The quicksand of stewardship: a qualitative study of antimicrobial learning during clinical placements in European nursing education
File(s)
Published version
Author(s)
Castro Sanchez, Enrique
Huguet-Torres, Aina
Yañez-Juan, Aina
Bennasar-Veny, Miquel
Type
Journal Article
Abstract
Aim
Investigate how undergraduate nursing students experience antimicrobial stewardship learning during clinical placements in two European countries.
Background
Nurses are vital but underused actors within antimicrobial stewardship interventions. Prior research has identified major gaps in undergraduate, university classroom-based antimicrobial stewardship education, yet how nursing students translate this learning during clinical placements remains unexplored.
Design
Qualitative design.
Methods
Semi-structured interviews conducted with 17 undergraduate nursing students (ten from the United Kingdom and seven from Spain) between 2023–2025. Data were analysed using reflexive thematic analysis. Rigour was enhanced through bilingual coding, peer debriefing and ongoing interpretive reflection.
Results
Students, across multiple educational and clinical contexts, found themselves navigating what we describe as an 'educational quicksand', a shifting terrain shaped by hidden curricula and systemic opacity, a disorienting and fragmented learning space marked by unclear roles, minimally structured teaching, workload-driven deviations in practice and sparse opportunities for reflection or interprofessional learning. Overall, four interconnected themes emerged: (1) antimicrobial stewardship is marginalised in both practice and pedagogy; (2) learning is self-directed and fragmented; (3) embodied learning and the role of modelling: between hesitation and enactment; and (4) students aspire to stewardship roles despite systemic constraints.
Conclusion
Across the two study settings, nursing students hover at the threshold of stewardship, constrained by comparable structural gaps, implicit curricula and unclear role boundaries. Embedding antimicrobial stewardship within mentorship, interprofessional dialogue and assessment frameworks could help students move more confidently through this ‘quicksand’ and support the development of antimicrobial stewardship as a core nursing competency.
Investigate how undergraduate nursing students experience antimicrobial stewardship learning during clinical placements in two European countries.
Background
Nurses are vital but underused actors within antimicrobial stewardship interventions. Prior research has identified major gaps in undergraduate, university classroom-based antimicrobial stewardship education, yet how nursing students translate this learning during clinical placements remains unexplored.
Design
Qualitative design.
Methods
Semi-structured interviews conducted with 17 undergraduate nursing students (ten from the United Kingdom and seven from Spain) between 2023–2025. Data were analysed using reflexive thematic analysis. Rigour was enhanced through bilingual coding, peer debriefing and ongoing interpretive reflection.
Results
Students, across multiple educational and clinical contexts, found themselves navigating what we describe as an 'educational quicksand', a shifting terrain shaped by hidden curricula and systemic opacity, a disorienting and fragmented learning space marked by unclear roles, minimally structured teaching, workload-driven deviations in practice and sparse opportunities for reflection or interprofessional learning. Overall, four interconnected themes emerged: (1) antimicrobial stewardship is marginalised in both practice and pedagogy; (2) learning is self-directed and fragmented; (3) embodied learning and the role of modelling: between hesitation and enactment; and (4) students aspire to stewardship roles despite systemic constraints.
Conclusion
Across the two study settings, nursing students hover at the threshold of stewardship, constrained by comparable structural gaps, implicit curricula and unclear role boundaries. Embedding antimicrobial stewardship within mentorship, interprofessional dialogue and assessment frameworks could help students move more confidently through this ‘quicksand’ and support the development of antimicrobial stewardship as a core nursing competency.
Date Issued
2026-07-01
Date Acceptance
2026-05-14
Citation
Nurse Education in Practice, 2026, 94
ISSN
1471-5953
Publisher
Elsevier
Journal / Book Title
Nurse Education in Practice
Volume
94
Copyright Statement
© 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
10.1016/j.nepr.2026.104864
Publication Status
Published
Article Number
104864
Date Publish Online
2026-05-23