Pre-registration nursing student's quality of practice learning: Clinical learning environment inventory (actual) questionnaire

Nursing students' perceptions of inadequate nurse staffing in the clinical learning environment - a systematic narrative review

AIM

The aim of this study was to substantiate the perceptions and experiences of nursing students related to nurse understaffing in the clinical learning environment.

BACKGROUND

The quality of the clinical learning environment affects students' learning experiences, shapes their thinking about the profession and can influence their choice to stay or leave the profession. Understaffing in the clinical learning environment has an adverse impact on patient safety, quality of care outcomes and mortality. Understaffing has an impact on students' learning by reducing the quality of supervision and mentoring.

DESIGN

A systematic narrative review.

METHODS

Databases of Academic Search Premier, MEDLINE, Psychology and Behavioural Sciences, APA PsycINFO, APA PsycArticles, CINAHL, AMED were searched systematically. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The reviewers independently conducted study selection, quality appraisal and data extraction. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT). Thematic analysis was used to synthesise the findings.

RESULTS

A total of eight research papers were included. Four themes were identified: inadequate support, feeling unprotected, being seen as a cover for staff shortages on shifts and patients ultimately suffer the consequences of understaffing.

CONCLUSIONS

This review revealed that understaffing in the learning environment meant that optimum level of supervision could not be provided, making students feel vulnerable and insecure, students felt unwelcome and used as cover for staff shortages. We recommend further examination of understaffing to inform policy for improvement in student-staff ratio, supervision and facilitation of learning.

Midwifery students' perceptions of clinical learning experiences and midwifery preceptors in Turkey

BACKGROUND

The clinical education environment presents a valuable opportunity for students to learn, acquire and develop the clinical skills essential for professional midwifery practice. The presence of competent and relevant preceptors plays a pivotal role in ensuring the success of midwifery students and fostering positive clinical experiences.

AIM

This study was conducted to evaluate the clinical practice experiences of midwifery students and their perceptions of midwifery preceptors.

DESIGN

A descriptive and cross-sectional study.

METHODS

This study was conducted with 205 students enrolled in the midwifery department of the Faculty of Health Sciences of a state university in Turkey. Data collection used a participant information form and the Clinical Learning Environment and Midwifery Preceptor Scales designed to assess factors affecting midwifery students' clinical learning. Data analysis was performed using the SPSS 22.0 program, employing methods such as the Independent Sample T-Test, One-Way Analysis of Variance and Tukey test.

RESULTS

The average total score on the Clinical Learning Environment scale was 31.08±2.16 out of a possible 32, while the average total score on the Midwifery Preceptors scale was 17.60 (SD 1.27) out of a possible 18. The mean total score of the Midwifery Preceptor Scale and the mean scores of the sub-dimensions of Skill Development and Midwifery Practice Philosophy were found to be statistically significantly higher in those aged 21 years and older than aged 20 years and younger (P < 0.05). The Midwifery Preceptor Scale total score, the Clinical Learning Environment Scale total score and Skill Development sub-dimensions mean scores of the second-year students were found to be statistically significantly higher than the first and third-year students (P <0.05). Furthermore, students who received education in larger groups and willingly chose and had a passion for the midwifery profession demonstrated significant positive perceptions regarding their clinical learning environment experiences and the impact of their preceptors on their professional growth.

CONCLUSIONS

Understanding the perspectives of midwifery students regarding the clinical education environment, preceptors and the teaching and learning process holds great importance for enhancing the quality of the clinical education environment and fostering the development of clinical competencies among midwifery preceptors.

Pediatric outpatient experiences of senior nursing students: A qualitative study

OBJECTIVES

This study aimed to explore the experiences of senior nursing students working in a pediatric outpatient clinic.

METHODS

This study adopted a descriptive phenomenological approach, through semi-structured interviews. Purposive sampling was used to select 12 senior nursing students in the pediatric outpatient clinic of West China Second University Hospital, Sichuan University, China, from August 2020 to March 2021. The collected data were analyzed using the Colaizzi method.

