Evaluating the learning environment of nursing students: A multisite cross-sectional study

Exploring Nursing Students' Awareness and Willingness to Participate in Multi-Site Practice: A Cross-Sectional Study

Background

With the growing awareness of health and the expanding aging population, the demand for health services continues to rise. According to statistics from China, the number of professionals engaged in medical and health care services is insufficient to meet the public's needs, particularly in terms of nursing human resources in medical institutions. Multi-site practice may offer a potential solution to this issue.

Aim

To investigate the willingness and motivation of nursing students for multi-site practice of reference and nurse, and to lay a foundation for subsequent research.

Research Questions

1. How much do nursing students know about multi-site practice? What are the main sources of their knowledge of multi-site practice? 2. What are the main intentions and motivations of nursing students to participate in multi-site practice? For example, is it for financial gain, self-worth, or other reasons? 3. What are the potential barriers for nursing students to participate in multi-site practice in the future? For example, will inadequate laws and regulations, occupational safety issues or excessive work load affect their willingness?

Methods

This cross-sectional study was conducted across eight provinces in China, involving 1014 nursing students who participated in an online survey between October and November 2021.

Results

Among the 1014 nursing students surveyed, 61.74% were introduced to multi-site practice through their educational institutions, 75.25% expressed support for multi-site practice, and 53.75% indicated a willingness to engage in multi-site practice. However, a smaller percentage of students reported having a comprehensive understanding of multi-site practice. Notably, 61.74% of students cited their schools as the primary source of multi-site practice-related knowledge.

Conclusion

Nursing students demonstrate positive attitudes toward multi-site practice and a willingness to participate. However, awareness of multi-site practice could be enhanced, and a standardized multi-site practice training system and model should be developed.

Transfer of learning in baccalaureate nursing education: a systematic scoping review

OBJECTIVES

Examine how transfer of learning (ToL) has been applied in baccalaureate nursing education.

METHODS

A systematic scoping review was conducted with the search terms transfer, transfer of learning, transfer of knowledge, and learning transfer, of peer-reviewed literature in CINAHL, Medline, and Google Scholar. Inductive content analysis with open coding was employed.

RESULTS

Thirty-three sources were included in the final review: 26 research and seven non-research. Researchers identified three ToL categories: process, measure, and context. A mixture of terminology, definitions, and theoretical underpinnings contributed to conceptual confusion.

IMPLICATIONS FOR INTERNATIONAL AUDIENCE

Understanding how ToL was applied in baccalaureate nursing education could inform educators how to develop competency-based curricula. Variable use of ToL in the literature limits meaningful applicability.

CONCLUSIONS

Identification of inconsistent terminology, measure, and varying applications of ToL in the literature was evident.

The opinions and experiences of nursing students, nurses, and patients regarding clinical practices: A mixed-methods study

The aim of this mixed-methods study was to examine the experiences of nursing students (NSs), nurses, and patients regarding the clinical practices of NSs and to determine NSs' stress levels regarding clinical practices. The quantitative part of the study was completed with 240 NSs, and the "Perceived Stress Scale for Nursing Students" was used. In the qualitative part, the focus group interviews were held with 24 NSs, and the individual interviews were conducted with 15 patients and 20 nurses. Descriptive and stepwise regression analyses were used to analyze quantitative data, and narrative analysis was used to analyze qualitative data. Regression analysis determined that the age, grade point average, and attitude of mentors were associated with the perceived stress levels of NSs. In the narrative analysis of the data obtained from the interviews with NSs and nurses, four categories were identified: Emotions, Facilitators, Barriers, Roles, and Competencies. Three categories (Emotions, Problems, Roles, and Competencies) were identified from patient interviews. This study showed that NSs' clinical practice experiences were affected by many factors and experienced high stress during clinical practice.

