Evaluation of students' satisfaction with nursing education in Norway

Measuring academic satisfaction in nursing students: a systematic review of the instruments

Student academic satisfaction is one of the most important factors affecting the success and quality of a higher education institute and is an indicator about teaching and learning. This study aims to summarize and critically evaluate the instruments assessing academic satisfaction in nursing education. A systematic review was undertaken, PRISMA were used for the screening of studies. MEDLINE, Cochrane, Scopus and CINAHL were searched using MeSH terms; seven eligible articles were identified referring to five assessment tools. COSMIN was used for evaluation of the methodological of the instruments. The systematic review identified five satisfaction measurement tools used in nursing education. The analysis of the instruments rarely considered a confirmative validity structure, measurement error or criterion validity. The best available instrument was the Nursing Students Satisfaction Scale (NSSS) for validation methodology; however, it needs further validation studies that consider CFA, reliability, criteria validity, hypothesis testing and measurement error.

Development and psychometric evaluation of postgraduate nursing student academic satisfaction scale

AIM

To develop and evaluate the psychometric properties of postgraduate nursing student academic satisfaction scale (PNSASS).

DESIGN

The mixed-method study was carried out in two phases; (a) item generation by hybrid concept analysis and (b) item reduction by psychometric evaluation of the developed scale.

METHODS

The initial item pool (N = 209) was prepared based on concept analysis results and similar instruments. A total of 402 postgraduate nursing students willingly participated in online data gathering from August 2019 to May 2020. The validity (face, content and construct) and reliability (stability and internal consistency) of the scale were assessed.

RESULTS

Exploratory factor analysis identified that the scale had four factors which explained 64.80% of the total extracted variance. The results of confirmatory factor analysis showed a good model fit. The reliability of scale was strong to excellent. The results showed that the PNSASS has suitable validity and reliability properties, which can be used to measure the academic satisfaction of postgraduate nursing students.

Nursing students' satisfaction with the curriculum: An integrative review

BACKGROUND

Student satisfaction is one indicator of quality in higher education, allowing access to funding and coming with repercussions on student performance. This theme is considered complex and highly studied; however, in the nursing literature, there are no studies that summarize and combine the variables and predictors of satisfaction, as well as the existing conceptual models.

PURPOSE

The purpose of this study is to define the following: 1) nursing students' academic satisfaction, 2) the existing theoretical models, 3) the academic satisfaction trend during the course, 4) the differences in academic satisfaction level between nursing student characteristics, and 5) the variables involved in the satisfaction process.

METHODS

An integrative review using Whittemore and Knafl's (2005) methodologies was conducted. The electronic databases CINAHL, PubMed, Cochrane, and Scopus were used. Two reviewers independently conducted the quality appraisal of the selected studies using the checklist proposed by Edwards (2015) and the Joanna Briggs Institute (JBI) tool.

FINDINGS

Nineteen papers were included. The articles were published between 1990 and 2018.

CONCLUSIONS

The review highlights the lack of a shared conceptual framework to guide the empirical research in the nursing degree field. Four dimensions that predict satisfaction with the curriculum have been identified: faculty, curriculum, social, and development.

Translation and First Pilot Validation Study of the "Undergraduate Nursing Student Academic Satisfaction Scale" Questionnaire to the Spanish Context

Satisfaction helps nursing students to develop skills and improve their academic performance, hence the importance of assessing it by means of a reliable instrument. The objective was to translate and culturally adapt the "Undergraduate Nursing Student Academic Satisfaction Scale" (UNSASS) instrument to the Spanish context. A cross-sectional study was conducted with a representative sample of 354 fourth-year nursing students from University of Seville, Seville, Spain. The validation process was carried out in five phases as follows: direct translation, synthesis of the translations, back translation, consolidation by a panel of experts, and pilot test with nursing students. After two rounds among two expert committees, the Content Validity Index (CVI) varied from 0.85 to 1, obtaining a CVI above 0.8 with the global questionnaire. A scale composed of 48 items and 4 subscales was obtained, resulting in a Cronbach's α coefficient of 0.96. Within the subscales, this coefficient varied between 0.92 and 0.94. No statistically significant differences were found between the total satisfaction of the scale and gender and teaching unit. An inversely proportional relationship was found between the age and the "Support & Resources" scale. The "Escala de Satisfacción Académica del Estudiante de Enfermería" (ESAEE) scale was obtained, translated, and adapted to the Spanish context from the UNSASS scale, with satisfactory consistency and validity.

