The clinical learning environment, supervision and nurse teacher scale (CLES+T): psychometric properties measured in the context of postgraduate nursing education

Pass or fail: Teachers' experience of assessment of postgraduate critical care nursing students' competence in placement. A qualitative study

BACKGROUND

Learning in placement is essential to postgraduate critical care nursing students' education. Assessment of students' competence in placement is important to ensure highly qualified postgraduate critical care nurses. The placement model applied in Norway involves students being assessed by a preceptor in practice and a teacher from the university. The teacher has a more distant role in placement, and the aim of this study was to explore how the teachers experience the assessment of postgraduate critical care nursing students' competence in placement. Additionally, to explore the content of assessment documents used for postgraduate critical care nursing placement education in Norway.

METHODS

This study has a qualitative design with main data collection from individual interviews with 10 teachers from eight universities and colleges in Norway. Additionally, we performed a document analysis of assessment documents from all 10 universities and colleges providing postgraduate critical care nursing education in Norway. We followed the Consolidated Criteria for Reporting Qualitative Research.

RESULTS

The teachers experienced the assessment of postgraduate critical care nursing students' competence in placement as important but complex, and some found it difficult to determine what critical care nursing competence is at advanced level. A thematic analysis resulted in one main theme: "Teacher facilitates the bridging between education and practice." Furthermore, three themes were identified: "Assessment based on trust and shared responsibility"; "The teacher's dual role as judge and supervisor"; and "A need for common, clear and relevant assessment criteria".

CONCLUSIONS

Teachers have a key role in placement as they contribute to the bridging between education and practice by providing valuable pedagogical and academic input to the assessment process. We suggest that more teachers should be employed in joint university and clinical positions to enhance the collaboration between practice and education. Clear and relevant assessment criteria are essential for providing assessment support for both students and educators. Education and practice should collaborate on developing assessment criteria. Further, there is a need to collaborate on developing, both nationally and internationally, common, clear, relevant and user-friendly assessment tools.

Using a Behavioral Health Integration Model in a Family Nurse Practitioner Residency

BACKGROUND

Primary care serves as an entry point for many patients to access health care services, especially those who reside in medically underserved areas. Because an initiative exists for family nurse practitioners (FNPs) to fill primary care gaps in medically underserved areas, they must be included in educational strategies to provide quality behavioral health care within their scope of practice.

METHOD

An academic-practice partnership was used to provide FNP residents the opportunity to learn to work within their scope of practice in a behavioral health integration model.

RESULTS

The residents noted satisfaction with the learning environment, supervisory relationship, and role of the faculty.

CONCLUSION

Innovative continuing education activities are needed to prepare novice FNPs to safely practice and enter into a health care workforce pipeline focused on reducing disparities in medically underserved areas. [J Contin Educ Nurs. 2024;55(4):203-208.].

Addressing a Critical Voice in Clinical Practice: Experiences of Nursing Students, Teachers, and Supervisors-A Qualitative Study

AIM

Our goal was to explore how power asymmetry manifests within the relationships between students, teachers, and supervisors, and how it influences students' ability for critical reflection.

DESIGN

This study has an explorative qualitative design.

METHODS

Thirty in-depth interviews with nursing students (15), teachers (9), and supervisors (6) were conducted in addition to 16 observations of mid-term assessments during clinical practice. The analysis was conducted using Braun and Clarke's thematic analysis.

RESULTS

The students described being a student as a balancing act between humility, conforming to the supervisor's expectations, and speaking their minds. The view expressed by the teachers and supervisors is that training for the nursing profession is closely linked to the students' ability to act independently. Due to the supervisors' hierarchical position, however, students are hesitant to voice any criticism regarding insufficient supervision or unsatisfactory performance of clinical tasks while at the same time being evaluated on their ability to critically reflect on their own and others' clinical performance. This study was prospectively registered with the Norwegian Centre for Research Data on the 15th of August 2017 with the registration number 54821.

Construction of an evaluation index system for undergraduate nursing teachers' curriculum humanistic competence: a Delphi study in China

BACKGROUND

The curriculum humanistic competence of nursing teachers is important to cultivate the humanistic qualities of undergraduate nursing students. However, there are no evaluation tools for the curriculum humanistic competence of undergraduate nursing teachers in China.

OBJECTIVE

To develop an index system to evaluate the curriculum humanistic competence of undergraduate nursing teachers.

DESIGN

This research conducted a Delphi study.

PARTICIPANTS

Semi-structured interviews were held with 19 experts, and Delphi rounds were conducted with 18 experts.