RESULTS

Four themes were identified in this study: knowledge and skills (triage, emergency care), communication (courage, communication skills), value re-evaluation (understand of outpatient nurses, judgment of outpatient nurses), and outpatient feelings (satisfaction, empathy, pressure).

CONCLUSION

Pediatric outpatient internships have a positive impact on senior nursing students. Research has found that constructing a nursing clinical practice pathway in pediatric outpatient clinics helps teachers and students clarify the objectives and content of internships, and the "shadow teaching" model is conducive to nursing students' empathy and thinking. In addition, outpatient internship experience can help students gain communication courage.

Are men treated differently in clinical placements during nursing studies? A cross-sectional study

AIM AND OBJECTIVE

To explore the perceptions of nursing students regarding the treatment of men in nursing during their clinical placement.

BACKGROUND

Negative placement experiences of men who are nursing students is a risk factor for student attrition. Hence, exploring gender disparity in treatment during placement from both men and women studying nursing will contribute to improving student experience and reducing attrition.

DESIGN

Survey capturing both quantitative and qualitative data.

METHODS

Nursing students were surveyed between July and September 2021 across 16 Schools of Nursing in Australia. In addition to the Clinical Learning Environment Inventory (CLEI-19), an open-ended question explored if men received different treatment during clinical placement.

RESULTS

Those who expressed difference in treatment of men were less satisfied with their clinical learning experience (p < .001). Of the 486 (39.6%) who responded to the open-ended question, 152 (31%) indicated a difference in the treatment of men, reporting that men received: (a) better (39%); (b) different, not exclusively better or worse (19%); and (c) worse (42%) treatment from either the clinical facilitator or ward staff. While both men and women perceived gender differences in the treatment of men during placement, men were more likely to report worse treatment.

CONCLUSION

Despite the advances achieved in recruiting men in nursing, negative experiences during clinical placement are characterised by stereotypes, prejudice and discrimination, adversely impact retention.

RELEVANCE TO CLINICAL PRACTICE

Nurse educators need to recognise specific support students require during placement regardless of gender. Our findings reinforce the adverse impacts of inequitable treatment on both men and women nursing students on learning, clinical performance, morale and ultimately on retention in the nursing workforce. Addressing gender stereotyping and discrimination in the undergraduate nursing program is an important step in promoting diversity and inclusivity in the nursing workforce.

Comparing Preferred and Actual Clinical Learning Environments and Perceptions of First-Year Nursing Students in Long-Term Care: A Cross-Sectional Study

The clinical learning environment, which includes the culture of clinical units, the mentoring process, and the different health organizations, influences the learning process of nursing students. However, scarce literature has been published on the impact of the clinical learning environment on first-year nursing students in long-term care. We aimed to assess first-year nursing students 'preferred' and 'actual' clinical learning environments when conducting their first placements in nursing homes within an innovative placement model that comprised the active participation of academic mentors. The validated Spanish version of the Clinical Learning Environment Inventory (CLEI) instrument was used in our study, and 99 first-year nursing students participated. The highest mean scores for the CLEI-Actual were found for the Satisfaction (22.7) and Involvement scales (19.09). The lowest mean scores were found for the Personalization (17) and Individualization (17.27) scales. The multiple correlation (R) between the Satisfaction and the other CLEI scales was 0.61 (p > 0.001), which means that in this study the association between student satisfaction and their perception of the clinical learning environment was strong. First-year students conducting their first clinical placements in nursing homes can have a positive learning experience considering a well-designed and organized pedagogical strategy, including constant support and feedback from academic and clinical mentors.

