ABSTRACTBackground: Clinical learning is a vital component of nurse education and assessing student’s experiences can provide useful insights for development. Whilst most research in this area has focused on the acute setting little attention has been given to all pre-registration nurses’ experience across the clinical placements arenas. Objectives: To examine of pre-registration nursing students (first, second and third year) assessment of their actual experiences of their most recent clinical learning clinical learning experience.Design: A cross sectional survey involving a descriptive online anonymous questionnaire based on the clinical learning environment inventory tool.Settings: One higher education institution in the United KingdomParticipants: Nursing students (n=147) enrolled in an undergraduate nursing degree.Methods: This questionnaire included demographic questions and the Clinical Learning Environment Inventory (CLEI) a 42 item tool measuring student’s satisfaction with clinical placement. SPPS version 22 was employed to analyse data with descriptive and inferential statistics.Results: Overall students were satisfied with their clinical learning experience across all placement areas. This was linked to the 6 constructs of the clinical learning environment inventory; personalization, innovation, individualization, task orientation, involvement, satisfaction. Significant differences in student experience were noted between age groups and student year but there was no difference noted between placement type, age and gender.Conclusions: Nursing students had a positive perception of their clinical learning experience, although there remains room for improvement. Enabling a greater understanding of students perspective on the quality of clinical education is important for nursing education and future research.
Bibliographical noteReference text: References
Abdollahimohammad, A., Ja'afar, R., 2014. Learning style preferences of nursing students
at two universities in Iran and Malaysia education. Eval. Health Prof. 11 (30). http://
Allan, T.H., Smith, P., O'Driscoll, M., 2011. Experiences of supernumerary status and the
hidden curriculum in nursing: a new twist in the theory–practice gap? J. Clin. Nurs.
20 (5–6), 847–855.
Awuah-Peasah, D., Akuamoah Sarfo, L., Asamoah, F., 2013. The attitudes of student
nurses toward clinical work. Int. J. Nurs. Midwifery 5 (2), 22–27.
Berntsen, K., Bjørk, I.T., 2010. Nursing students' perceptions of the clinical learning
environment in nursing homes. J. Nurs. Educ. 49 (1), 17–22.
Bigdeli, S., Pakpour, V., Aalaa, M., Shekarabi, R., Sanjari, M., Haghani, H., Mehrdad, N.,
2015. Clinical learning environments (actual and expected): perceptions of Iran
University of Medical Sciences nursing students. Med. J. Islam. Repub. Iran (MHIRI)
289 (173), 1–8.
Bjørk, I.T., Berntsen, K., Brynildsen, G., Hestetun, M., 2014. Nursing students' perceptions
of their clinical learning environment in placements outside traditional hospital
settings. J. Clin. Nurs. 23, 2958–2967.
Boyd-Turner, D., Bell, E., Russell, A., 2016. The influence student placement experience
can have on the employment choices of graduates: a [pediatric nursing context].
Nurse Educ. Today 16 (1), 263–268.
Boynton, P.M., 2004. Administering, analysing and reporting your questionnaire. Br.
Med. J. 328, 1372–1375.
Brown, T., Williams, B., McKenna, L., Palermo, C., McCall, L., Roller, L., Hewitt, L.,
Molloy, L., Baird, M., Aldabah, L., 2011. Practice education learning environments:
the mismatch between perceived and preferred expectations of undergraduate health
science students. Nurse Educ. Today 31 (8), 22–28.
Callaghan, A., 2011. Student nurses' perceptions of learning in a perioperative placement.
J. Adv. Nurs. 67 (4), 854–864.
Chan, D.S., 2002. Development of the clinical learning environment inventory: using the
theoretical framework of learning environment studies to assess nursing students'
perceptions of the hospital as a learning environment. J. Nurs. Educ. 41, 69–75.
Chan, D.S., 2003. Validation of the clinical learning environment inventory. West. J.
Nurs. Res. 25 (5), 519–532.
Chan, D.S., 2004. Nursing students' perceptions of hospital learning environments: an
Australian perspective. Int. J. Nurs. Educ. Scholarsh. 1, 1.
