Nursing students' satisfaction of the clinical learning environment: a research study

The clinical environment: A facilitator of professional socialisation

BACKGROUND

Competencies of health care workers, including nurses, often do not meet the health needs of populations. The clinical learning environment (CLE) is vital in socialising neophyte student nurses to display the desired competencies. Student nurses are however confronted with challenges, especially in the CLE, during this process.

AIM

This article shares three validated guidelines to support professional nurses and nurse educators in facilitating appropriate professional socialisation of student nurses in the CLE.

SETTING

The study was conducted in an 832-bed academic hospital and nine nursing education institutions (NEIs) that offered the nursing programme concerned in a province in South Africa.

METHOD

A sequential, exploratory, mixed-methods study was conducted and qualitative data were collected from two purposive samples, consisting of seven focus group interviews and field notes. Five themes that emerged from the integrated data guided the instrument design to collect data quantitatively from 277 educators. Experts validated 10 guidelines to a set of criteria, which was developed combining all data.

RESULTS

Qualitative and quantitative research evidenced that the CLE mostly did not support student nurses during professional socialisation. A few role models' behaviour was noteworthy, while student supervision was inadequate. The CLE was stressful, lacked in resources, marked by uncoordinated student placement, insufficient communication and inadequate preparation of student nurses. This evidence informed the development of the guidelines.

CONCLUSIONS

The guidelines were (1) the empowerment of role models through reflective practice, (2) capacity building of professional nurses and nurse educators as clinical supervisors by means of intervention strategies and (3) adopting a multifaceted approach in the creation of a positive CLE. These guidelines could facilitate appropriate professional socialisation of student nurses.

Validity and reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T), Turkish version1

Aim:

A methodological type of study was conducted for the purpose of investigating the validity and reliability of the Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale of the clinical learning environment of students, clinical nurses, and educators.

Methods:

Sample was comprised of 602 Turkish nursing students with clinical practice experience at the hospital. The CLES+T, developed by Saarikoski, was used for data collection. Language equivalency, internal consistency, item-total correlation, and structure validity were conducted within the scope of the validity and reliability study on the CLES +T scale.

Results:

It was determined that item-total correlations of four items were lower than 0.30, and those items were removed from the scale as a result of item analysis. The Cronbach’s alpha value of the scale was 0.93-0.99; item total point correlations of the scale varied between 0.45 and 0.66; six factors were identified in the CLES+T factor analysis study, with a total variance explained by these six factors of 64%.

Conclusion:

According to the findings of the research, the CLES+T Turkish version was found to be a valid and reliable scale, which can be used to evaluate satisfaction of nursing students with their clinical education in Turkey.

Lack of respect, role uncertainty and satisfaction with clinical practice among nursing students: the moderating role of supportive staff

BACKGROUND AND AIMS

Clinical learning placements provide a real-world context where nursing students can acquire clinical skills and the attitudes that are the hallmark of the nursing profession. Nonetheless, nursing students often report dissatisfaction with their clinical placements. The aim of this study was to test a model of the relationship between student's perceived respect, role uncertainty, staff support, and satisfaction with clinical practice.

METHOD

A cross-sectional, descriptive survey was completed by 278 second- and third-year undergraduate nursing students. Specifically, we tested the moderating role of supportive staff and the mediating role of role uncertainty.

RESULTS

We found that lack of respect was positively related to role uncertainty, and this relationship was moderated by supportive staff, especially at lower levels. Also, role uncertainty was a mediator of the relationship between lack of respect and internship satisfaction; lack of respect increased role uncertainty, which in turn was related to minor satisfaction with clinical practice.

CONCLUSION

This study explored the experience of nursing students during their clinical learning placements. Unhealthy placement environments, characterized by lack of respect, trust, and support increase nursing students' psychosocial risks, thus reducing their satisfaction with their clinical placements. Due to the current global nursing shortage, our results may have important implications for graduate recruitment, retention of young nurses, and professional progression.

Using preceptors to improve nursing students' clinical learning outcomes: A Malawian students' perspective

Objective

Clinical environment remains an important aspect in the development of student's competence, confidence and fulfillment of their expected learning outcomes. Preceptors and clinical teachers play a significant role in preparing students to achieve their professional goals through continuous support and resource provision. This study explored the students' perception of using clinical preceptors to improve their clinical learning outcomes.

Methods

The researchers used semi structured interviews to collect qualitative data. A total of 48 students were purposively and conveniently sampled from 8 hospitals to participate in the study. Content analysis was used to analyse the data.

Findings

Two themes emerged from the study findings namely: creating a positive clinical learning environment and facilitating academic clinical collaboration.

Conclusions

The findings of the study revealed that students gained more confidence and competence in clinical practice when supported by preceptors as well as achieved clinical learning outcomes. These findings suggest the need to train more clinical preceptors for improvement of students' clinical learning outcomes.

Factors Affecting the Belongingness Sense of Undergraduate Nursing Students towards Clinical Setting: A Qualitative Study

Introduction: One of the most important needs of the students to work reliably in the clinical setting is the feeling of belongingness. Understanding and recognizing such a distinguishing feature among students can reduce their stress and tension. The current research aimed at studying the experiences of belongingness among nursing students in clinical settings.

Methods: In this conventional content analysis study, 12 nursing students were selected from Lorestan University of Medical Sciences by purposive method. In-depth interviews were employed to collect data. All interviews were recorded and transcribed for analyses. Data collection and analysis were carried out at the same time.

Results: The nature of belongingness with respect to clinical setting was expressed and classified in five themes and 11 subthemes. Five concepts (themes), which constituted the nature of nursing students’ experiences, were as follows: moving in the direction of evolvement, attention to human and ethical values, professional integrity, achieving inner satisfaction, and the environment conformity with learner.

Conclusion: The issue of belongingness and its promotion are of utmost importance. The clinical staff, including head nurses and nurses, must perform their roles properly in providing supportive and facilitative clinical environment, positive and constructive interactions, and professional development contexts for students, so that they feel being accepted and valued.

Lack of respect, role uncertainty and satisfaction with clinical practice among nursing students: the moderating role of supportive staff

BACKGROUND AND AIMS

Clinical learning placements provide a real-world context where nursing students can acquire clinical skills and the attitudes that are the hallmark of the nursing profession. Nonetheless, nursing students often report dissatisfaction with their clinical placements. The aim of this study was to test a model of the relationship between student's perceived respect, role uncertainty, staff support, and satisfaction with clinical practice.

METHOD

A cross-sectional, descriptive survey was completed by 278 second- and third-year undergraduate nursing students. Specifically, we tested the moderating role of supportive staff and the mediating role of role uncertainty.

RESULTS

We found that lack of respect was positively related to role uncertainty, and this relationship was moderated by supportive staff, especially at lower levels. Also, role uncertainty was a mediator of the relationship between lack of respect and internship satisfaction; lack of respect increased role uncertainty, which in turn was related to minor satisfaction with clinical practice.

CONCLUSION

This study explored the experience of nursing students during their clinical learning placements. Unhealthy placement environments, characterized by lack of respect, trust, and support increase nursing students' psychosocial risks, thus reducing their satisfaction with their clinical placements. Due to the current global nursing shortage, our results may have important implications for graduate recruitment, retention of young nurses, and professional progression.