Journal article
Threshold concepts in Primary Health Care nursing education – What they are, why they matter and how to facilitate learning: A reflexive thematic analysis
Nurse education today, Vol.168, pp.1-10
01/2027
PMID: 42735648
Appears in Recent Faculty of Health Publications
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Abstract
Aim: To identify threshold concepts encountered by undergraduate nursing students during Primary Health Care placements, examine influences and supports that help students master these concepts, and explore how addressing them may better prepare students for placement and future workforce.
Background: Primary Health Care workforce shortages are a growing international concern, emphasising the need to better prepare nursing students for the complexity of Primary Health Care practice. Threshold Concepts provide a lens for examining how students develop new ways of thinking and learning; however, little is known about the threshold concepts encountered during Primary Health Care placements and experiences. Understanding these concepts may strengthen future workforce preparation.
Design: A qualitative descriptive study.
Participants: Eight undergraduate nursing students who had completed Primary Health Care placements.
Methods: Semi-structured interviews were conducted in 2026, via an online platform and analysed using reflexive thematic analysis.
Results: Two threshold concepts underpinning transformative learning during Primary Health Care placements were identified. The first transformed students' understanding of patients by shifting their perspective from illness- and procedure-focused care to understanding the person within the broader personal, social and environmental factors that shape health. The second transformed students' understanding of nursing by integrating previously fragmented knowledge to understand the whole clinical picture. Threshold concept mastery was facilitated through authentic Primary Health Care experiences, supervisor11Note: In this study, the term ‘Supervisor’ refers to the Registered Nurse (RN) who undertakes the role of mentor, assessor, facilitator, preceptor or educator for students during clinical placement and can be either university or facility-based, depending on the placement model. guidance and debriefing, with supervisors playing a critical role by making expert thinking explicit.
Conclusion: These findings provide new insight into how transformative learning occurs during Primary Health Care placements. Identifying threshold concepts and the educational processes that support students to master them offers a theoretical foundation for intentionally designing learning experiences and supervision that better prepare graduates for contemporary nursing practice and the future Primary Health Care workforce.
Details
- Title
- Threshold concepts in Primary Health Care nursing education – What they are, why they matter and how to facilitate learning: A reflexive thematic analysis
- Creators
- Debbie Procter - Edith Cowan UniversityKylie McCullough - Edith Cowan UniversityDebbie Massey - Edith Cowan UniversityKaren Strickland - Edith Cowan University
- Publication Details
- Nurse education today, Vol.168, pp.1-10
- Publisher
- Elsevier Ltd
- Identifiers
- 991013400934402368
- Copyright
- © 2026 The Authors
- Academic Unit
- Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article