Chan, D.S., Ip, W.Y., 2007. Perception of hospital learning environment: a survey of Hong
Kong nursing students. Nurse Educ. Today 27 (7), 677–684.
Chuan, O.L., Barnett, T., 2012. Student, tutor and staff nurse perceptions of the clinical
learning environment. Nurse Educ. Pract. 12 (4), 192–197.
Courtney-Pratt, H., FitzGerald, M., Ford, K., Marsden, K., Marlow, A., 2012. Quality
clinical placements for undergraduate nursing students: a cross-sectional survey of
undergraduates and supervising nurses. J. Adv. Nurs. 68 (6), 1380–1390.
Field, A., 2006. Research Methods II: Reliability Analysis. The University of Sussex,
England(Available at: http://www.sussex.ac.uk/Users/andyf/reliability.pdf,
Accessed on 6th July 2015).
Happel, B., Gaskin, C.J., 2013. The attitudes of undergraduate nursing students towards
mental health nursing: a systematic review. J. Clin. Nurs. 22, 148–158.
Happel, B., Platania-Phung, C., 2012. Mental health placements in a general health
setting: no substitute for the real thing!. J. Clin. Nurs. 21, 2026–2033.
Harrington, C., Choiniere, J., Goldmann, M., Jacobsen, F.F., Lloyd, L., McGregor, M.,
Stamatopoulos, V., Szebehely, M., 2012. Nursing home staffing standards and staffing
levels in six countries. J. Nurs. Scholarsh. 44, 88–98.
Hasson, F. 2012. An investigation into student nurses' perceptions of the role of the
healthcare assistant and the influence on students' clinical learning experience. PhD
Unpublished Thesis. Ulster University, Northern Ireland.
Henderson, A., Twentyman, M., Heel, A., Lloyd, B., 2006. Students' perception of the
psycho-social clinical learning environment: an evaluation of placement models.
Nurse Educ. Today 26, 564–571.
Henning, M., Shulruf, B., Hawken, S., Pinnock, R., 2011. Changing the learning
environment: the medical student voice. Clin. Teach. 8 (2), 83–87.
Ip, W.Y., Chan, D.S.K., 2005. Hong Kong nursing students' perception of the clinical
learning environment: a questionnaire study. J. Adv. Nurs. 42, 665–672.
Kaphagawani, N.C., Useh, U., 2013. Analysis of nursing students learning experiences in
clinical practice: literature review. Ethno Med. 7 (3), 181–185.
Killam, L.A., Mossey, S., Montgomery, P., Timmermans, K.E., 2013. First year nursing
students' viewpoints about compromised clinical safety. Nurse Educ. Today 33 (5),
Lamont, S., Brunero, S., Woods, K., 2015. Satisfaction with clinical placement – the
perspective of nursing students from multiple universities. Collegian 22 (1), 125–133.
Leigh, J., 2014. The role of the nurse lecturer situated within a practice–education
partnership. Int. J. Pract. Based Learn. Health Soc. Care 2 (1), 122–141.
Leigh, J., Hill, P., Bullpit, S., Dean, S., O'Flanagan, S., Fishburn, N., 2014. Opening up
placement opportunities for students. Nurs. Times 110 (38), 20–22.
Levett-Jones, T., Lathlean, J., Maguire, J., McMillan, M., 2007. Belongingness: a critique
of the concept and implications for nursing education. Nurse Educ. Today 27 (3),
McInnes, S., Peters, K., Hardy, J., Halcomb, E., 2015. Primary care clinical placements:
the views of Australian registered nurse mentors and pre-registration nursing
students (part 2). Nurse Educ. Pract. 15 (6), 443–449.
McKenna, L., McCall, L., Wray, N., 2010. Clinical placements and nursing students' career
planning: a qualitative exploration. International Journal Nursing. Practice 16 (2),
Midgley, K., 2006. Pre-registration student nurses perception of the hospital learning
environment during clinical placements. Nurse Educ. Today 26, 338–345.
Moattari, M., Ramezani, S., 2009. Nursing Students' perspective toward clinical learning
environment. Iran. J. Med. Educ. 9 (2), 137–145.
Moos, R.H., 1974. The Social Climate Scales: An Overview. Consulting Psychologists
Press, Palo Alto, California.