A multicenter cross-sectional study in China revealing the intrinsic relationship between medical students' grade and their perceptions of the learning environment

BACKGROUND

Medical school learning environment (MSLE) has a holistic impact on students' psychosomatic health, academic achievements, and personal development. Students in different grades perceive MSLE in different ways. Thus, it is essential to investigate the specific role of student's grade in the perception of MSLE.

METHODS

Using the Johns Hopkins Learning Environment Scale (JHLES) as a quantification instrument for the perception level of MSLE, 10,901 medical students in 12 universities in China were categorized into low or high JHLES group according to their questionnaires. We investigated the relationship between student's grade and JHLES category by univariate analysis employing Pearson Chi-square test and Welch's ANOVA. Then multivariable logistic regression analysis confirmed the predictive efficacy of student's grade. A nomogram concerning the prediction of low JHLES score probability in medical students was also constructed.

RESULTS

A significant difference between two JHLES categories among students in different grades was observed (p < 0.001), with the proportion of the high JHLES group dominating in grade 1, 5, and the graduate subgroups (p < 0.001). The mean JHLES score declined especially in the third and fourth graders compared to freshmen (p < 0.001), while the mean score among the fifth graders had a remarkable rebound from the third graders (p < 0.001). Most imperatively, identified by multivariable logistic regression analysis, students in grade 3 (OR = 1.470, 95% CI = 1.265-1.709, p < 0.001) and 4 (OR = 1.578, 95% CI = 1.326-1.878, p < 0.001) perceived more negatively than freshmen. The constructed nomogram provided a promising prediction model for student's low JHLES score probability, with accuracy, accordance, and discrimination (area under the curve (AUC) = 0.627).

CONCLUSION

The student's grade was a significant influencing factor in medical students' perception of MSLE. The perceptions among the third and fourth graders got worse, probably due to the worrying changes in various aspects of MSLE during that period. The relevant and appropriate interventions to improve medical students' perceptions are urgently needed.

Clinical students' perception of educational environment in a Nigerian university: a mixed method study

BACKGROUND

Learning environment (LE) research has been given priority in higher education institutions globally because of its influence on learning processes and outcomes. Although studies reporting the perceptions of health science students about LE in Nigeria are available, none have compared the perceptions of students from different health professions. Therefore, this study aimed to assess final-year clinical students' perceptions of their LE from four programs (dentistry, medicine, nursing, and physiotherapy) and compared their LE perceptions.

METHODS

This study adopted a cross-sectional study design using a mixed method approach. The quantitative survey involved all the final-year clinical students at the University of Ibadan, and they completed the Dundee Ready Education Environment Measure (DREEM) questionnaire. The qualitative aspect involved 24 consenting students in four focus group discussions.

RESULTS

A total of 214 out of 223 copies of the DREEM questionnaire were duly completed and returned, yielding 96.0% response rate. The participants' mean age was 24 ± 2.3 years (ranged between 22 and 25 years, p = 0.001). The mean DREEM scores of the students from the four programs ranged between 119.68 ± 18.02 and 147.65 ± 15.89 out of a maximum of 200, interpreted as more positive than negative perceptions of LE. Physiotherapy students' DREEM score was significantly higher than those of medical, dental, and nursing students (p < 0.001). The DREEM scores of other students did not differ significantly (p > 0.05). Dental and medical students had similar positive perceptions. The qualitative aspect revealed that the students had positive perceptions of their teachers' knowledge base and self-acquisition of knowledge but negative perceptions of their teachers' communication skills, infrastructural facilities, lecturer-student relationships, and hostel accommodations.

CONCLUSION

Although the survey indicated that these clinical students had more positive than negative perceptions of their learning environment, the qualitative aspect of the study revealed many challenges that the students were confronted with. The clinical students' perception of their learning environment could be improved if the university authorities would address these challenges.

