INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)  
ISSN No. 2454-6186 | DOI: 10.47772/IJRISS | Volume IX Issue XI November 2025  
Factors Affecting Clinical Practice at the Mabel Mccombs College of  
Health Sciences  
Ms Naomi T. Joe  
Vice President for Student Affairs, Carver Christian University, Liberia  
DOI: https://dx.doi.org/10.47772/IJRISS.2025.91100081  
Received: 11 November 2025; Accepted: 16 November 2025; Published: 29 November 2025  
ABSTRACT  
Despite the importance of clinical practice in health sciences education, challenges persist that hinder its  
effectiveness. Reports from students and faculty at the Mabel McCombs College of Health Sciences indicate  
recurring issues such as inadequate clinical placements, limited access to modern medical equipment, and  
varying levels of supervision and mentorship. These challenges threaten the ability of students to acquire the  
necessary skills and competencies for their professional roles. This study addresses this gap by examining the  
factors influencing clinical practice and proposing actionable recommendations.  
According to the study, findings indicated that there was established and standardized hospital protocol to  
welcome student nurse for preceptor-ship. However, many of the participants revealed that the working  
environment was not healthy and there was no possibility for continuing professional development for interns.  
Also, the study findings suggested that most participants disagree the existence of good interdisciplinary culture  
and there was no opportunity for nursing student to participate in hospital management.  
The study outlined strategies that could contribute to improving the working environment and process of  
enhancing student nurses clinical exposure. Among the strategies suggested student nurses involvement in  
quality improvement, provision of in-service training in hospital management, performance-based stipend and  
adequate supervision were considered key among participants.  
INTRODUCTION  
Clinical practice is an integral component of health sciences education, serving as the bridge between theoretical  
knowledge and practical application. (World Health Organization.2021). According to World Health  
Organization. (2019). it is identified that Clinical practice encompasses the direct provision of healthcare services  
to individuals by healthcare professionals, grounded in evidence-based standards, ethical principles, and  
practical expertise. Across the globe, the delivery of clinical care is influenced by an intricate interplay of factors,  
ranging from global trends to localized socio-economic, cultural, and institutional realities. This background  
analysis explores the factors influencing clinical practice, bridging global perspectives with the realities in  
Liberia. Global Trends in Clinical Practice Globally, clinical practice has been shaped by advancements in  
medical science, the proliferation of technology, and the establishment of evidence-based guidelines. Key  
influencing factors include: Technological Advancements: Innovations such as telemedicine, electronic health  
records (EHRs), and precision medicine have revolutionized clinical practice. (World Health Organization,  
2021).  
Gates, (2020), acknowledges that technologies enable faster diagnoses, improve patient outcomes, and expand  
access to care. Global Health Policies and Frameworks: Organizations like the World Health Organization  
(WHO) set standards and policies to promote universal health coverage (UHC), combat communicable and non-  
communicable diseases, and improve healthcare quality. Workforce Dynamics: The global shortage of  
healthcare workers, coupled with migration trends, influences clinical service delivery, especially in low-  
resource settings. Emerging Diseases: The recent COVID-19 pandemic underscored the need for agility in  
clinical practice, driving changes in infection control, vaccine development, and digital health integration.  
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INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)  
ISSN No. 2454-6186 | DOI: 10.47772/IJRISS | Volume IX Issue XI November 2025  
Cultural and Ethical Considerations: Global clinical practices are increasingly influenced by culturally sensitive  
approaches to care, emphasizing patient-centered models and ethical standards. Regional Influences: Sub-  
Saharan Africa In Sub-Saharan Africa, clinical practice is deeply affected by resource constraints, disease  
burden, and governance structures. Common challenges include: Limited Resources: Scarcity of medical  
supplies, infrastructure, and skilled healthcare professionals often hampers effective clinical delivery. High  
Disease Burden: Sub-Saharan Africa faces a dual burden of communicable diseases (e.g., malaria, HIV/AIDS)  
and non-communicable diseases (e.g., hypertension, diabetes). (Gates, 2020).  
Donor-Driven Initiatives: External funding and global health initiatives play a pivotal role in shaping clinical  
priorities, but these often focus narrowly on specific diseases or programs. Traditional Medicine Integration:  
The coexistence of traditional and modern medicine creates unique dynamics in clinical practice. Policy and  
Governance Gaps: Weak regulatory frameworks and inconsistent policy implementation hinder standardized  
care delivery. Local Context: Liberia Liberia’s healthcare system is emblematic of the challenges and  
opportunities inherent in clinical practice within low-income, post-conflict nations. (Gates, 2020).  