A Multisite Assessment of Saudi Bachelor Nursing Students' Perceptions of Clinical Competence and Learning Environments: A Multivariate Conceptual Model Testing

Background: It is thought that students’ perceptions of educational and clinical learning environments improve the effectiveness of curricula and professional standards. It is essential to examine the educational and clinical learning environments in which nursing students learn, as well as how nursing students evaluate particular factors of these environments. Objectives: The objectives of this study were to (1) identify nursing students’ perceptions on professional competence and learning environments in the classroom and clinical settings and (2) test a hypothetical model of variables that influence and predict students’ perceptions of learning environments and professional competencies. Methods: The study employed a descriptive cross-sectional methodological design. Five hundred and eighteen undergraduate nursing students were recruited from three Saudi Arabian universities using a convenient sampling technique. Using valid and reliable self-reported questionnaires, including the Dundee Ready Educational Environment Measure (DREEM), the modified Clinical Learning Environment Inventory (CLEI), and the Nurse Professional Competence Scale-Short (NPCS-SF), data were collected. Results: Perceptions of professional competence and learning environments were positive among nursing students. With satisfactory fit indices, the final model found that students’ perceptions of clinical competence were significantly predicted by their perceptions of the clinical environment (B = 0.43, p < 0.001), students’ perceptions of university environments (B = 0.29, p < 0.001), ward type (B = 0.12, p < 0.001), and students’ year of study (B = 0.11, p < 0.001). The students’ perceptions of clinical environments were significantly predicted by their perceptions of the university environment (B = 0.31, p < 0.001), gender (B = 0.13, p < 0.001), students’ year of study (B = 0.12, p < 0.001), and ward type (B = 0.11, p < 0.001). Moreover, the students’ perceptions of the university environment were significantly predicted by gender (B = 0.11, p < 0.001) and length of training (B = 0.12, p < 0.001). Conclusions: A range of factors might influence students’ perceptions of their professional competence and learning environments. Improving the learning environments and clinical experiences of students could enhance their clinical competence. This study’s findings provide evidence for how to enhance the learning environments in the classroom and clinical settings in order to improve students’ clinical competence, which will ultimately result in better patient outcomes. It is a top priority for nursing educators all around the world to improve classroom and clinical learning settings that foster students’ learning and professional competencies.

Nursing students' satisfaction with clinical placements: The contribution of role modeling, epistemic authority, and resilience-a cross- sectional study

BACKGROUND

Clinical learning is an essential and irreplaceable component of nursing studies. Satisfaction with clinical placements may improve students' learning outcomes as well as their retention in nursing studies. Satisfaction with clinical placements has mostly been associated with environmental factors. The associations between students' satisfaction with clinical placement and students' resilience, clinical instructors' (CI) epistemic authority and perception as a role model have yet to be fully explored.

OBJECTIVE

To explore the associations between students' satisfaction with clinical placement and resilience, as well as CI epistemic authority and perception as a role model.

DESIGN AND METHODS

A cross-sectional survey design with a convenience sample of 131 Israeli nursing students in advanced years of studies, at a large university in central Israel. Data were collected through a self-administered structured questionnaire.

RESULTS

Strong positive correlations were found between students' satisfaction with the clinical placement and their perception of the CI as an epistemic authority and as a role model. Additionally, strong positive correlations were also found between students' satisfaction with the clinical placements and the three sub-categories included in the perception of their CI as a role model (personal traits, clinical skills, and teaching skills). Resilience and CI's teaching skills explained 75.3% of students' satisfaction with their clinical placement.

CONCLUSIONS

Nurse educators and CIs should be aware of their significant role in students' professional development and satisfaction with clinical placements. Special attention should be given to the refinement of clinical skills and teaching skills during CI training, along with deeper awareness of one's personal traits. CIs have the potential to be significant professional role models for their students, while enhancing students' resilience and promoting clinical competencies and quality care. These lead to higher student satisfaction and retention in studies as future nurses.

Psychometric properities of the Polish version of clinical learning environment inventory

Background

Clinical experience is a crucial activity for nursing students. The way students` perceive clinical placement exerts an immense influence on the learning process. This study aims to test the psychometric properties of a 19-item version of the Clinical Learning Environment Inventory under Polish clinical conditions.