Does Project-Based Learning (PBL) Promote Student Learning? A Performance Evaluation

The purpose of the study on which this paper is based was to conduct a performance evaluation of student learning for an introductory course in project management in a higher educational institution in Norway. This was done by utilizing performance measurement philosophy to evaluate perceived student learning after a project-based assignment was applied as an instructional tool. The evaluation was conducted at the end of the semester to determine whether it facilitated learning effectiveness by providing an authentic learning experience. Relevant learning criteria were identified from existing literature and were measured by means of a questionnaire survey. Ten measurement scales were established using a 5-point Likert scale. The survey was then rolled out for the same subject for two consecutive semesters for just over 100 project management students. The results indicated that the incorporation of project-based assignments has a positive impact on student learning, motivation, and performance both in the short and long term. The study finally revealed that the incorporation of project-based assignments enables the creation of real-life experiences, which further stimulates the creation and development of real-life competencies.

Perceived Clinical Practice Competency and Associated Factors Among Undergraduate Students of Medicine and Health Science Collage in Dilla University, SNNPR, Ethiopia

BACKGROUND

The dynamic and uncertain nature of the healthcare environment requires competent health professionals to manage the changing environment. However, globally and regionally there is a shortage of competent health professionals. Understanding the causes of poor performance of healthcare is crucial to provide high-quality healthcare service. So this study aims to assess perceived clinical competence and associated factors among undergraduate medicine and health science students at Dilla University, medical and health Science College.

METHODS

Institutional-based cross-sectional study was conducted among 267 students. Initially, departments were stratified, then simple random sample was used to select students. A 2 days of training was given for data collectors and supervisors. Data were entered into Epi-info version 7 and analyzed using Stata version 12. Logistic regression analysis was used to assess associated factors of clinical competency.

RESULTS

A total of 267 students participated in this study. The majority of students were males 197 (73.8%) and more than half of the participants 186 (69.7%) were in the age group of 20 to 24 years. The study found only 39.3%, 95% CI (33.3, 44.9) of the participants perceived themselves as clinically competent. This study also identified instructor provided constructive feedback (AOR= 2.12, 95% CI =1.164-3.861), instructor orientation about assessment method (AOR=1.855 95% CI =1.03-3.408) and staff encouragement during clinical practice (AOR= 2.608, 95% CI= 1.425-4.77) were statistically significant factors.

CONCLUSION AND RECOMMENDATION

In this study, perceived clinical competency was 39%. Teachers should give constructive feedback to their students to boost their confidence and ability. Furthermore, nationally there should be standard and clear assessment methods in which teachers, school administrators and responsible stakeholders should briefly explain assessment methods to their students and it also needs an action to improve the interaction between staff and students.

Nursing students' well-being using the job-demand-control model: A longitudinal study

BACKGROUND

Students' well-being is very important both for students and institutions. However, this field lacks longitudinal research, which focuses on the change of nursing students' well-being during their study. In order to asses such changes the four study types according to Job-Demand-Control-Support-model were used: passive, high-strain, low-strain, and active.

DESIGN

A longitudinal design was employed: participants were recruited in 2010/2011 (phase I) and at the end of their study in 2012 (phase II).

SETTINGS

The study was performed in one school of health care in a university of applied sciences in Finland.

PARTICIPANTS

The final sample consisted of 135 nursing students (BSc) who started their study either in September 2008 or January 2009, and finished in December 2011 or May 2012.

METHODS

The participants responded to the same close-ended questionnaire in both phases.

RESULTS

The majority of the participants experienced the study type as low-strain (phase I: 61.5%; phase II: 48.2%). The distribution according to their study type did not change substantially between both phases, although 42.2% of the participants changed their study type. The major changes of study types were from low-strain to others (21.4%), and from other study types to the active one (12.6%).

CONCLUSIONS

The results indicate that the majority of students do not change their study type and consequentially their well-being during their study, which is in contrast with previous research. Special attention should be put to the identification of students who change their study type to high-strain or remain in it.

Cultural adaptation and validation of the Portuguese version of the Nursing Clinical Facilitators Questionnaire

Objective:

to perform the cultural adaptation to Portuguese of the Nursing Clinical Facilitators Questionnaire (NCFQ), which was designed by the Centre for Learning and Teaching at the University of Technology of Sydney, and to validate this instrument.

