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

The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study

BACKGROUND

Clinical practice is a core component of nurse education. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, satisfaction, as well as influence their choice of future career. To examine nursing students' perception of clinical learning environment and mentoring in hospital where they perform their clinical placement and the connection of these factor with intention to work as a nurse once graduated.

METHODS

Nursing students enrolled in clinical practice at least 6 months in hospitals in China were surveyed between January-March 2021. Percentages, frequencies, mean, standard deviation, t-test, ANOVA, and regression analysis were used to analyse the data.

RESULTS

Of the five scales in the CLES+T, 'Leadership style of the ward manager' scored the highest mean while 'Pedagogical atmosphere at the ward' scored the lowest. Nursing students with lower educational level, those supervised by fixed preceptor, and those intent to be a nurse in the future were significantly more satisfied with the CLES+T. Most of the nursing students are intent to work as a nurse in the future. CLES+T total scores and sub-dimensions (Premises of nursing on the ward) have significantly effectiveness on the intention to be a nurse in the future.

CONCLUSIONS

Given the significant correlation of between learning environments and nursing students intention to be a nurse in the future, ward managers need to build a good clinical teaching atmosphere and promote opportunities for theoretical and practical connections among students through effective feedback mechanisms, which can enable students to experience a better clinical learning environment and meaningful experiences to build their professional roles and competencies, thus helping to enhance students' willingness to pursue nursing careers in the future.

Evaluation of the Midwifery Student Evaluation of Practice (MidSTEP) tool using Rasch analysis

PROBLEM

Quantitative feedback from students about their clinical learning experiences is used to inform program quality, but the extent to which tools are reliable, valid and refined receives less attention.

AIM

To evaluate the psychometric properties of the Midwifery Student Evaluation of Practice (MidSTEP) tool using Rasch analysis.

METHODS

The Midwifery Student Evaluation of Practice tool was completed by Bachelor of Midwifery students (n = 901) attending seven universities in Australia and New Zealand. The tool consists of the Clinical Learning Environment Scale (16 items) and Impact of the Midwifery Preceptor Scale (10 items), each with two subscales. Rasch analysis was conducted on all subscales separately using the partial credit model of RUMM2030. Response format, item fit, dimensionality of the scale and its targeting were assessed.

RESULTS

Rasch analysis confirmed the internal construct validity of the Clinical Learning Environment and Impact of the Midwifery Preceptor subscales, with no evidence of mis-fitting items, local dependency or multidimensionality. The 4-point response scale was found to be appropriate, and internal consistency reliability of each subscale was good.

DISCUSSION

Results provide support for the reliability and validity of the Midwifery Student Evaluation of Practice tool. The four subscales can confidently be used in undergraduate midwifery clinical education. The use of Rasch analysis is consistent with growing awareness in health and education of the need to apply more advanced, sophisticated psychometric techniques to ensure measures are suitable for their intended use.

TWEETABLE ABSTRACT

Midwifery students clinical learning experiences should be measured using robust tools. MidSTEP is reliable and valid.

Clinical learning environment, supervision and nurse teacher scale (CLES+T): Psychometric evaluation of the Chinese version

BACKGROUND

Clinical learning environment plays a vital role in nursing clinical education. The Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) scale is a reliable and valid instrument to evaluate the quality of the clinical learning process in international nursing education contexts.

OBJECTIVES

To validate the Chinese version of the CLES+T scale that is in line with the Chinese culture and educational context.

DESIGN

A cross-sectional survey.

SETTING

Data were collected from nursing students in six provinces in different parts of China between September and October 2018.

PARTICIPANTS

Six hundred and ninety-four nursing students participated in this study.

METHODS

Purposeful sampling was used, and students completed online survey to explore the structure of the CLES+T scale. Internal consistency reliability was tested on the total scale and its sub-dimensions using Cronbach's alpha.

RESULTS

An exploratory factorial analysis identified a three-component solution, with 11 items, and explained 60.01% of the variance. Confirmatory factor analysis supported the factor structure. Cronbach's alpha coefficient for the scale was 0.82, and those of the three subscales were 0.79, 0.71, and 0.70.

CONCLUSIONS

The unique, stable and relatively concise Chinese version of CLES+T scale instrument could be a useful instrument for using as an assessment scale in Chinese-speaking countries.

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.

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

Background

The Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T) instrument is internationally used for the evaluation of clinical learning environment in undergraduate nursing education. However, no evidence is available on the possible applications of this instrument in the context of postgraduate nursing education.

Purpose

To examine the basic psychometric properties of CLES+T in the context of clinical postgraduate nursing education in Poland.

Methods

Study among a sample of 417 nurses participating in the clinical postgraduate training in Poland.

Results

Cronbach's alpha for the total scale was 0.97. A five-factor structure was confirmed in accordance with the assumptions adopted by the authors of the original version of the scale. Cronbach's alpha coefficient for the Polish version of the CLES+T subscales ranged from 0.83 (Nursing care on the ward) to 0.95 (The content of supervisory relationship). The mean results for individual subscales ranged from 4.52 ± 0.63 for nursing care on the ward to 4.73 ± 0.45 for role of the nurse teacher.

Conclusions

Having shown satisfactory psychometric properties, CLES+T can be considered a useful instrument to assess those elements of clinical learning environment which are important for the assurance of education quality at the postgraduate level.

The Clinical Learning Environment, Supervision and the Nurse Teacher Evaluation Scale: Turkish Version

AIM

The aim of this study is to adapt the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale to the Turkish language and culture.

METHODS

This psychometric test was conducted in a nursing school in Ankara, Turkey, from April to June 2014. Convenience sampling was used. The sample of this study was 190 third- and fourth-year nursing students. The items of the scale were evaluated by Pearson correlation coefficient for correlation-based item analysis. Cronbach's alpha, test and retest analysis were used to measure reliability. Exploratory factor analysis and correlation analysis were performed to determine validity. Principal component analysis was used to analyze factor.

RESULTS

The subscales' Cronbach's alpha values were varied between .760 and .933. A positive relationship was found between tests and retests points of the subscales (P < .05). Five factors were identified in the exploratory factor analysis. There was a meaningful correlation between subscale points of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale and the Clinical Learning Environment Scale (P < .05).

CONCLUSION

The Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale was validated and a reliable measurement tool. It can be used to evaluate clinical nursing education in Turkey.

Quality assurance of the clinical learning environment in Austria: Construct validity of the Clinical Learning Environment, Supervision and Nurse Teacher Scale (CLES+T scale)

BACKGROUND

Within nursing education, the clinical learning environment is of a high importance in regards to the development of competencies and abilities. The organization, atmosphere, and supervision in the clinical learning environment are only a few factors that influence this development. In Austria there is currently no valid instrument available for the evaluation of influencing factors.

OBJECTIVES

The aim of the study was to test the construct validity with principal component analysis as well as the internal consistency of the German Clinical Learning Environment, Supervision and Teacher Scale (CLES+T scale) in Austria.

METHOD

The present validation study has a descriptive-quantitative cross-sectional design. The sample consisted of 385 nursing students from thirteen training institutions in Austria. The data collection was carried out online between March and April 2016. Starting with a polychoric correlation matrix, a parallel analysis with principal component extraction and promax rotation was carried out due to the ordinal data.

RESULTS

The exploratory ordinal factor analysis supported a four-component solution and explained 73% of the total variance. The internal consistency of all 25 items reached a Cronbach's α of 0.95 and the four components ranged between 0.83 and 0.95.

CONCLUSION

The German version of the CLES+T scale seems to be a useful instrument for identifying potential areas of improvement in clinical practice in order to derive specific quality measures for the practical learning environment.