Method

For this study, Discriminant validity and Cronbach’s alpha reliabilities were computed. In order to measure content validity, the criterion validity Generalized Self Efficacy Scale and the Life Orientation Test - Revised were used.

Results

Cronbach’s Alpha for the Clinical Facilitator Support of Learning Scale and the Satisfaction with Clinical Placement scale is 0.949 and 0.901, respectively. The Spearman’s rank correlation coefficient indicates the existence of a positive correlation between the students’ satisfaction with clinical placement and their [overall] life optimism. Age correlates negatively with perceived teacher support and positively with satisfaction with clinical placement. The sense of self-efficacy correlates negatively with their satisfaction with clinical placement. Clinical Learning Environment Inventory − 19 could be a useful tool to evaluate the quality of the clinical learning process in Polish conditions.

Interpersonal skills mediate the relationship between communicative and clinical competencies among nursing students: A descriptive study

BACKGROUND

The development of clinical competency reduces nursing students' stress and turnover intention and improves their clinical practice satisfaction and academic performance. Still, many nursing supervisors feel that new graduate nurses have inadequate communicative and clinical competencies, and no prior study has analyzed the mediating effect of interpersonal skills in the relationship between these two variables.

OBJECTIVES

To examine the factors that affect nursing students' clinical competency, including the mediating effect of interpersonal skills, and to identify/determine interventions that promote it and improve students' clinical performance.

DESIGN

This study employed a cross-sectional, descriptive correlational design.

SETTING

Four departments of nursing in Jeollabuk-do, South Korea.

PARTICIPANTS

Participants (N = 222; mean age = 22.7 years; 75.2% women) were students enrolled in the third and fourth year of nursing.

METHODS

From February 5-28, 2018, we collected data through self-reported questionnaires; these asked about participants' demographic characteristics and measured their communicative competency, interpersonal skills, and clinical competency. The relationships among the variables were identified using Pearson's correlation coefficient. We also used the Sobel test and a three-step multiple regression analysis to verify the mediating effects of interpersonal skills.

RESULTS

Students who were female, in their fourth year, satisfied with their major, and satisfied with their clinical practice had higher clinical competency scores than their counterparts. Interpersonal skills completely mediated the effects of communicative competency on clinical competency (explanatory power = 53.8%).

CONCLUSIONS

The results suggest the need for a program that improves nursing students' social relationship skills and diminishes their anxiety. In particular, students in the third and fourth years need a continuous/intensified curriculum that fosters their communicative competencies, such as listening to patients' needs and establishing effective interpersonal relationships with peers/superiors. Longitudinal studies are warranted to identify differences in communicative/clinical competencies among nursing students in different academic years.

The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals

AIMS AND OBJECTIVES

To analyse nursing students' perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals.

BACKGROUND

Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace.

DESIGN

Cross-sectional, correlational study.

METHODS

One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students' satisfaction with the clinical learning environment and learning process was measured using a 4-point Likert scale developed by the researchers. The STROBE checklist was used in this paper.

RESULTS

Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction.

CONCLUSIONS

This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies.

RELEVANCE TO CLINICAL PRACTICE

Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.

Magnet hospital attributes in nursing work environment and its relationship to nursing students' clinical learning environment and satisfaction

AIMS

To analyse nursing students' perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated.

DESIGN

This study had a cross-sectional, correlational, design.

METHODS

Data were collected using self-reported questionnaires from 180 nursing students at a university in southeast Spain between September-October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students' satisfaction with the work environment and with the clinical learning process were measured using a four-point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ² test, Mann-Whitney U test, Spearman and phi correlation were used to analyse the data.

RESULTS

Nursing students' perception of greater Magnet-like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22-0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02).

CONCLUSION

Magnet-like features at the work environment lead to superior clinical learning environment and higher students' satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation.

IMPACT

In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.

Nursing students' views and satisfaction of their clinical learning environment in Singapore

Aims

This study aims to investigate final-year nursing students' actual perception of their clinical learning environment in Singapore.