Veterinary Nursing Students' Experience in the Clinical Learning Environment and Factors Affecting Their Perception

Student veterinary nurses (SVNs) spend a significant proportion of their training time within the clinical learning environment (CLE) of a veterinary practice. These clinical experiences are vital for building practical and professional skills. To evaluate the current satisfaction of SVNs in the CLE, a cross-sectional survey design was used incorporating a previously validated instrument. To provide understanding of factors that may affect the SVN satisfaction, additional validated tools were added across factors, including resilience, well-being, personality, and workplace belonging. A total of 171 SVNs completed the survey. In addition, two open questions were included to provide greater depth of understanding of the SVN experiences. Results showed that 70.76% of respondents were satisfied/very satisfied with the CLE. Significant factors that affected the satisfaction scores included, depression, anxiety, and stress (p ≤ .001), psychological sense of organizational membership (p ≤ .001), agreeableness (p = .022), and emotional stability (p = .012). The qualitative data demonstrated shared SVN factors that are considered to contribute to clinical learning and those that detract from clinical learning. Educational facilities and training veterinary practices can support the SVN within the CLE by creating a greater sense of belonging, considering the SVN individual personality and well-being, and including the SVN in discussions around learning support needs.

Exploring the sociocultural experiences of student veterinary nurses in the clinical learning environment through the lens of situated learning theory

BACKGROUND

Student veterinary nurses (SVNs) complete significant time in clinical placements and this training can have a positive or negative impact on the development of professional skills and identity.

METHODS

A cross-sectional design, using semi-structured interviews, explored 12 SVNs' experiences of clinical placements. Interpretative phenomenological analysis was used to explore each individual participant's experience, prior to the identification of themes across participants' experiences.

RESULTS

Most students reported a sense of belonging within the practice team, which fostered engagement. Clinical supervisors were considered key role models and vital support for student progress. Students reported conflict between the demands of the practice and the requirements of their student status. Some poor interpersonal interactions led to reduced confidence.

LIMITATIONS

The results may not reflect experiences of the diversity of student demographics, such as those students with protected characteristics, as described in the Equality Act 2010, who may encounter specific workplace challenges.

CONCLUSION

To ensure parity and positive experiences, accredited educational institutes can plan regular engagement with student feedback and support of the training practice. Training practice teams can ensure they are meeting the student's needs and fostering a positive learning environment by adhering to the RCVS Framework for Veterinary Nurse Education and Training, which will, in turn, benefit the whole team. Clinical supervisors can play a convening role in increasing belonging and participation within the clinical learning environment.

Healthcare Students' Perceptions of the Quality of the Clinical Learning Environment in Morocco: A Cross-Sectional Study

Background

The clinical learning environment (CLE) is critical for developing the practical skills needed in healthcare professions. This study aimed to evaluate healthcare students' perceptions of the quality of the CLE using the Arabic version of the Clinical Learning Environment, Supervision and Nurse Teacher (ar. CLES + T) scale. The study also aimed to evaluate the tool's measurement invariance and compare perceptions among student groups.

Methods

This cross-sectional study was carried out at two health education institutes in Morocco throughout the academic year 2018-2019 among 1550 undergraduate students who had just finished a clinical practicum in a hospital or primary healthcare facility. Data were gathered using the ar. CLES + T scale. Confirmatory factor analysis (CFA) and multigroup CFA were performed. The measurement invariance of the ar. CLES + T scale was assessed across gender, study year, and clinical practicum duration, using configural invariance, metric invariance, scalar invariance, and strict invariance. The t-test and analysis of variance were used to compare the mean scores of the student groups.

Results

Students expressed positive perceptions toward the CLE. The "Pedagogical atmosphere on the ward" dimension scored the highest, while the "Role of the nurse teacher" dimension received the lowest scores. The measurement invariance of the ar. CLES + T scale by gender, study year, and clinical practicum duration was established. First-year students and those with an extended practicum period were the most satisfied.

Conclusion

To promote effective learning in the clinical environment, nurse teachers might use innovative teaching approaches tailored to their evolving role in these settings. Moreover, extending the duration of clinical practicum can further enhance student learning outcomes.

