Introduction:
In the context of nursing education, clinical placements are crucial for the development of students' competencies. These settings require the mobilization and articulation of theoretical knowledge into clinical practice, emphasizing reflection in and about the action to meet the complex demands of professional care. However, a range of intrinsic and extrinsic factors can act as barriers to the effective acquisition of these competencies, impacting students’ confidence, critical thinking, and ability to deliver high-quality personalized care.

Objective:
This study aimed to examine the self-perceived barriers to competency development among nursing students during their first clinical placement.
Methods: A qualitative, exploratory-descriptive design was employed. Data were collected through semi-structured interviews with 20 nursing students in October 2024 during their initial clinical placement. The interview guide was subjected to content validation by two experts in clinical supervision. Ethical considerations, including anonymity and confidentiality, were rigorously observed. Data was analyzed using thematic content analysis, leading to the identification of key categories and subcategories.

Results:
The participants, comprising 8 males and 12 females with a mean age of 21 years (range 20–23), identified two overarching categories of barriers: intrinsic and extrinsic. Intrinsic barriers included anxiety, immaturity, lack of motivation, deficits in theoretical knowledge, insufficient manual skills, and the absence of critical reflection. These factors were perceived as personal limitations negatively influencing clinical performance. Extrinsic barriers encompassed aspects such as the presence or absence of clinical supervision, contextual variables of the clinical environment, the lack of integration manuals, and curricular program deficiencies, all of which hindered adaptation and performance in the clinical setting.

Discussion:
Clinical placements, as a basis of nursing education, play an essential role in bridging the gap between theoretical learning and practical application. Benner (2005) emphasizes that the clinical context is central in facilitating students’ progression from "novice" to "competent" practitioners. Reflective thinking emerges as a key strategy in this process, fostering self-awareness and confidence, which are vital for critical analysis and the development of clinical competencies. The findings of this study suggest that intrinsic and extrinsic barriers could be mitigated through targeted pedagogical interventions, such as robust clinical supervision programs and enhanced emphasis on reflective practice. Examples of such interventions include the implementation of individual tutoring sessions, group reflective activities, and the integration of digital tools to promote self-reflection and critical analysis. These strategies would contribute to the development of nurses equipped to deliver personalized high-quality care.
This study underscores the need for greater focus on the barriers encountered by nursing students during clinical placements, both at individual and contextual levels. The results highlight the potential of structured supervision and reflective practices not only in enhancing clinical competency acquisition but also in fostering the overall professional growth of nursing students, ultimately contributing to improved quality of care.

Keywords: Nursing, students, clinical competence.