A Co-CREATES framework to foster a positive learning environment for nursing students' professional development in Rwanda

Aim: The future of the nursing profession in Rwanda in large part depends on the students who join the workforce and the education they have received. Preparing students with the necessary knowledge, values and judgement requires practice settings to be learner-centered. This study aimed at exploring strategies that might improve the current practice-based learning environment. Design: A focused ethnographic approach was used. Methods: Nursing students, staff nurses, clinical instructors and nurse leaders from three hospitals and an educational program participated in individual interviews. Results: Five key areas of improvement emanated from study data: 1) strengthening institutional support; 2) improving school-hospital collaboration; 3) building the capacity of nurses and clinical instructors; 4) restructuring clinical placement; and 5) reviewing the current supervision model. Based on these findings a Co-CREATES framework grounded in the actions of collaboration, care, recognizing, empowering, actively engaging, transforming, enhancement and support was developed. The framework offers a collaborative approach that engages every stakeholder in cocreating conditions that build positive practice environments which are conducive to preparing students as professional nurses. Conclusion: The positive outcomes stemming from such a collaborative approach can further enhance a positive culture of collaboration in nursing education and practice.