Development and testing of a Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students

A scoping review of the questionnaires used for the assessment of the perception of undergraduate students of the learning environment in healthcare professions education programs

The learning environment (LE) includes social interactions, organizational culture, structures, and physical and virtual spaces that influence the learning experiences of students. Despite numerous studies exploring the perception of healthcare professional students (HCPS) of their LE, the validity evidence of the utilized questionnaires remains unclear. This scoping review aimed to identify questionnaires used to examine the perception of undergraduate HCPS of their LE and to assess their validity evidence. Five key concepts were used: (1) higher education; (2) questionnaire; (3) LE; (4) perception; and (5) health professions (HP). PubMed, ERIC, ProQuest, and Cochrane databases were searched for studies developing or adapting questionnaires to examine LE. This review employed the APERA standards of validity evidence and Beckman et al. (J Gen Intern Med 20:1159-1164, 2005) interpretation of these standards according to 5 categories: content, internal structure, response process, relation to other variables, and consequences. Out of 41 questionnaires included in this review, the analysis revealed a predominant emphasis on content and internal structure categories. However, less than 10% of the included questionnaires provided information in relation to other variables, consequences, and response process categories. Most of the identified questionnaires received extensive coverage in the fields of medicine and nursing, followed by dentistry. This review identified diverse questionnaires utilized for examining the perception of students of their LE across different HPs. Given the limited validity evidence for existing questionnaires, future research should prioritize the development and validation of psychometric measures. This will ultimately ensure sound and evidence-based quality improvement measures of the LE in HP education programs.

Appraisal and Evaluation of the Learning Environment Instruments of the Student Nurse: A Systematic Review Using COSMIN Methodology

BACKGROUND

Nursing education consists of theory and practice, and student nurses' perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently available tools for measuring the clinical and educational learning environments of student nurses and to evaluate their measurement properties in order to provide solid evidence for researchers, educators, and clinical tutors to use in the selection of tools.

METHODS

We conducted a systematic review to evaluate the psychometric properties of self-reported learning environment tools in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Guidelines of 2018. The research was conducted on the following databases: PubMed, CINAHL, APA PsycInfo, and ERIC.

RESULTS

In the literature, 14 instruments were found that evaluate both the traditional and simulated clinical learning environments and the educational learning environments of student nurses. These tools can be ideally divided into first-generation tools developed from different learning theories and second-generation tools developed by mixing, reviewing, and integrating different already-validated tools.

CONCLUSION

Not all the relevant psychometric properties of the instruments were evaluated, and the methodological approaches used were often doubtful or inadequate, thus threatening the instruments' external validity. Further research is needed to complete the validation processes undertaken for both new and already developed instruments, using higher-quality methods and evaluating all psychometric properties.

Profiling health professionals' personality traits, behaviour styles and emotional intelligence: a systematic review

BACKGROUND

Non-cognitive traits have been theorised to predict characteristics, career choice and outcomes of health professionals and could represent a homogenous group. This study aims to profile and compare personality traits, behaviour styles and emotional intelligence of health practitioners across a variety of professions.

METHODS

Empirical literature was systematically reviewed. A two-concept search strategy was applied to four databases (CINAHL, PubMed, Embase, ProQuest). Title/abstract and full text articles were screened against inclusion and exclusion criteria. Methodological quality was assessed using Mixed Methods Appraisal Tool. Data was synthesised narratively and meta-aggregated where feasible.

RESULTS

Three hundred twenty-one studies representing 153 assessment tools of personality (n = 83 studies), behaviour (n = 8), and emotional intelligence (n = 62) were included. Most studies (n = 171) explored personality (medicine, nursing, nursing assistants, dentistry, allied health, paramedics), revealing variation in traits across professions. Behaviour styles were least measured with only ten studies exploring these across four health professions (nursing, medicine, occupational therapy, psychology). Emotional intelligence (n = 146 studies) varied amongst professions (medicine, nursing, dentistry, occupational therapy, physiotherapy, radiology) with all exhibiting average to above-average scores.

CONCLUSION

Personality traits, behaviour styles and emotional intelligence are all key characteristics of health professionals reported in the literature. There is both heterogeneity and homogeneity within and between professional groups. The characterisation and understanding of these non-cognitive traits will aid health professionals to understand their own non-cognitive features and how these might be useful in predicting performance with potential to adapt these to enhance success within their chosen profession.