Design

Descriptive cross-sectional survey.

Methods

An online survey based on the clinical learning environment inventory (CLEI; "Actual" version) was administered to final-year (third year) nursing students (N = 301) in a polytechnic in Singapore between May-July 2018.

Results

Most nursing students reported moderate satisfaction with their clinical learning environment, reflecting their positive (although not strongly positive) perceptions. Among the six constructs of the CLEI, the higher scores of the constructs of "Personalization" and "Task orientation" implied their greater contribution to the positive view. Conversely, the lower scores of "Individualization" and "Innovation" implied their lesser contribution. Additionally, the positive correlation between "satisfaction" and the other five CLEI constructs was found to be statistically significant.

Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey

OBJECTIVE

To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type.

BACKGROUND

Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date.

METHODS

The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha.

RESULTS

Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest.

CONCLUSION

The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.

Clustering clinical learning environment and mentoring perceptions of nursing and midwifery students: A cross-sectional study

AIMS

This study aimed to explore nursing and midwifery students' evaluation of the clinical learning environment and mentoring and to identify distinct student profiles relating to their perceptions.

DESIGN

This study employed a cross-sectional design.

SETTINGS

The study population included nursing and midwifery students in a university hospital in Finland.

PARTICIPANTS

All nursing and midwifery students who completed their clinical placement were invited to take part in the study in the academic year 2017-2018.

METHODS

The data (N = 2,609) were gathered through an online survey using the Clinical Learning Environment, Supervision and Nurse Teacher scale. The data were analysed using a K-mean cluster algorithm to identify nursing and midwifery students' profiles.

RESULTS

The findings from this study indicate four distinct profiles (A, B, C, & D) of nursing and midwifery students in relation to the clinical learning environment and mentoring. Profile A (N = 1,352) students evaluated their clinical learning environment and mentoring to the highest level (mean varied from 9.44-8.38); and Profile D (N = 151)- to the lowest (mean varied from 5.93-4.00).

CONCLUSION

The findings highlight that nursing and midwifery students evaluate their clinical learning environment and mentoring more highly when: they have a named mentor, student and mentor discuss learning goals, there is a final assessment in clinical learning, the mentor's guidance skills support student learning, the clinical learning supports the student's professional development and pre-clinical teaching in an educational institution supports learning in the clinical placement.

IMPACT

Clinical learning plays an important role in nurse and midwifery education. Mentoring of clinical practice was shown to have a great influence on students' perceptions of their success in clinical learning. We suggest that clinical practice should be strengthened by the building of collaboration between nursing teachers and registered nurses.

A comparison of faculty led, mentorship program and peer mentoring on nursing students wound dressing clinical skills

BACKGROUND

The promotion of clinical nursing education requires using modern educational methods to develop students' knowledge and skills. There are however many different models by which education can be delivered with a wealth of literature supporting varying approaches. This is of particular relevance to clinical education where to date no singular approach has been identified as being the most appropriate.

OBJECTIVES

This study aimed to compare and investigate the effect of a peer education method, a mentor-led education method versus a traditional faculty-led method for instruction regarding surgical wound care skills among nursing students.

DESIGN

This study used an experimental three-group pre- and post-test design.

SETTINGS

The research was conducted within two surgical wards of a university-affiliated hospital in the west of Iran.

PARTICIPANTS

A total of 102 nursing students (first and second year) were assigned to three groups; peer-led learning group (n = 34), mentorship-led group (n = 34) or a faculty-led control group (n = 34).

METHODS

To ascertain performance in surgical dressing skill, data was collected in each group before and after the respective educational intervention. Data was collected using a surgical dressing skills checklist made by the research team which was piloted prior to the study. All statistical analysis was performed using SPSS v.22.0 (SPSS Inc., Chicago, IL).

