduction Clinical placement is an essential component in nursing education that provides nursing students an opportunity to apply theoretical knowledge to practice, which cannot be achieved by classroom edu- cation alone (Forneris and Peden-McAlpine, 2009; Lamont et al., 2014; Mann et al., 2009; Wallin et al., 2013). As identified by Henderson et al. (2012), clinical placement engages nursing students with the environ- ment of nursing care and educates them about the norms of nursing practice. The first clinical placement usually starts in the first year of aca- demic nursing programs and subsequent clinical placements continue until the end of the program. Huggett et al. (2008) considered that an early clinical placement can affect the student perceptions about the nursing profession. Therefore, a negative experience during the first clinical placement may be a critical factor that contributes to nursing students withdrawing from nursing education programs. A comprehensive review of the literature identified a range of ap- proaches used by nursing schools and clinical institutions to enable first year nursing students to have a positive experience of the first clinical placement. However, the voice of nursing students was absent from the literature. The literature did not include strategies developed by first year nursing students that had assisted them to cope with the first clinical placement. https://doi.org/10.1016/j.nedt.2018.07.005 Received 6 December 2017; Received in revised form 1 June 2018; Accepted 3 July 2018 ⁎ Corresponding author. E-mail addresses: yousef.alshahrani@adelaide.edu.au (Y. Alshahrani), lynette.cusack@adelaide.edu.au (L. Cusack), philippa.rasmussen@adelaide.edu.au (P. Rasmussen). Nurse Education Today 69 (2018) 104–108 0260-6917/ © 2018 Elsevier Ltd. All rights reserved. T