Developing the SVN CLEI: A Novel Psychometric Instrument for Evaluating the Clinical Learning Environment of Student Veterinary Nurses in the UK

Student veterinary nurses (SVNs) in the United Kingdom can spend over half their training time within the clinical learning environment (CLE) of a training veterinary practice before achieving clinical competency. Sociocultural complexities and poor management within the CLE may have a significant impact on the learning experiences of SVNs, as has been found in studies involving student human nurses. The aim of this research was to develop and validate the SVN CLE Inventory (CLEI) using principal component analysis (PCA), via a cross-sectional design, based on inventories already established in human nursing CLEs. The SVN CLEI was distributed to SVNs via an online survey over a 3-month period, generating 271 responses. PCA resulted in a valid and reliable SVN CLEI with 25 items across three factors with a total variance explained of 61.004% and an overall Cronbach's alpha (α) of .953 (factor 1: clinical supervisor support of learning [α = .935]; factor 2: pedagogical atmosphere of the practice [α = .924]; factor 3: opportunities for engagement [α = .698]). Gaining student feedback is a requirement set out by the Royal College of Veterinary Surgeons Standards Framework for Student Veterinary Nurse Education and Training, and the SVN CLEI can be used to complement the current evaluation of the training veterinary practice CLE. This will facilitate development of a more comparable, consistent, and positive experience for SVNs during clinical training in the UK.

Assessing Professional Competencies Among Undergraduate Nurses: An Exploratory Study

AIM

The study aimed to identify nursing students' professional competencies and examine which factors of the clinical learning environment affect these competencies.

BACKGROUND

Professional competencies are vital for the quality and safety of nursing practice. The learning environment is important for the development of professional competencies.

METHOD

Data were collected from 178 nursing students using the Clinical Learning Environment and Supervision Scale and the Nursing Professional Competencies Scale-Short Form.

RESULTS

The highest competency was achieved in value-based nursing care; the lowest competency was achieved in development, leadership, and organization of nursing. Factors such as positive pedagogical atmosphere, nursing care on the ward, and good supervisory relationship affected learning and, in turn, improved professional competencies.

CONCLUSION

The results establish a link between the clinical environment and reported professional competencies, leading to a call for more focused coverage of these factors in the academic curricula.

Psychometric properties of the clinical learning environment, Supervision and Nurse Teacher scale (CLES+T) for undergraduate nursing students in Hong Kong

The Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale is useful for understanding students' perceptions towards clinical placement and for measuring the quality of clinical education. Validated versions of the scale are only available for Western countries. Therefore, this study aimed to establish the validity and reliability of the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale for undergraduate nursing students in Hong Kong. Six experts including clinical mentors, clinical teachers, advanced practice nurse and nursing students participated in phase 1. Fifteen nursing students participated in phase 2 and 178 nursing students participated in phase 3 of this study during January 2017 to June 2017. The Scale-Content Validity Index was 0.93 and the Item-Content Validity indexes ranged from 0.83 to 1. Exploratory factor analysis indicated a 6-factor solution (i.e. "supervisory relationship", "role of nurse teacher", "leadership style of ward manager", "premises of nursing on the ward appreciated", "interaction with staff" and "learning atmosphere"). The internal consistency was good (Cronbach's alpha = 0.94) and test-retest reliability over a 2-week interval was satisfactory (Pearson's coefficient = 0.85). The Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale showed acceptable psychometric properties for use as an evaluation scale in Hong Kong.

Evaluation of midwifery students' satisfaction with regards to clinical internship

Background and aim of the work.

The clinical internship is fundamental for the training of the future socio-health professional. Through the practical activity, the student develops professional skills, critical thinking and decision-making ability, internalizing the complexity of the professional role. While in the nursing field there are several tools for assessing the clinical experience of students, in the obstetric field there is a lack of validated tools. Therefore, the purpose of this work was to investigate the perception of the students of the Degree Course in Midwifery regarding the internship experience.

Method.

The study was conducted at the obstetric clinical internship where students carry out practical activities and involved all the students of the Degree Course in Midwifery at the University of Modena and Reggio Emilia. The data were collected through an anonymous online questionnaire (Google Model), which was inspired by the nursing CLES + T, simplified and adapted to the obstetric field.

Results.

In total, 54 students took part in the research (81.8% of all students enrolled in the degree program examined). They were mainly of Italian nationality (98.1%), women (94.4%), aged between 18-22 years (85.2%). In general, the third-year students were more satisfied with the internship experience than the second- and first-year students, most likely for having achieved a degree of autonomy of care, awareness and greater professional motivation.