RESULTS

Based on findings, after the intervention, the mean (SD) scores of surgical dressing and wound care skills were 28.24 (4.63), 31.76 (4.89), and 29.12 (5.33) for the peer-led, mentor-led and faculty-led groups, respectively. There was no significant difference between mentor group and faculty group or between peer group and faculty group (P > 0.05). However, the findings did demonstrate statistical difference in performance in surgical dressings and wound care techniques in the mentorship group method compared to the peer method (P = 0.006).

CONCLUSIONS

Although participants in the mentor group performed best of all groups, our findings demonstrate that those in the peer method group performed as well as those in the faculty-led group in surgical dressing performance. Therefore, it is recommended that peer and mentor learning methods are given consideration by curriculum planners in for use in the development of student nurse clinical skill and competence in surgical wound care.

Quality Assurance in Nursing Education: A Qualitative Study Involving Students and Newly Graduated Nurses

Background: Assuring quality training for future nursing professionals is essential to preserving population health and socio-economic development. Quality assurance in the European Higher Education Area places students in a leading role to transform and improve higher education programs. Therefore, an innovative way of reviewing strengths and weaknesses of the nursing education program of a Spanish university has been developed. Objectives: The aim of this paper was to explore the perceptions and opinions of nursing students and newly-qualified nurses regarding the contents of the nursing curriculum in order to improve its quality. Methods: Descriptive and exploratory qualitative research was carried out involving 12 newly-qualified nurses and 12 student nurses. Semi-structured interviews and focus groups were performed. Results: Based on the thematic analysis, two themes emerged: improving clinical practices and reviewing the theoretical curriculum. Conclusions: Among the improvements suggested by the participants, the most relevant ones were establishing a clear structure of learning contents in the practicum, and redistributing the European Credit Transfer and Accumulation System ECTS credits in various courses of the study program. However, additional evidence is needed prior to proceeding with any changes.

Evaluating the learning environment of nursing students: A multisite cross-sectional study

BACKGROUND

Identifying students' experiences of the university and clinical learning environments informs quality improvement of courses.

OBJECTIVES

To investigate undergraduate nursing students' perceptions of their education environment and the facilitators and barriers to learning, during university and clinical experiences.

DESIGN

Multi-site cross-sectional survey.

SETTING

Four universities in Vietnam.

PARTICIPANTS

Undergraduate nursing students (n = 891).

METHODS

Between May and August 2016, Vietnamese versions of the Dundee Ready Education Environment Measure (Nursing) and the modified Clinical Learning Environment Inventory measured students' perceptions of university and clinical environments respectively. Two additional open-ended questions elicited perceptions of facilitators and/or barriers to clinical learning.

RESULTS

The university environment was rated as needing improvement and significant differences between universities and year of study detected. University environment mean scores were significantly higher in second year students compared with those in the third or fourth years of study. Active teaching and interpersonal relationships at university were rated positively. Overall, clinical environment scores were mid-range and second year students' mean scores were significantly higher than third or fourth years. Clinical placements greater than four weeks duration had significantly higher mean score than two week placements.

CONCLUSIONS

Evaluation of university and clinical experiences assists with identifying potential areas of interruption to nursing students' transfer of learning. In both learning environments, Vietnamese students' experiences were similar to those experienced in Western countries in that interpersonal relationships with teachers and ward staff were key factors perceived to influence learning. A notable difference in this study was the hospital environment in Vietnam had features unique to this country that interrupted students' transfer of learning. Globally it is a priority for nurse educators to facilitate both on and off campus environments that promote students' learning. Assessing these environments is a useful strategy for quality improvement of courses.

Clinical learning experiences of nursing students using an innovative clinical partnership model: A non-randomized controlled trial

BACKGROUND

Clinical practicum is a major learning component for pre-registration nursing students. Various clinical practicum models have been used to facilitate students' clinical learning experiences, employing both university-based and hospital-based clinical teachers. Considering the strengths and limitations of these clinical practicum models, along with nursing workforce shortages, we developed and tested an innovative clinical partnership model (CPM) in Hong Kong.

