Effectiveness of supervision on patient safety during nursing students´ clinical practice: A systematic-narrative hybrid literature review
Abstract
AIM: To synthesize empirical evidence on the effectiveness of supervision on patient safety of nursing students during clinical practice, students' perceptions and the influencing factors.
BACKGROUND: Patient safety is a key component of nursing education, yet its integration into clinical practice remains inconsistent internationally, with supervision serving as an important determinant of students' safety learning.
DESIGN: A systematic-narrative hybrid review (registered on PROSPERO: CRD42025636289), combining the methodological rigor of systematic reviews with interpretive depth of narrative synthesis.
METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses, ten databases were searched (January-August 2025) using SPIDER tool. Thirty-four empirical studies met the inclusion criteria and were critically appraised using the Mixed Methods Appraisal Tool. Qualitative and mixed-method evidence underwent inductive coding; quantitative findings were analyzed using correlation-based effect sizes. Finally, evidence was analyzed through convergent synthesis.
RESULTS: Three overarching themes emerged: (1) scope and models of safety supervision; (2) supervision as a determinant of patient safety; and (3) factors influencing safety supervision. Structured and supportive supervision models demonstrated moderate to strong associations with patient safety (r ≈ .30-.60). Key supervisory attributes included competence, authority, continuity and professional…
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