Conclusions.

The results indicate the need to periodically investigate the quality and satisfaction of the clinical internships to ensure increasingly effective obstetric training. (www.actabiomedica.it)

The Turkish version of the Nursing Students' Perceptions of Instructor Caring Scale: An assessment of psychometric properties

PURPOSE

The aim of this study was to determine the psychometric properties of the Turkish version of the Nursing Students' Perceptions of Instructor Caring (NSPIC-Tr) Scale.

DESIGN AND METHODS

Methodological study. The sample of this study consisted of 344 nursing students.

FINDINGS

Its four-factor structure was confirmed with explanatory factor analysis (EFA) and confirmatory factor analysis (CFA) results. The results of CFA showed that the scale's fit index supported the EFA. The scale's Cronbach's alpha internal consistency coefficient had high reliability.

PRACTICE IMPLICATIONS

NSPIC-Tr is a valid and reliable scale for the assessment of Turkish nursing students' perceptions of instructor caring.

Facebook addiction and personality

This study explored the associations between Facebook addiction and personality factors. A total of 114 participants (age range of participants is 18-30 and males were 68.4% and females were 31.6 %) have participated through an online survey. The results showed that 14.91 % of the participants had reached the critical polythetic cutoff score, and 1.75 % has reached the monothetic cutoff score. The personality traits, such as extraversion, openness to experience, neuroticism, agreeableness, conscientiousness, and narcissism, are not related to Facebook addiction and Facebook intensity. Loneliness was positively related to Facebook addiction, and it significantly predicted Facebook addiction by accounting to 14% of the variation in Facebook addiction. The limitations and suggestions for further research have been discussed.

Translation and validation of a Vietnamese version of the modified Clinical Learning Environment Inventory (V-CLEI)

The quality of students' experiences in an education environment directly affect learning outcomes. In an applied profession such as nursing, students undertake work-integrated learning in unpredictable health settings where multiple influences interact. Understanding students' perspectives with a valid instrument is the first step in improving learning environments and maximizing learning outcomes. It is important that language and cultural nuances are accounted for when instruments are translated. This paper reports translation and psychometric properties of the Vietnamese language version (V-CLEI) of the modified English language Clinical Learning Environment Inventory (CLEI) (Newton et al., 2010). The V-CLEI was tested with a convenience sample of 209 Vietnamese nursing students to assess clinical learning experiences in hospitals in central Vietnam. The internal consistency, test-retest reliability, content validity and factor structure of the V-CLEI were examined. Results indicate that the V-CLEI is unlikely to be valid and reliable in the Vietnamese context and revision is required. This study informs research, particularly the different cultural dimensions considered when translating and adapting instruments.

Evaluation of the Clinical Learning Experience of Nursing Students: a Cross-Sectional Descriptive Study

The purpose of the cross-sectional descriptive study was to explore and compare the students’ experiences of the clinical environment and supervision in Slovakia. Students’ clinical learning experience were measured by the valid and reliable clinical learning instrument. A higher frequency of successful supervisory experience was found in the universities which provided accredited mentor preparation programmes or courses and individualised supervisory approaches. Frequency of supervision meetings, the occupational title of a supervisor and mainly the supervision model have an association with students ‘perceptions of different domains of clinical learning environment. The duration of the placement was not related to students’ experience and perceptions of the learning environment. Slovak students reported higher score regarding the quality of nursing care or ward culture than in the supervisory relationships between students, clinical and school staff. Further studies in this field, extended to different Eastern European countries and clinical settings, may help us to understand factors affecting workplace training.

Clinical Supervision and Support: Exploring Pre-registration Nursing Students' Clinical Practice in Malawi

Background:

Supervised clinical practice plays a significant role in the nursing profession, as it has an influence on the students’ clinical learning.

Objectives:

The aim of this study was to explore how the pre-registration nursing students find their experience on clinical supervision in the clinical placements.

Methods:

The study used both quantitative and qualitative approach to collect data through focus groups (n = 144) and self-administered questionnaires (n = 590) from nursing students of various programmes in selected colleges in Malawi.

Results:

About 75% (n = 443) of the participants indicated that they received supervision from both clinical staff and Nurse Educator. However, qualitative results indicated that students received inadequate clinical supervision. Themes that emerged from the discussion included lack of human resources, learning support, availability of instructors yet not supporting learning, job insecurity and lack of remuneration as reasons for lack of supervision, role models and student guidance despite pressure and self-directed.