Murphy, F., Rosser, M., Bevan, R., Warner, G., Jordan, S., 2012. Nursing students'
experiences and preferences regarding hospital and community placements. Nurse
Educ. Pract. 12, 170–175.
Niederhauser, V., Schoessler, M., Gubrud-Howe, P.M., Magnussen, L., Codier, E., 2012.
Creating innovative models of clinical nursing education. J. Nurs. Educ. 51, 603–608.
Nursing and Midwifery Council, 2008. Standards to support learning and assessment in
practice: NMC standards for mentors, practice teachers and teachers. NMC, London.
O'Reilly-Knapp, M., 1994. Reports by baccalaureate nursing students of social support. J.
Nurs. Scholarsh. 26, 139–142.
Papathanasiou, I.V., Tsaras, K., Sarafis, P., 2014. Views and perceptions of nursing
students on their clinical learning environment: teaching and learning. Nurse Educ.
Today 34 (1), 57–60.
Papp, I., Markkanen, M., Von Bonsdorff, M., 2003. Clinical environment as a learning
environment: student nurses' perceptions concerning clinical learning experiences.
Nurse Educ. Today 23, 262–268.
Perli, S., Brugnolli, A., 2009. Italian nursing students' perception of their clinical learning
environment as measured with the CLEI tool. Nurse Educ. Today 29, 886–889.
Polit, D.F., Beck, C.T., 2006. The content validity index: are you sure you know what's
being reported? Critique and recommendations. Res. Nurs. Health 29, 489–497.
Poon, W.S., 2014. “Nursing students” perception of the clinical learning environment in
Macao. In: Presentation Sigma Theta Tau International the Honor Society of Nursing,
25th International Nursing Research Congress, (Available at: http://www.
nursinglibrary.org/vhl/handle/10755/335152, Accessed on 15 February 2016).
Ralph, E., Walker, K., Wimmer, R., 2009. Practicum and clinical experiences:
postpracticum students' views. J. Nurs. Educ. 48 (8), 434–440.
Rodger, S., Fitzgerald, C., Davila, W., Millar, F., Allison, H., 2011. What makes a quality
occupational therapy practice placement? Students' and practice educators'
perspectives. Aust. Occup. Ther. J. 58 (3), 195–202.
Royal College of Nursing, 2008. Nursing Our Future. An RCN Study into the Challenges
Facing Today's Nursing Students in the UK. Royal College of Nursing, London.
Saarikoski, M., Warne, T., Aunio, R., Leino-Kilpi, H., 2006. Group supervision in
facilitating learning and teaching in mental health clinical placements: a case
example of one student group. Issues Ment. Health Nurs. 27, 273–285.
Serena, P., Anna, B., 2009. Italian nursing students' perception of their clinical learning
environment as measured with the CLEI tool. Nurse Educ. Today 29 (8), 886–890.
Siggins Miller Consultants, 2012. Promoting Quality in Clinical Placements: Literature
Review and National Stakeholder Consultation. Health Workforce Australia,
Skaalvik, M.W., Normann, K., Henriksen, N., 2011. Clinical learning environment and
supervision: experiences of Norwegian nursing students – a questionnaire survey. J.
Clin. Nurs. 20, 2294–2304.
Smedley, A., Morey, P., 2010. Improving learning in the clinical nursing environment:
perceptions of senior Australian bachelor of nursing students. J. Res. Nurs. 5,
Tavakol, M., Dennick, R., 2011. Making sense of Cronbach's alpha. Int. J. Med. Educ. 2,
The European Directive, 2005. Recognition of Professional Qualifications Article 31 of
Thomas, J., Jinks, A., Jack, B., 2015. Finessing incivility the professional socialization
experiences of student nurses' first clinical placement, a grounded theory. Nurse
Educ. Today 35 (12), e4–e9.
Willis Commission, 2012. Quality with compassion: the future of nursing education.
Available at: http://www.williscommission.org.uk/__data/assets/pdf_file/0007/
495115/Willis_commission_report_Jan_2013.pdf (Accessed on 18 February 2016).
- Nursing students
- Clinical learning environment
- Clinical learning environment inventory