Methods:

this methodological study involved the cultural adaptation of the questionnaire by using translation, back-translation, semantic comparison, idiomatic and conceptual equivalence, and validation through validity and reliability analyses and used a sample of 767 students in their second year of the Nursing Program.

Results:

construct validity had a two-factor solution according to the varimax rotation method. In addition, there was a high overall internal consistency for the questionnaire (Cronbach's alpha of 0.977) and for the factors found (0.966 and 0.952, respectively).

Conclusion:

the Portuguese version has good psychometric characteristics; therefore, it is adequate to obtain reliable information on the perception of nursing students concerning the type of supervision that is provided in clinical practice, and this version is adequate to improve teaching practices.

Perceptions of final-year nursing students on the facilities, resources and quality of education provided by schools in Turkey

The purpose of this study is to determine the perceptions of final-year nursing students regarding the adequacy of education, resources and internships in preparation for graduation. The study design was a descriptive cross-sectional study of nursing students (n: 1804) in their final year of education and questionnaires were used to collect data. Information related to student-to-instructor ratios and internships was obtained from each institution. Most students reported receiving instruction or supervision by lecturers and clinicians who did not specialise in the field. Overall, students did not find the facilities, educational or technological resources and the quality of education offered by their respective schools adequate. The proportion of students who found the level of theoretical education, clinical practice and instructor support adequate was higher in state university colleges of nursing/faculties of health sciences than in state university schools of health sciences.

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

BACKGROUND

Clinical nursing education provides baccalaureate nursing students an opportunity to combine cognitive, psychomotor, and affective skills in the Middle East.

OBJECTIVE

The aim of the paper is to assess the satisfaction with and effectiveness of the clinical learning environment among nursing students in Oman.

DESIGN

A cross-sectional descriptive design was used.

SETTING AND PARTICIPANTS

A convenience sample consisting of 310 undergraduate nursing students was selected in a public school of nursing in Oman.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

RELEVANCE TO PRACTICE

The CLE model provides information to nurse educators regarding best clinical practices for improving the CLE for BSN students.

Nursing Student Satisfaction with an Associate Nursing Program

PURPOSE

The purpose of this study was to conduct a nationwide survey to understand the satisfaction of associate of science in nursing (ASN) students with a nursing program as a whole.

BACKGROUND

Student satisfaction is viewed as an indicator of program success. Yet, nursing student satisfaction has not been sufficiently studied in the United States.

METHOD

The Curriculum, Faculty, Social Interaction, and Environment model was used to support this nationwide study. Stratified random sampling was used to recruit 56 ASN programs from 31 US states for participation.

RESULTS

The students rated their satisfaction with the nursing program as close to "satisfied." The faculty, curriculum, and social interaction significantly and positively predicted overall student satisfaction with a nursing program.

CONCLUSION

A nursing program can evaluate students' satisfaction periodically to determine the impact of the educational experience on the program's performance.

Evaluation of the Project P.A.T.H.S. based on the client satisfaction approach: view of the students

STUDY OBJECTIVES

Based on several data sets collected from 2009/10 to 2011/12 school years, this study examined the views of 242,705 students participating in the Tier 1 Program in the extension phase of the Project P.A.T.H.S. in Hong Kong.

DESIGN

Students responded to a validated client satisfaction measure after completion of the program. Analyses were based on the reports submitted by the schools participating in the project.

RESULTS

High proportions of the students viewed the program, implementers, and benefits of the program in a favorable light. Compared with students in lower grades, students in higher grades showed relatively lower satisfaction ratings, although the differences were small. Perceived qualities of program and instructor predicted perceived effectiveness of the program.

CONCLUSION

The Tier 1 Program was received favorably by the students. Perceived qualities of the program and the program implementers predicted perceived program effectiveness. The findings are consistent with those reported in the initial phase of the project.

Nursing students' perceptions of clinical supervision: the contributions of preceptors, head preceptors and clinical lecturers

AIM

The aims of the study were 1) to investigate to what extent nursing students were satisfied with the supervision provided by facilitators (preceptor, head preceptor, and clinical lecturer), 2) to compare nursing students' ratings of facilitators' contribution to supervision as supportive and challenging, and 3) to examine relationships between facilitators' supportive and challenging behavior in supervision and nursing students' perception of fulfillment of expected learning outcomes in clinical education.