Conclusion:

There is a need for clear policies regarding clinical supervision as well as a structured and well monitored process.

Italian version of Nursing Students' Perception of Instructor Caring (I-NSPIC): assessment of reliability and validity

BACKGROUND

Clinical experience is an essential component of nursing education since it provides students with the opportunity to construct and develop clinical competencies. Instructor caring is a pivotal facilitator at the forefront of clinical education, playing a key and complex educating role in clinical sectors. For these reasons the aims of this study was to assess the validity and reliability of the Italian version of NSPIC (I-NSPIC).

METHODS

A validation multicentre study was conducted in three different Italian universities. A total of 333 nursing students were enrolled in the 2014/2015 academic year. Exploratory factor analysis (EFA) with oblique rotation was performed to test the construct validity of I-NSPIC. The Cronbach's alpha coefficient and test retest via Intraclass Correlation Coefficient (ICC) analyses were done to assess the internal consistency and stability of the scale. A Spearman's correlation with another scale (CLES-T) was used to examine the concurrent validities.

RESULTS

Four factors (control versus flexibility, supportive learning climate, confidence through caring, appreciation of life meaning and respectful sharing) were identified in EFA. The Cronbach's alpha value showed that I-NSPIC was a reliable instrument (α = 0.94) and the ICC coefficient was satisfactory.

CONCLUSION

The I-NSPIC is a valid instrument for assessing the perception of instructor caring in Italian nursing students. It may also prove helpful in promoting the caring ability of nursing students and in increasing the caring interactions in the relationship between instructor and nursing students. The knowledge emerged from this study provide important insight in developing effective training strategies in the clinical training of undergraduate nursing students.

Comparison of Differing Clinical Schedules for Nursing Students

Maximizing student clinical schedules involves a range of nurse educator activities including scheduling, placement, and learning activity construction. The purpose of this study was to compare opportunities for students to develop their psychomotor skills on the clinical unit and perceptions of clinical experiences across 6-hour day, 6-hour evening, and 12-hour day schedules in an acute care setting. The main finding was that 12-hour schedules provided an overall significantly higher rate of skill opportunities than either of the other 6-hour schedules.

The clinical learning environment in nursing education: a concept analysis

AIM

The aim of this study was to report an analysis of the clinical learning environment concept.

BACKGROUND

Nursing students are evaluated in clinical learning environments where skills and knowledge are applied to patient care. These environments affect achievement of learning outcomes, and have an impact on preparation for practice and student satisfaction with the nursing profession. Providing clarity of this concept for nursing education will assist in identifying antecedents, attributes and consequences affecting student transition to practice.

DESIGN

The clinical learning environment was investigated using Walker and Avant's concept analysis method.

DATA SOURCES

A literature search was conducted using WorldCat, MEDLINE and CINAHL databases using the keywords clinical learning environment, clinical environment and clinical education. Articles reviewed were written in English and published in peer-reviewed journals between 1995-2014.

METHODS

All data were analysed for recurring themes and terms to determine possible antecedents, attributes and consequences of this concept.

RESULTS

The clinical learning environment contains four attribute characteristics affecting student learning experiences. These include: (1) the physical space; (2) psychosocial and interaction factors; (3) the organizational culture and (4) teaching and learning components. These attributes often determine achievement of learning outcomes and student self-confidence.

CONCLUSION

With better understanding of attributes comprising the clinical learning environment, nursing education programmes and healthcare agencies can collaborate to create meaningful clinical experiences and enhance student preparation for the professional nurse role.

Psychometric Testing of the Greek Version of the Clinical Learning Environment-Teacher (CLES+T)

Clinical practice is an important part of nursing education, and robust instruments are required to evaluate the effectiveness of the hospital setting as a learning environment. The study aim is the psychometric test of the Clinical Learning Environment+Teacher (CLES+T) scale-Greek version. 463 students practicing in acute care hospitals participated in the study. The reliability of the instrument was estimated with Cronbach's alpha coefficients. The construct validity was evaluated using exploratory factor analysis (EFA) with Varimax rotation. Convergent validity was examined by measuring the bivariate correlations between the scale/subscales. Content, validity and semantic equivalence were examined through reviews by a panel of experts. The total scale showed high internal consistency (α=0.95). EFA was identical to the original scale, had eigen values larger than one and explained a total of 67.4% of the variance. The factor with the highest eigen value and the largest percentage of variance explained was "supervisory relationship", with an original eigenvalue of 13.1 (6.8 after Varimax rotation) and an explanation of around 38% of the variance (or 20% after rotation). Convergent validity was examined by measuring the bivariate correlations between the scale and a question that measured the general satisfaction. The Greek version of the CLES+T is a valid and reliable instrument that can be used to examine students' perceptions of the clinical learning environment.