The following factors significantly influence clinical practice in Liberia: Post-Conflict Recovery: Following  
years of civil unrest, Liberia’s healthcare infrastructure remains fragile. Clinics and hospitals are often under-  
resourced, and there is a persistent shortage of trained medical personnel. Epidemic Impact: Liberia’s experience  
with the Ebola epidemic highlighted critical gaps in clinical preparedness, infection control, and public health  
coordination. Lessons learned have shaped current clinical practices, particularly in emergency response (World  
Bank. 2015) Human Resource Constraints: Despite efforts to train and retain healthcare workers, the country  
faces significant brain drain, with many professionals seeking opportunities abroad. Cultural Beliefs and  
Practices: Local beliefs about illness and healing influence healthcare-seeking behavior, often creating barriers  
to accessing clinical services. Policy Frameworks and Support: Liberia’s National Health and Social Welfare  
Policy and Plan (2011-2021) and subsequent strategic frameworks aim to strengthen health service delivery.  
However, implementation challenges persist. Community Engagement: Local communities play a vital role in  
supporting healthcare delivery, particularly through initiatives like community health worker programs, which  
address gaps in access and education. Emerging Health Concerns: The rise in non-communicable diseases,  
mental health issues, and maternal and child health challenges is reshaping clinical priorities in Liberia. Bridging  
Global and Local Perspectives Understanding the factors influencing clinical practice in Liberia requires  
synthesizing global best practices with local realities. For example: Leveraging global advancements in  
telemedicine can address geographic barriers to care in remote Liberian communities. Strengthening local health  
governance using global frameworks can ensure the sustainability of donor-driven programs. Integrating  
traditional medicine practices into modern healthcare systems can enhance community acceptance and trust in  
clinical interventions. Conclusion Clinical practice is shaped by a myriad of factors that operate at global,  
regional, and local levels. Liberia’s experience highlights the importance of contextualizing global health  
strategies to fit local needs and realities. Addressing the systemic challenges in Liberia’s clinical practice will  
require coordinated efforts, leveraging global support while fostering homegrown solutions to improve (Perry,,  
Zulliger,, & Rogers,. 2014).  
I At the Mabel McCombs College of Health Sciences, clinical practice prepares students for the multifaceted  
demands of healthcare delivery. However, several factors influence the efficacy and quality of this critical  
educational component. These factors include institutional resources, faculty expertise, student preparedness,  
and the quality of partnerships with clinical sites. Identifying and addressing these factors is essential for  
optimizing clinical education and producing competent healthcare professionals. This study seeks to investigate  
the factors that impact clinical practice at the Mabel McCombs College of Health Sciences, contributing to  
improvements in student learning outcomes and overall healthcare quality.  
Background  
Training improves the effectiveness of Registered Nurses' clinical teaching skills, which consequently increases  
their confidence. This, in turn, may then lead to Registered Nurses having a more positive attitude towards their  
students and clinical teaching. Lethale et al. (2019) conducted research in Canada, which found that over half of  
the surveyed clinical teachers believed they required training for the role, including guidance while teaching. A  
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INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)  
ISSN No. 2454-6186 | DOI: 10.47772/IJRISS | Volume IX Issue XI November 2025  
lack of training and its negative influence on clinical teaching was also observed in a study conducted in Ireland  
by McSharry and Lathlean (2017) who found that the majority of their participants (final‐year student nurses)  
stated that clinical learning was not helpful to them because most of their clinical teachers lacked the requisite  
teaching skills due to a lack of training.  
The large workload of Registered Nurses was another factor that was found to negatively influence clinical  
teaching (Gcawu et al., 2021). Indeed, Registered Nurses who are also clinical teachers require more time to  
cope with the demands of their teaching position because they are also expected to fulfil the responsibilities of  
a full patient load (Collier, 2018). Nurse midwives have likewise expressed concern about managing their own  
workloads while simultaneously monitoring and evaluating student nurses (Bifftu et al., 2018). Ashipala and  
Nghole (2022) research similarly revealed that heavy workloads interfere with teaching roles because, apart from  
clinical teaching, these nurses have patients to see and management responsibilities. Ashipala and Nghole (2022)  
study also revealed that Registered Nurses require support from their managers if they are to be effective clinical  
instructors.  
When considering the students' role in clinical learning, Albsoul et al. (2019) found that student barriers, such  
as a lack of motivation to learn, have a negative impact on clinical teaching. Registered Nurses who are clinical  
facilitators have complained that unmotivated students show no interest in learning, which negatively impacts  
their development of key skills (Ratcliffe & George, 2022). Derya et al. (2022) further expressed that working  
with unmotivated students overwhelms Registered Nurses because, as clinical teachers, they feel as though they  
have to force some nursing students to engage with their own learning. Yet, clinical teachers are not necessarily  
trained in student engagement strategies and the pressure they are already under due to their patient workload is  
compounded by the large numbers of students they have to teach.  
Several studies on clinical teaching have been conducted in Africa, including one by Asirifi et al. (2017), which  
explored the perceptions of Ghanaian nursing students, clinical nurses and nurse educators of their clinical  
teaching experience. Their findings indicated that clinical teaching using the preceptorship approach in Ghana  
was not well established. Many African studies, such as Asirifi et al., had similar findings to those conducted in  
Western countries (e.g. Natesan et al., 2020; Stander et al., 2020; Torous et al., 2020; Wisniewski et al., 2020).  