SETTINGS

This study was conducted in 12 universities and 4 Grade A tertiary hospitals in China.

METHODS

A literature review and semi-structured interviews were conducted to develop an initial framework. A two-round Delphi survey was employed to build the index system for undergraduate nursing teachers' curriculum humanistic competence.

RESULTS

After two rounds of consultation, the index system included 5 first-level indicators, 11 second-level indicators and 41 third-level indicators. The Cr for two rounds of consultation were 0.929 and 0.923, and Kendall's W was 0.152(P<0.001).

CONCLUSIONS

The index system for the evaluation of undergraduate nursing teachers' curriculum humanistic competence offers guidelines for undergraduate nursing teachers in China. It can be used in practice to develop high humanistic qualities in undergraduate nursing teachers.

Factors Associated with Nursing Student Satisfaction with Their Clinical Learning Environment at Wolkite University in Southwest Ethiopia

Background. The clinical learning environment has been defined as “an interactive network of strengths within the clinical environment that influence the clinical learning outcomes of students. Understanding students’ level of satisfaction with their clinical learning environment is crucial to ensuring the required teaching and learning process. Therefore, this study was designed to assess the level of satisfaction with the CLE among nursing students at the Wolkite University of Ethiopia. Methods. A cross-sectional study was conducted at Wolkite University. This study was carried out in March 2022 on 208 student nurses selected by purposive and convenient sampling techniques. This study used the English version of the Clinical Learning Environment and Supervision + Nurse Teacher (CLES + T) evaluation scale. The collected data were cleaned, coded, and entered into Epi data 3.1, and then, statistical analyses were performed using SPSS version 26. Bivariate and multivariable logistic regression models were used to identify factors associated with the satisfaction level of nursing students towards CLE. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated, and $p$ values < 0.05 were considered to indicate statistical significance. Results. More than half of the study participants were females, and nearly half (50.5%) of the participants were in year three of the nursing program. The study found that 39.9% (95%CI: 32.2%, 46.6%) of students were satisfied with their CLE. Factors that had a significant association with the satisfaction level of nursing students towards CLE were gender (female students) (AOR = 16.053 (6.397, 40.286)), year of study (4th year) (AOR = 6.296 (2.679, 14.796)), and the type of the hospital in which their last clinical placement was held (at a primary hospital) (AOR = 2.961 (1.122, 7.815)). Conclusion. Effective nursing education programs need to be developed to increase satisfaction with clinical practice and to promote positive emotional regulation in nursing students. Nurse practitioners and managers should be aware of their important role in the professional development of students and their satisfaction with clinical placements.

First and second cycle nursing students' perceptions of the clinical learning environment in acute care settings - A comparative crossectional study using the CLES+T scale

BACKGROUND

Research has shown that the clinical learning environment can both facilitate and hinder students' learning. Students' perceptions need to be evaluated, preferably using nationally and internationally validated instruments. In Sweden, there is a lack of research about students' evaluation in acute care settings and from the perspectives of different levels of students.

OBJECTIVES

The aim was to explore and compare perceptions of the clinical learning environment of first- and second-cycle nursing students in an acute care setting using the Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T).

DESIGN

The design involves cross-sectional data collection with comparisons between groups.

SETTING AND PARTICIPANTS

Data were collected from a convenience sample of first- and second-cycle students at the end of their clinical placements in an acute care setting at a university hospital.

METHODS

A paper version and a web version of the culturally adapted version of CLES+T was filled out by the students. An independent t-test was used to explore the differences between CLES+T scores and distribution methods and educational level. Internal consistency was evaluated using Cronbach's alpha.

RESULTS

Overall, the students (N = 179) were satisfied with the clinical learning environment. There was no significant difference in the total score (m = 4.31, SD = 0.63) between first- and second-cycle students except for the subscale of "Premises of nursing on the ward" and the individual items "The ward's nursing philosophy was clearly defined" and "Patients received individual nursing care", showing that the first-cycle students were more satisfied compared to the second-cycle students. The scale demonstrated high internal consistency (α = 0.97 vs. 0.96) for the paper survey and the web survey, respectively.

CONCLUSIONS

Our findings provide initial support for the CLES+T as a useful instrument to evaluate the clinical learning environment at different levels of education and in different contexts regardless of distribution method.

Student satisfaction level, clinical learning environment, and tutor participation in primary care clinical placements: An observational study

BACKGROUND

Competence evaluations in the clinical setting represent approximately 50% of the nurse training process. Factors, such as perceived learning environment and clinical nurse participation, may influence nursing student satisfaction during clinical placements.