Psychometric properties of the Scale for Quality Evaluation of the Bachelor Degree in Nursing Version 2 (QBN 2)

To evaluate all the variables that affect nursing education is important for nursing educators to have valid and reliable instruments that can measure the perceived quality of the Bachelor Degree in Nursing. This study testing the Scale for Quality Evaluation of the Bachelor Degree in Nursing instrument and its psychometric properties with a descriptive design. Participant were first, second and third year students of the Bachelor Degree in Nursing Science from three Italian universities. The Scale for Quality Evaluation of Bachelor Degree in Nursing consists of 65 items that use a 4 point Likert scale ranging from "strongly disagree" to "strongly agree". The instrument comes from a prior version with 41 items that were modified and integrated with 24 items to improve reliability. Six hundred and fifty questionnaires were completed and considered for the present study. The mean age of the students was 24.63 years, 65.5% were females. Reliability of the scale resulted in a very high Cronbach's alpha (0.96). The construct validity was tested with factor analysis that showed 7 factors. The Scale for Quality Evaluation of the Bachelor Degree in Nursing, although requiring further studies, represents a useful instrument to measure the quality of the Bachelor Nursing Degree.

Exploratory Factor Analysis of the Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T)

Background and Purpose: The Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) scale measures student nurses’ perceptions of clinical learning environments. This study evaluates the construct validity and internal reliability of the CLES+T in hospital settings in New Zealand. Comparisons are made between New Zealand and Finnish data. Methods: The CLES+T scale was completed by 416 Bachelor of Nursing students following hospital clinical placements between October 2008 and December 2009. Construct validity and internal reliability were assessed using exploratory factor analysis and Cronbach’s alpha. Results: Exploratory factor analysis supports 4 factors. Cronbach’s alpha ranged from .82 to .93. All items except 1 loaded on the same factors found in unpublished Finnish data. The first factor combined 2 previous components from the published Finnish component analysis and was renamed: connecting with, and learning in, communities of clinical practice. The remaining 3 factors (Nurse teacher, Supervisory relationship, and Leadership style of the manager) corresponded to previous components and their conceptualizations. Conclusion: The CLES+T has good internal reliability and a consistent factor structure across samples. The consistency across international samples supports faculties and hospitals using the CLES+T to benchmark the quality of clinical learning environments provided to students.

The South African Military Nursing College Pupil Enrolled Nurses’ experiences of the clinical learning environment