OBJECTIVE

To evaluate an innovative CPM among nursing students actual and preferred clinical learning environment, compared with a conventional facilitation model (CFM).

DESIGN

A non-randomized controlled trial examining students' clinical experiences, comparing the CPM (supervised by hospital clinical teacher) with the CFM (supervised by university clinical teacher).

SETTING

One university in Hong Kong.

PARTICIPANTS

Pre-registration nursing students (N = 331), including bachelor of nursing (n = 246 year three-BN) and masters-entry nursing (n = 85 year one-MNSP).

METHODS

Students were assigned to either the CPM (n = 48 BN plus n = 85 MNSP students) or the CFM (n = 198 BN students) for their clinical practice experiences in an acute medical-surgical ward. Clinical teachers supervised between 6 and 8 students at a time, during these clinical practicums (duration = 4-6 weeks). At the end of the clinical practicum, students were invited to complete the Clinical Learning Environment Inventory (CLEI). Analysis of covariance was used to compare groups; adjusted for age, gender and prior work experience.

RESULTS

A total of 259 students (mean age = 22 years, 76% female, 81% prior work experience) completed the CLEI (78% response rate). Students had higher scores on preferred versus actual experiences, in all domains of the CLEI. CPM student experiences indicated a higher preferred task orientation (p = 0.004), while CFM student experiences indicated a higher actual (p < 0.001) and preferred individualization (p = 0.005). No significant differences were noted in the other domains.

CONCLUSIONS

The CPM draws on the strengths of existing clinical learning models and provides complementary methods to facilitate clinical learning for pre-registration nursing students. Additional studies examining this CPM with longer duration of clinical practicum are recommended.

Needing to Belong: First Practice Placement Experiences of Children's Nursing Students

This study examines first year children's nursing students' anxieties before their first practice placement and their support needs during that time. Strategies to address needs are highlighted. A questionnaire was completed by children's nursing students (n = 21) before their initial practice placement to establish their expectations and concerns. A subgroup (n = 5) took part in a focus group following placement to establish consensus around the support that helped and what could help future students prepare for first placement. The resultant data indicated the importance of students having a sense of belonging to their practice placement, trusting website information, induction days, and the involvement of a more senior student in their preparation, in addition to facilitative mentors. Using similar methodology to that used with students, a subgroup of professional staff took part in two focus groups (FG1 n = 5, FG2 n = 4) to establish consensus around support initiatives using areas identified by students as priorities that could better facilitate this initial practice placement. Although commonalities existed within both students and professionals, some differences were highlighted. A student's first practice placement is of utmost importance in affirming their choice to study nursing. Academic and clinical staff play a crucial part in this decision-making.

Exploring the perception of nursing students about consequences of reflection in clinical settings

BACKGROUND

Reflection on practical experiences is a key element that enables students to recognize their own strengths and weaknesses and develop nursing skills. Whilst reflection may enhance students' learning in practice, there is little evidence about nursing students' perception of the consequences of reflection in clinical settings.

OBJECTIVE

This study aimed to explore Iranian nursing students' perception regarding the consequences of reflection during clinical practices.

METHODS

This qualitative study was conducted by a conventional content analysis approach in two nursing schools at Shiraz and Fasa Universities of Medical Sciences in Iran. Data were collected through in-depth semi-structured interviews during 2015-2016, from 20 students selected by purposive sampling. All the interviews were tape-recorded, transcribed verbatim, and analyzed by content analysis method. Rigor of this study was approved by member check and external audit.

RESULTS

Two categories emerged from the data analysis, including movement toward professionalism and self-actualization of emotions. The former consisted of three subcategories of function modification, sharing experiences and generalizing experiences. The latter consisted of two subcategories of inner satisfaction and peace of mind.

CONCLUSION

The results indicated that nursing students' reflection in clinical settings is effective in personal and professional levels. Reflection in a personal level led to positive emotions that increased the quality of care in patients. Accordingly, nursing educators need to create a nurturing climate as well as supporting reflective behaviors of nursing students.