In other words, research, globally, has shown that when Registered Nurses, who are also clinical teachers, receive  
inadequate orientation to clinical teaching, they have insufficient time to carry out their teaching roles, have too  
many students in their classes and lack the support of management to motivate their students to learn. Additional  
findings from a study by Magobolo and Dube (2019) were that students lack motivation to learn, and clinical  
nurses focus too much on clinical needs rather than clinical teaching. Important to note here is that our research  
shows that no Namibian studies were conducted on the barriers facing Registered Nurses who are also clinical  
teachers have been completed, hence the relevance of this study.  
Global Context of Clinical Practice in Health Sciences  
Globally, clinical practice in health sciences is shaped by various institutional, pedagogical, and environmental  
factors. According to Benner (1984), the transition from novice to expert is foundational in clinical training,  
emphasizing the need for structured mentorship and expertise to guide learners. Similarly, Frenk et al. (2010)  
highlighted the critical role of inter-professional education in improving health outcomes and ensuring  
competency in clinical practice. These studies underscore the importance of a robust institutional framework and  
faculty expertise in facilitating quality clinical learning experiences.  
Faculty mentorship has been globally recognized as a determinant of student success in clinical practice. For  
instance, Barker et al. (2012) demonstrated that faculty who provide consistent feedback and guidance  
significantly enhance students' practical skills and confidence. Moreover, institutional partnerships with clinical  
sites are identified as crucial in bridging the gap between theoretical knowledge and real-world practice (World  
Health Organization, 2016).  
Regional Context: Sub-Saharan Africa  
In Sub-Saharan Africa, the quality of clinical practice is influenced by resource availability, faculty expertise,  
and student attitudes. Akinsanya and Henrichs (2019) found that limited infrastructure and insufficient faculty  
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INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)  
ISSN No. 2454-6186 | DOI: 10.47772/IJRISS | Volume IX Issue XI November 2025  
development programs impede effective clinical training. Furthermore, the mentorship model is less developed  
in many African institutions, affecting the transfer of practical skills (Ndungu, 2018).  
External factors such as partnerships with healthcare facilities play a significant role in enhancing clinical  
practice. For instance, a study by Mukhwana et al. (2020) revealed that collaborative training programs between  
universities and hospitals in Kenya improved student preparedness and clinical competence. These findings align  
with the need for tailored strategies to address regional challenges in clinical education.  
Local Context: Liberia  
In Liberia, clinical training faces challenges such as limited resources, inadequate faculty development, and  
weak institutional partnerships. A study by Kollie (2021) identified that students at the Mabel McCombs College  
of Health Sciences often struggle with access to clinical sites and lack consistent mentorship. Faculty shortages  
and insufficient training for clinical instructors further exacerbate these issues (Smith & Johnson, 2022).  
However, initiatives such as partnerships with international organizations have begun to improve the quality of  
clinical training (Doe, 2020).  
DISCUSSION  
Despite the importance of clinical practice in health sciences education, challenges persist that hinder its  
effectiveness. Reports from students and faculty at the Mabel McCombs College of Health Sciences indicate  
recurring issues such as inadequate clinical placements, limited access to modern medical equipment, and  
varying levels of supervision and mentorship. These challenges threaten the ability of students to acquire the  
necessary skills and competencies for their professional roles. The lack of comprehensive research on these  
issues further compounds the problem, leaving gaps in understanding and potential solutions. This study  
addresses this gap by examining the factors influencing clinical practice and proposing actionable  
recommendations  
The study also sought to explore student nurses affirmation of factors that could enhance or impede their clinical  
leadership and managerial skills. According to the study, findings indicated that there was established and  
standardized hospital protocol to welcome student nurse for preceptor-ship. However, many of the participants  
revealed that the working environment was not healthy and there was no possibility for continuing professional  
development for interns.  
Also, the study findings suggetsed that most participants disagree the existence of good interdisciplinary culture  
and there was no opportunity for nursing studnent to particopte in hospitla managemnt.  
The study outlined strategies that could contribute to improving the working environment and process of  
enhancing student nurses clinical exposure. Among the strategies suggested student nurses involvement in  
quality improvement, provision of in-service training in hospital management, performance-based stipend and  
adequate supervision were considered key among participants  
CONCLUSION  
The study found out that growth in nursing students clinical practice will be mainly experienced through good  
clinical environment , which is enhanced by a supportive relationship with a preceptors or mentors, the use of  
reflective practices and modelling from other leaders. Furthermore, a supportive work environment triggers  
ownership, confidence and motivation, and thereby growth in clinical nursing leadership competencies.  
Fostering competencies for clinical leadership among student nurses requires multifaceted strategies. Strategies  
are successful if, and only if, they combine learning by doing, by knowing and by observing, and establish a  
responsive and healthy work environment. Hospital policy should ensure that student nurses have access to  
reciprocal relationships with leaders and managerial activities. In order to grow clinically, student nurses must  
be guided to develop, ownership and self-reflection on own leadership behaviour needed to in performance  
during clinical exposure,  
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INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)  
ISSN No. 2454-6186 | DOI: 10.47772/IJRISS | Volume IX Issue XI November 2025  
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