The study focused on the clinical learning experiences of Pupil Enrolled Nurses (PENs) within the military health service. The purpose of the research was to explore and describe the learning experiences of PENs within the Military health clinical learning environment. An explorative, descriptive, contextual design which is qualitative in nature was used to guide the study. The military as a training institution prides itself on preparing nurses both as soldiers and nurses, this could be both challenging and exasperating for students, as the scopes are diverse. Being notably very hierarchical, the military’s rules constantly take precedence over nursing rules. For the duration of nursing training, students are allocated in the clinical learning area to acquire competencies such as problem solving, cognitive and psychomotor skills (Kuiper & Pesut 2003:383). Students learn how to merge theory and practice and apply theories in the practical sense. This is however, not done in isolation from the military codes, as they are intertwined. Attendance of military parades and drills are incorporated during this phase. This could create missed opportunities from the clinical learning as students are expected to leave the clinical setting for this purpose. Three focus group sessions were conducted and the experiences of the students, as narrated by themselves, yielded valuable insights. The researcher wrote field notes and assisted with the management of the audio tapes for easy retrieval of information. Data was analysed by the researcher, independent of the cocoder. Two themes relating to the PENs’ learning experiences emerged from the data analysed: (1) facilitators of clinical learning, (2) and barriers to clinical learning. The findings obtained depicted those factors which facilitated and obstructed student learning. These findings made it possible for the researcher to make recommendations concerning positive interventions which could be taken to enhance learning.Die studie het gefokus op die kliniese leerervarings van leerling-ingeskrewe verpleegkundiges (LIV’s) in die militêre gesondheidsdiens. Die doel met die navorsing is om die kliniese leerervarings van LIV’s binne die militêre gesondheidsomgewing te verken en te beskryf. ’n Verkennende, beskrywende, kontekstuele ontwerp, kwalitatief van aard, is gebruik om die studie te rig. As ’n opleidingsinstituut roem die weermag hulle op die opleiding van verpleegkundiges as soldate, en nie slegs verpleegkundiges nie. Dit kan uitdagend sowel as frustrerend vir studente wees omdat die omvang van hierdie opleiding so divers is. In die weermag, bekend vir sy hiërargie, geniet militêre reëls gedurig voorrang bo verpleegkundige reëls. Vir die duur van die verpleegopleiding word studente aan die kliniese leerareas toegewys om vaardighede soos probleemoplossing en kognitiewe en psigomotoriese vaardighede te bekom (Kuiper & Pesut 2003:383). Studente leer hoe om teorie en praktyk te verenig en teorie in die praktyk toe te pas. Dit word egter nie geïsoleerd van militêre kodes gedoen nie, aangesien dit alles vervleg is. Bywoning van militêre parades en drilsessies moet in hierdie fase geïnkorporeer word. Dit kan tot verbeurde kliniese opleidingsgeleenthede lei, aangesien daar van studente verwag word om die kliniese omgewing vir hierdie doeleindes te verlaat. Drie fokusgroepsessies is gehou en die ervarings van die studente, soos deur hulleself vertel, het waardevolle insigte gelewer. Die navorser het veldnotas gemaak en was behulpsaam met die hantering van bandopnames om die herroeping van inligting te vergemaklik. Die navorser het die data onafhanklik van die medekodeerder geanaliseer. Twee temas met betrekking tot die leerervarings van LIV’s het na afloop van die data-analise aan die lig gekom: (1) fasiliterende faktore vir kliniese leerervaring, (2) struikelblokke tot kliniese leerervaring. Die bevindinge dui op faktore wat die studente se leerervaring fasiliteer, asook struikelblokke tot leerervaring. Na aanleiding van hierdie bevindinge het dit moontlik gemaak vir die navorser om aanbevelings te maak aangaande positiewe intervensies wat toegepas kan word ter bevordering van die leerervaring.

Perceptions of extrinsic factors that contribute to a nursing internship experience

Clinical learning experiences have always been considered a hallmark of nursing education. Introduced in 2004, the ten-week paid internship is a fourth year summer course offered to select students who have demonstrated strong academic and clinical performance. The purpose of this paper is to report the findings of a study designed to explore student and staff perceptions about extrinsic factors that promote or impede learning during a nursing internship course. A descriptive exploratory design was used to conduct this research. Findings have been grouped into two main themes: extrinsic factors that promote interns' learning and extrinsic factors that impede interns' learning. The sub-themes under extrinsic factors that promote interns' learning are: staff making themselves available, having knowledge of policy, and units setting the tone for success. The sub-themes under extrinsic factors that impede interns' learning are: difficulty accessing staff, lack of knowledge of policy, and units not setting the tone for success. It is apparent that the factors identified in this study are similar to those found in the literature. It is striking that research findings of multiple studies examining factors that affect clinical learning converge regardless of the context or clinical learning models examined.

Dundee Ready Education Environment Measure: psychometric testing with Chinese nursing students

AIM

This paper is a report of the psychometric testing of the Dundee Ready Education Environment Measure with Chinese nursing students.

BACKGROUND

Although the Dundee Ready Education Environment Measure has been widely used to measure educational environments in the healthcare professions, no psychometric evaluation of the measure with Chinese nursing students has been reported.

METHOD

Data from 214 nursing students were collected during a 2-month period between December, 2004 and January, 2005. Exploratory factor analysis, internal consistency reliability and Cronbach's alpha were examined.

RESULTS

Five factors were found by principal components analysis with Oblimin with Kaiser Normalization rotation. The original factor names were maintained, but items in each factor changed. These five factors all achieved eigenvalues >1, and in total accounted for 52.186% of the variance. Cronbach's alpha ranged from 0.623 to 0.9 across factors, with an overall alpha of 0.949.

CONCLUSION

The Chinese version of the Dundee Ready Education Environment Measure could be a valuable measurement for nursing educators in professional development programmes and nursing curriculum design. Further studies need in different Chinese nursing schools and larger sample sizes to be conducted to validate its stability and factor structure.