BACKGROUND

Although there are many studies on support of students in clinical education, few have addressed this from the students' point of view or made comparisons between different facilitators.

METHODS

A cross-sectional survey study was conducted during April to November 2010, where 107 nursing students, from a university in central Sweden, answered a questionnaire about supervision immediately after their period of clinical education.

RESULTS

Supportive behavior in supervision was rated higher by students for all facilitator groups as compared with challenging behavior. The students rated preceptors and clinical lecturers as more supportive than head preceptors and clinical lecturers as providing more challenges than the two other facilitator groups. Supportive and challenging behavior in supervision explained 39% of the variance in students' overall learning outcomes. However, the regression coefficient was only significant for students' ratings of supportive behavior for the preceptor.

CONCLUSIONS

Nursing students were satisfied with facilitators' supervision and by their contribution to fulfillment of overall learning outcomes. Comparisons showed that preceptors in a higher degree were perceived as supportive while clinical lecturers were perceived as more important as challengers for critical thinking, reflection and exchange of experiences between students. The model of supervision seems to be promising, but the roles across facilitators need to be made clearer, especially the head preceptor's role, which seemed to be the most unclear role in this model.

Students' well-being in nursing undergraduate education

BACKGROUND

Although previously the Job-Demand-Control-Support model has been successfully applied in many studies in the field of health care and education, the model was never used for the evaluation of the nursing students' well-being.

OBJECTIVES

The aim of this study was to promote nursing students' well-being. The objective was to verify whether the Job-Demand-Control-Support model is appropriate for the evaluation of their well-being.

DESIGN

The Job-Demand-Control-Support model was implemented and investigated in a multiple-case study, which consisted of two phases. In phase I the students' well-being along with the perceived levels of control, support, and demand for each individual student during their study were identified. These results were used in phase II, where the usefulness of the presented model was evaluated.

SETTINGS

The study was performed at the end of the academic year 2009/2010 in two institutions: Tampere University of Applied Sciences, School of Health Care, Finland (institution 1); and the University of Primorska, Faculty of Health Sciences, Slovenia (institution 2).

PARTICIPANTS

Participants of the study were nursing graduates who finished their studies in 2009/2010 and the Vice-Deans for education of both institutions. The final sample included 83 students in institution 1 and 79 students in institution 2.

METHODS

The case study was combined with a survey (phase I) and an interview (phase II).

RESULTS

Although the students' well-being in these two institutions was different, most students of both institutions perceived their studies as low strain, placid, and only some of the students in both institutions had a high risk of malaise. The Vice-Deans for education of both institutions confirmed that the application of the Job-Demand-Control-Support model provided relevant information on the nursing students' well-being, which helped in planning improved nursing study programmes.

CONCLUSIONS

This study demonstrated that the Job-Demand-Control-Support model is appropriate for estimating undergraduate nursing students' well-being.

Finnish and Swedish nursing students' experiences of their first clinical practice placement--a qualitative study

BACKGROUND

Nursing is a practice-based discipline. Clinical practice settings are important in preparing undergraduate nursing students for the role of registered nurse.

AIM

The aim of this Nordic qualitative study is to illuminate first year undergraduate nursing students' experiences of clinical practice during their first clinical placement, with a focus on preception, reflection, and the link between theory and practice.

METHOD

Data were collected by focus group interviews with 22 nursing students, and analyzed with qualitative content analysis.

FINDINGS

Positive experiences included stimulating and visible preceptors, a permissive atmosphere, and reflection as a matter of course. Negative experiences were related to feelings of abandonment and powerlessness when preceptors were invisible and the atmosphere at the ward was non-permissive. The implementation of research-based knowledge was insufficient.

CONCLUSIONS

A permissive atmosphere and visible preceptors are crucial if learning is to be maximized. Consequently, it is important to set aside time for preceptors to be more visible and to make the atmosphere at the clinical placement more permissive. The student must have the opportunity to combine scientific knowledge with evidence-based knowledge in order to develop nursing actions.

Development and psychometric assessment of the undergraduate nursing student academic satisfaction scale (UNSASS)

BACKGROUND AND PURPOSE

To examine the psychometric properties of a newly developed instrument: The Undergraduate Nursing Student Academic Satisfaction Scale (UNSASS).