OBJECTIVE

To evaluate the relationship between the levels of nursing student satisfaction with clinical placements, the clinical learning environment, and the level of nurse tutor participation.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

We included 61 nursing students and 45 clinical nurses from 35 primary care centres assigned to the Universitat Jaume I.

VARIABLES AND DATA COLLECTION

We assessed the overall level of student satisfaction with clinical placements, students' perception of the learning environment, tutors' level of participation, and socio-demographic variables.

DATA ANALYSIS

We performed a descriptive analysis of the study sample, as well as correlation and simple linear regression analyses. Questionnaire results were analysed depending on the nature of the variables.

RESULTS

The students' perception of the learning environment was 4.39 ± 0.48 points out of 5. The overall satisfaction level was 8.89 ± 1.22 points out of 10. Tutor participation level in students learning was 3.91 ± 0.58 points out of 5.

CONCLUSIONS

Both student perception of the learning environment in the clinical setting and their overall level of satisfaction with clinical placements in the primary care centres were considered high. Tutors were participative, but poorly satisfied.

Development of the competency assessment scale for clinical nursing teachers: Results of a Delphi study and validation

BACKGROUND

Highly competent clinical faculty is a prerequisite for graduating competent nurses, and it is very important to explore the comprehensive ability and post competence of clinical nursing teachers (CNT).

OBJECTIVE

To construct the competency evaluation elements of clinical nursing teachers and test the reliability and validity of the scale.

DESIGN

A Delphi study.

SETTINGS

34 Grade A tertiary hospitals and eight colleges and universities in China, covering 14 provinces, autonomous regions, and municipalities directly under the Central Government.

METHODS

Modified Delphi method was used in this study. Between August 2018 and May 2019, 40 experts participated in three rounds of consultation to build the CNT competency assessment scale. The expert coordination coefficient (W) and the coefficient of variation (CV) were used to examine the level of coordination and concentration of expert advice. Then, the reliability and validity of the scale were tested. Using the convenient sampling method, a total of 190 questionnaires were distributed to nursing teachers, and 187 were recovered. Cronbach's α coefficient was used to evaluate the reliability of the scale. Validity was evaluated using the content validity index.

RESULTS

After the three rounds of expert consultation, the questionnaire contained five dimensions and 44 elements. After expert inquiry, the total coefficient of variation index (CVI) value of the scale was 0.992, and the CVI of each item was 0.95-1.00. The Spearman-Brown correlation coefficient was 0.984. By comparing the results of the two surveys 2 months apart, the Pearson correlation coefficient was tested, and the retest reliability was 0.852. The Cronbach's α of the scale was 0.962, indicating excellent internal consistency.

CONCLUSIONS

The scale of clinical nursing teachers' competence has high reliability and validity. This tool could be widely used to evaluate and improve nursing teaching.

Healthcare student-patient relationship and the quality of the clinical learning environment - a cross-sectional study

BACKGROUND

Relationships with patients are seen as the core component of establishing the quality of patient-centred care and promoting patients' autonomy and relevant use of services. A clinical learning environment that emphasizes relationship-based healthcare is essential for encouraging future healthcare professionals to work in partnership with patients. There is also broad agreement that the insight of patients should be used actively in healthcare students' clinical learning. The aim of this study was to describe healthcare students' perceptions of their relationship with patients and the quality of the clinical learning environment and to identify factors associated with both of these.

METHODS

A cross-sectional survey using an electronic questionnaire was applied to collect data from 1644 Finnish healthcare students, mostly nursing students, between January 2018 and May 2018. The data were analysed statistically using descriptive statistics, Spearman's correlation coefficients, and multifactor analysis of variance.

RESULTS

Students perceived the level of the student-patient relationship and the role of the teacher as good while pedagogical atmosphere, premises of care, premises of learning, and supervisory relationship were perceived to be at very good level. The correlations between the student-patient relationship and all clinical learning environment dimensions were perceived as moderate. Furthermore, a number of student-related factors associated with the student-patient relationship and the quality of the clinical learning environment were detected.

CONCLUSIONS

In this study, the rarely explored perspective of the student-patient relationship within the context of the clinical learning environment was included. The student-patient relationship and the quality of the clinical learning environment were perceived as good by the students, with a number of determining factors affecting these perceptions. Giving the student-patient relationship a role in clinical education may be conducive to students' learning with the patient in focus, and may thus promote the competence needed in the rapidly evolving healthcare environment and the changing scope of clinical practice.