Abstract
BACKGROUND: At the end of internships, students do not feel fully qualified to work as nurses due to a lack of confidence. However, during the COVID-19 pandemic, students worked as healthcare aide providing basic health assistance under the supervision of a nurse. This study aimed to explore the learning experiences of fourth-year nursing students who worked under healthcare aide contracts during the COVID-19 pandemic, and how these experiences enabled an effective transition to professional nursing roles. METHOD: An exploratory qualitative study using a qualitative content analysis of reflective texts was undertaken. Seventeen fourth-year nursing students (2020-21), who had completed just over 50% of their on-site practicum and had worked as healthcare aides since the second wave of the pandemic, participated. Reflective texts written by students about their experience were collected via email. A qualitative content analysis was used with multiple rounds of coding to ensure consistency and reliability. The COREQ reporting guidelines were used. FINDINGS: Two main themes appeared: (1) meaningful learning: learning more, deeper, and faster than in internships, and (2) being “almost nurses”. Students reported instances where they felt a significant increase in their clinical decision-making skills due to real-time feedback from mentors. CONCLUSIONS: These findings suggest that integrating more responsibility and team-based learning experiences into nursing practicums could accelerate competency development. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-026-08930-4.