METHODS

A self-report test-retest questionnaire was administered to a convenience sample of 313 students enrolled in Bachelor of Science in Nursing (BScN) program in Ontario, Canada.

RESULTS

The psychometric analysis yielded a 48-item multidimensional instrument. Validity testing revealed a content validity index (CVI) of .83. Factor analysis suggested a four-dimension scale with distinct factor loadings that all exceeded .4 and explained 50% of the variance. The scale had an overall Cronbach's alpha coefficient of .96 and a test-retest correlation coefficient of .88, indicating a highly reliable instrument.

CONCLUSIONS

The newly developed instrument provides a tool to comprehensively measure the satisfaction of nursing students with the academic aspects of their nursing programs.

Clinical learning environment and supervision: experiences of Norwegian nursing students - a questionnaire survey

AIM AND OBJECTIVE

To measure nursing students' experiences and satisfaction with their clinical learning environments. The primary interest was to compare the results between students with respect to clinical practice in nursing homes and hospital wards.

BACKGROUND

Clinical learning environments are important for the learning processes of nursing students and for preferences for future workplaces. Working with older people is the least preferred area of practice among nursing students in Norway.

DESIGN

A cross-sectional design.

METHODS

A validated questionnaire was distributed to all nursing students from five non-randomly selected university colleges in Norway. A total of 511 nursing students completed a Norwegian version of the questionnaire, Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale in 2009. Data including descriptive statistics were analysed using the Statistical Program for the Social Sciences. Factor structure was analysed by principal component analysis. Differences across sub-groups were tested with chi-square tests and Mann-Whitney U test for categorical variables and t-tests for continuous variables. Ordinal logistic regression analysis of perceptions of the ward as a good learning environment was performed with supervisory relationships and institutional contexts as independent variables, controlling for age, sex and study year.

RESULTS

The participating nursing students with clinical placements in nursing homes assessed their clinical learning environment significantly more negatively than those with hospital placements on nearby all sub-dimensions.

CONCLUSIONS

The evidence found in this study indicates that measures should be taken to strengthen nursing homes as learning environments for nursing students.

RELEVANCE TO CLINICAL PRACTICE

To recruit more graduated nurses to work in nursing homes, actions to improve the learning environment are needed.

Clinical Nursing Faculty Competence Inventory - development and psychometric testing

AIM

This paper is a report of the development and psychometric testing of the Clinical Nursing Faculty Competence Inventory.

BACKGROUND

Clinical faculty plays a vital role in nursing education. Highly competent clinical faculty is a prerequisite for graduating competent future nurses. Many studies have examined the effectiveness of clinical nursing teaching. Yet, translating this body of knowledge into accurate and comprehensive assessment tools for measuring the competence of nursing faculty remains a challenge.

METHOD

Thirty-one indicators of core competence of clinical nursing faculty were identified thorough literature review, expert consultation and a small sample pilot test. A total of 237 nursing faculty members, students and administrators from six advanced medical colleges in China were surveyed during 2007-2008. Using a five-point Likert-type scale, the respondents identified their level of agreement with statements addressing the components of clinical nursing faculty competence. Exploratory factor analysis was used to determine the factor structure of the inventory.

RESULTS

Students and faculty members valued aspects of clinical nursing faculty competence differently. Exploratory factor analysis using varimax rotation determined construct validity of the inventory and 26 items were retained. Five important categories of clinical nursing faculty competence were revealed: leadership ability, problem solving ability, educational intelligence, general teaching ability and clinical nursing skills. The Cronbach's alpha level of the inventory was 0·91, with each domain ranging from 0·61 to 0·85.

CONCLUSION

The inventory has good psychometric properties and can be used in training and evaluation of clinical nursing faculty.

Perception of hospital learning environment: a survey of Hong Kong nursing students

The last two decades have seen widespread changes to nurse education but the clinical field remains an essential and invaluable resource in preparing students for the reality of their professional role, supporting the integration of theory and practice, and linking the 'knowing what' to do with the 'knowing how' to deliver care. The clinical learning environment represents a vital element of nurse education that needs to be measurable and warrants further investigation. This survey study examined Hong Kong nursing students' perception of the social climate of the clinical learning environment. Participants were invited to complete the two versions, the Actual and Preferred Forms, of the Clinical Learning Environment Inventory following the completion of their clinical field placement. Two hundred eighty one Actual Forms and 243 Preferred Forms returned. SPPS version 11 was employed to analyse data with descriptive and inferential statistics. It was found that there were significant differences between students' perceptions of the actual clinical learning environment and the ideal clinical learning environment they desired. The study highlights the need for a supportive clinical learning environment which is of paramount importance for students in clinical practice.

