英文摘要:Background: It is critical to understand the process of how learning outcomes are implemented in practice in order to guide clinical nursing practice. Purpose: The aim of this study was to explore how learning outcomes are implemented and to elicit and analyze the factors that affect this process. Methods: This study adopted a participatory action research approach. The challenges to implementing student learning outcomes were explored and the factors that affect this process and the solutions were elicited from clinical teachers, from research groups, and from the reflection notes, the interview notes, and other documents of 49 five-year nursing students. Results: The learning outcomes of nursing clinical practice must be developed to address the needs of students. These needs include the competencies of reflective thinking and practice skills, the ability to communicate and to cooperate, the character of autonomy and responsibility, and the professional identity of ethical attitudes. The factors that influence the implementation of learning outcomes relate primarily to the role of the teacher. The teacher uses a diverse range of leadership styles to develop a friendly relationship with students. Conclusions/ Implications for Practice: The results of this study suggest three conclusions. First, the learning outcomes of nursing clinical practice should be developed based on the needs of students and should enhance their abilities in terms of self-reflection and ethical understanding. Second, in order to attain intended educational outcomes, students must gain a strong grasp of theory and professional knowledge; enhance their ability to communicate and cooperate with others; and strengthen their ability to work independently, responsibly, and compassionately. Third, the teacher should apply different types of leadership approaches to promote the autonomy of students and should develop a friendly relationship with them.