Perception of and satisfaction with the clinical learning environment among nursing students.

Clinical nursing education provides baccalaureate nursing students an opportunity to combine cognitive, psychomotor, and affective skills in the Middle East. The aim of the paper is to assess the satisfaction with and effectiveness of the clinical learning environment among nursing students in Oman. A cross-sectional descriptive design was used. A convenience sample consisting of 310 undergraduate nursing students was selected in a public school of nursing in Oman. Ethical approval was obtained from the Research and Ethics Committee, College of Nursing in 2011. A standardized, structured, validated and reliable Clinical Learning Environment Supervision Teacher Evaluation instrument was used. Informed consent was obtained from all the students. Data was analyzed with ANOVA and structural equation modeling. Satisfaction with the clinical learning environment (CLE) sub-dimensions was highly significant and had a positive relationship with the total clinical learning environment. In the path model 35% of its total variance of satisfaction with CLE is accounted by leadership style, clinical nurse commitment (variance=28%), and patient relationships (R(2)=27%). Higher age, GPA and completion of a number of clinical courses were significant in the satisfaction with the CLE among these students. Nurse educators can improvise clinical learning placements focusing on leadership style, premises of learning and nursing care, nurse teacher, and supervision while integrating student, teacher and environmental factors. Hence the clinical learning environment is integral to students' learning and valuable in providing educational experiences. The CLE model provides information to nurse educators regarding best clinical practices for improving the CLE for BSN students.

D'Souza MS ，Karkada SN ，Parahoo K ，Venkatesaperumal R ... -  《-》

Nepalese undergraduate nursing students' perceptions of the clinical learning environment, supervision and nurse teachers: A questionnaire survey.

Clinical practice enables nursing students to acquire essential professional skills, but little is known about nursing students' perceptions of the clinical learning environment (CLE) in Nepal. To examine Nepalese nursing students' perceptions regarding the CLE and supervision. A cross-sectional questionnaire design was used. Government and private hospitals in Nepal where the undergraduate nursing college students undertook their clinical practice. Students with clinical practice experience were recruited from years 2-4 of the B.Sc. nursing program in Nepal (n=350). The final sample comprised 263 students. A self-administered questionnaire including demographic characteristics, latest clinical practice site, and general satisfaction was administered February-March 2014. The previously validated Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was used in the questionnaire. The analytical approach used exploratory factor analysis, assessments of the scale and sub-dimension reliability, correlations of factors between scale sub-dimensions, and multiple regression analysis. Students' practicum satisfaction level at government hospitals was significantly higher than those at private hospitals (p<0.0001). Five factors explained 85.7% of the variance, with minor factorial structure differences compared with the original scale. Reliability was confirmed (Cronbach's alpha=0.93 for total scale, 0.76-0.92 for sub-dimensions). Inter-correlations between the five original sub-dimensions were 0.27-0.68 (p<0.0001). Students undertaking their practicum in private hospitals evaluated their clinical placements significantly more negatively on most sub-dimensions than those in government hospitals. Multiple regression analysis revealed a significant positive relationship between satisfaction and pedagogical atmosphere (p<0.0001). This is the first study to investigate nursing students' perceptions of the CLE in undergraduate nursing programs in Nepal. Students were satisfied with the CLE overall, but satisfaction varied by practicum hospital sector. The most influential factor explaining satisfaction was pedagogical atmosphere.

Nepal B ，Taketomi K ，Ito YM ，Kohanawa M ，Kawabata H ，Tanaka M ，Otaki J ... -  《-》

Student nurses' experiences of the clinical learning environment in relation to the organization of supervision: a questionnaire survey.

The aim was to investigate student nurses' experiences of the clinical learning environment in relation to how the supervision was organized. The clinical environment plays an essential part in student nurses' learning. Even though different models for supervision have been previously set forth, it has been stressed that there is a need both of further empirical studies on the role of preceptorship in undergraduate nursing education and of studies comparing different models. A cross-sectional study with comparative design was carried out with a mixed method approach. Data were collected from student nurses in the final term of the nursing programme at three universities in Sweden by means of a questionnaire. In general the students had positive experiences of the clinical learning environment with respect to pedagogical atmosphere, leadership style of the ward manager, premises of nursing, supervisory relationship, and role of the nurse preceptor and nurse teacher. However, there were significant differences in their ratings of the supervisory relationship (p<0.001) and the pedagogical atmosphere (p 0.025) depending on how the supervision was organized. Students who had the same preceptor all the time were more satisfied with the supervisory relationship than were those who had different preceptors each day. Students' comments on the supervision confirmed the significance of the preceptor and the supervisory relationship. The organization of the supervision was of significance with regard to the pedagogical atmosphere and the students' relation to preceptors. Students with the same preceptor throughout were more positive concerning the supervisory relationship and the pedagogical atmosphere.

Sundler AJ ，Björk M ，Bisholt B ，Ohlsson U ，Engström AK ，Gustafsson M ... -  《-》

Baccalaureate nursing students' perceptions of learning and supervision in the clinical environment.

This study is an exploration of nursing students' experiences within the clinical learning environment (CLE) and supervision provided in hospital settings. A total of 357 second-year nurse students from all universities in Cyprus participated in the study. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher instrument. The dimension "supervisory relationship (mentor)", as well as the frequency of individualized supervision meetings, were found to be important variables in the students' clinical learning. However, no statistically-significant connection was established between successful mentor relationship and team supervision. The majority of students valued their mentor's supervision more highly than a nurse teacher's supervision toward the fulfillment of learning outcomes. The dimensions "premises of nursing care" and "premises of learning" were highly correlated, indicating that a key component of a quality clinical learning environment is the quality of care delivered. The results suggest the need to modify educational strategies that foster desirable learning for students in response to workplace demands.

Dimitriadou M ，Papastavrou E ，Efstathiou G ，Theodorou M ... -  《-》

Factors associated with student learning processes in primary health care units: a questionnaire study.

Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models. The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units. The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above. The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction. These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management.

Bos E ，Alinaghizadeh H ，Saarikoski M ，Kaila P ... -  《-》