Use of factor analysis in Journal of Advanced Nursing: literature review

AIM

This paper reports a review analysing the use of factor analysis in papers in Journal of Advanced Nursing.

BACKGROUND

Factor analysis is a multivariate statistical method for reducing large numbers of variables to fewer underlying dimensions. There are several methods of factor analysis with principal components analysis being the most commonly applied. Factor analysis has been used by researchers in nursing for many years but the standards for use and reporting are variable.

METHOD

Papers using factor analysis in Journal of Advanced Nursing were retrieved from 1982 to the end of 2004. The search term 'factor analysis' was used in the CINAHL database and applied specifically to Journal of Advanced Nursing in December 2004. Retrieved papers were included in the review if they came from Journal of Advanced Nursing and used factor analysis as part of the method of the reported study.

RESULTS

One hundred and twenty-four papers were retrieved as a result of the initial search criteria of which 116 were from Journal of Advanced Nursing. Screening of papers for the use of factor analysis left 100 papers for review. Principal components analysis was the most commonly used method of factor analysis; Eigenvalues greater than one was the most commonly applied criterion for selecting the number of factors followed by orthogonal rotation to achieve simple structure. The majority of papers did not report the whole factor solution and there were papers that did not specify anything beyond the fact that they carried out factor analysis. Confirmatory factor analysis was rarely used and exploratory methods other than principal components analysis were also rarely used.

CONCLUSIONS

Factor analysis is quite commonly used in nursing research reported in Journal of Advanced Nursing. While some papers are exemplary there is room for improvement in the reporting of all aspects of factor analysis.

What matters most? Predictors of student satisfaction in public health educational courses

The development of primary care trusts, the health protection agency, and non-medical public health (PH) specialists' pathways requires a competent PH workforce to be in place. Hence, the quality of education and training of PH workers is increasingly critical. With the diversity of courses and programmes that contribute to building a competent PH workforce, few studies have examined the satisfaction of students (and reasons for it) on educational PH programmes. The present study investigated the influences that four demographic variables (gender, disability, ethnicity and age bracket) and seven education-related variables (mode of study, academic term, academic level, pre-/postregistration status, entry qualification, qualification aim and class size) have on PH students' perceptions of satisfaction with 18 aspects of their learning. After controlling for the effects of the other variables, five variables explained 32% of the reported satisfaction levels. These were class size, study mode, qualification aim, pre-/postregistration status and academic level. Part-time students on postgraduate programmes are a particularly vulnerable group who may need extra support from PH educators and trainers. For these students, smaller class sizes could be beneficial, and if larger classes are inevitable, smaller group work sessions within the classes is advocated. Equally important is the availability of library resources required for learning, and course materials, handbooks and briefs need to be clear, informative, user friendly and available early in the course. Satisfied students achieved better final grades, reflecting an increased amount of transferable knowledge. The implications of the study findings for research and practice are discussed.

Hong Kong nursing students’ perception of the clinical environment: a questionnaire survey

Clinical practice is a vital component of the nursing curriculum yet it takes place in a complex social context. This survey examined Hong Kong nursing students' perception of the social climate of the clinical learning environment. The targeted subjects were all Years 2-4 pre-registration nursing students at the school of nursing of a major University in Hong Kong. Participants were invited to complete the two versions, the actual and preferred forms, of the Clinical Learning Environment Inventory following the completion of their clinical field placement. Two hundred and eighty one actual forms and 243 preferred forms were returned. SPPS version 11 was employed to analyse the data using descriptive and inferential statistics. It was found that there were significant differences between students' perceptions of the actual clinical learning environment and the ideal clinical learning environment they desired. The study highlights the need for a supportive clinical learning environment which is of paramount importance in securing the required teaching and learning process for students on clinical practice.

Student learning in clinical nursing education: perceptions of the relationship between assessment and learning

There is a wealth of literature demonstrating that clinical nursing education is an important part of the baccalaureate programme in preparing students for entry into the nursing profession. While much attention has been given to the factors that can affect learning outcomes in the clinical environment, student and teacher perceptions of the relationship between assessment and learning has remained an under-researched area. The purpose of this study was to explore the perceptions about what students learned and how they learned during their clinical practicum, and to examine the role played by assessment in influencing student learning. Data were collected through a series of focus group interviews with groups of nursing students, graduates, and teachers. It was revealed that students' learning during the clinical practicum was, to a large extent, affected by their perceptions of the assessment tasks. As a result, they adopted a surface approach to learning and focused on preparing for the assessment tasks to the detriment of their learning. Assessment, in this study, exerted what has been described as a negative "backwash" effect on learning. Since assessment may also foster student learning in a positive way, suggestions are offered as to what can be done to bring about a positive "backwash" effect.

Experiences of online learning: students' perspective

This paper explores students' views of an online learning initiative within a post-registration degree in nursing in Hong Kong. A self-administered questionnaire was used for data collection. One hundred and ninety eight students completed the study. Online learning was seen to be convenient allowing students to study at their own pace and time. Students reported that online learning enabled them to hold a higher level of accountability for their own learning and to learn independently. Not all experiences were positive. A major hindrance to online learning was the inadequate opportunity for human interaction which was deemed necessary for establishing peer support and developing in-depth group discussion on subject matter. These findings provide a guide for further development and improvement in online teaching and learning methodologies.

Analyzing the Teaching Effectiveness of Clinical Nursing Faculty of Full- and Part-Time Generic BSN, LPN–BSN, and RN–BSN Nursing Students

Effective clinical teaching has been a focus for scrutiny across the health-care disciplines. Nursing researchers have investigated students' and faculty members' views of effective clinical teaching. Various students (diploma, ADN, BSN) and their respective faculty have been studied, and some investigators have researched opinions of part-time students. No study was available that analyzed effective clinical teaching from the perspectives of students representing various formats of nursing education (basic BSN, RN-BSN, LPN-BSN students) and whether they were full or part time. The purpose of the study was to examine full- and part-time basic BSN, LPN-BSN, and RN-BSN students' ratings of effective clinical teaching behaviors. A stratified sample (n = 198) of baccalaureate nursing students (basic, LPN-BSN, RN-BSN) who represented both full- and part-time attendees was obtained. Students were informed about the study's purpose and asked to complete a demographic questionnaire and two instruments, by Knox and Mogan [Knox, J. E., & Mogan, J. (1985). Important clinical teaching behaviors as perceived by university nursing faculty, students, and graduates. The Journal of Nursing Education , 10, 295-301] and Zimmerman and Westfall [Zimmerman, L., & Westfall, J. (1988). The development and validation of a scale measuring effective clinical teaching behaviors. The Journal of Nursing Education , 27, 274-277], measuring perceptions of effective clinical teaching. Responses to open-ended questions were recorded on one instrument. Data were analyzed using summary and inferential statistics utilizing SPSS version 12.0. Responses to open-ended questions were thematically analyzed. Findings from the study demonstrated that part-time students rated their clinical instructors statistically significantly higher in effective clinical teaching and associated subscales. Type of student (basic BSN, LPN-BSN, RN-BSN) did not affect students' ratings. Type of program format and type of student did not interact to affect ratings at a statistically significant level. Implications for nursing education, administration, and future research are delineated.

An Evaluation on Medical Students' Satisfaction with Clinical Education and its Effective Factors

PURPOSE

To evaluate medical students' satisfaction with clinical education during medical internship and the effects of variables in the organizational domain on satisfaction.

METHOD

A cross-sectional descriptive analytic study in 2000 identified students' satisfaction with clinical education in medical students of Tehran University of Medical Sciences. Students' satisfaction was assessed by a modified job satisfaction questionnaire. Clinical education was classified into; outpatient, bedside and theoretical teaching.

RESULTS

Overall satisfaction with clinical education was 38.8%; outpatient and bedside teaching 52% each and theoretical education 70.8%. Overall satisfaction had a significant association with approach to common and epidemic diseases, class size, and the course planning.

CONCLUSION

Based on the present study, we conclude that clinical education should be reevaluated in our university with the specific attention to the class size, variety of diseases and course planning considered for each session in clinical education.