Clinical Learning Environment: Perceptions of Palestinian Nursing Students

Clinical learning environment play a vital role in bridging theory with practice, equipping nursing students with essential skills for patient care and support their smooth transition into the nursing workforce. To assess Palestinian nursing students' perceptions of clinical learning environment and supervision. A total of 308 undergraduate nursing students were conveniently recruited from Arab American University-Palestine for this descriptive cross-sectional study. Data collection utilized the Arabic version of the Clinical Learning Environment and Supervision plus Nurse Teacher scale. In general, nursing students expressed positive perceptions regarding their clinical learning environment (M = 130.56 ± 21.03), with the "supervisory relationship" and "role of nurse teacher" scoring highest (M = 3.85 ± 0.82 each). Conversely, the lowest rating was observed for "leadership style of the ward manager" (M = 3.8 ± 0.84). Fourth-year students and those trained in public hospitals showed significantly more positive perceptions (P < .001). Furthermore, students with higher professional satisfaction had more positive perceptions of the clinical learning environment (P < .001). The positive perceptions of Palestinian nursing students underscore the importance of the supervisory relationship and nurse teacher. However, finding suggest an area for improvement in the leadership style of the ward manager, emphasizing the necessity for strengthened partnership between nursing faculties and healthcare facilities. These insights expand our understanding of student perceptions and stress the importance of addressing these concerns to adequately prepare students for professional practice.

The challenges of the Iranian nursing system in addressing community care needs

BACKGROUND

The nursing system is one of the major and important fields of health and medicine in every country, responsible for providing nursing care and addressing medical and health-related community care needs. The aim of this study was to explain the challenges of the Iranian nursing system in addressing community care needs.

MATERIALS AND METHODS

A conventional content analysis method was performed in this exploratory qualitative study, and 27 participants were selected through a purposive sampling method based on the inclusion criteria. In-depth semi-structured interviews were conducted with the subjects, and data saturation was achieved in the 27th interview. The main interviews with the participants were individual, in person, and face-to-face, conducted at different times (morning and evening) in a peaceful environment and at the convenience of the participants. The interviews were recorded by the researcher with the participants' consent. The duration of the interviews ranged from 50 to 70 minutes, given the participants' energy and time. Data analyses were done using Graneheim and Lundman approach.

RESULTS

After conducting the interviews and the simultaneous analysis, three themes were extracted, including the challenging structure in the internal environment, the operating environment, and the social environment, with seven main categories and 26 subcategories. An inadequate number of nurses given the real needs of society, the unbalanced proportion of employed clinical nurses to the real needs of society, poor presence of nurses in community-based nursing services, insufficient attention to the optimization of the work environment, the gap between education and clinical practice in the nursing system, poor mutual accountability of the community, and policies in the health system were seven main categories in this study.

CONCLUSION

In general, the results showed that the Iranian nursing system faces many micro, meso, and macroscale challenges. It is necessary to plan properly to enhance the accountability of the nursing system to the current community care needs by improving the situation.

Emotional intelligence is more important than the learning environment in improving critical thinking

PURPOSE

To examine the association of critical thinking (CT) and emotional intelligence (EI) versus CT and learning environment (LE) in order to investigate which has the greatest influence EI or LE.

MATERIALS AND METHODS

A cross-sectional study was conducted with 340 s-year healthcare university students in two nursing and one medical schools from three universities in Greece, between October and December 2020. Critical Thinking Disposition Scale, Dundee Ready Education Environment Measure, and Trait Emotional Intelligence Questionnaire-Short Form were administered. Hierarchical multiple linear regression analysis, with five steps, was used to compare the associations of CT and EI to CT and LE.

RESULTS

Participants' mean age (years) was 20.9 (6.6 SD); 82.6% female; 86.8% studying nursing. Students mean scores were moderate to high for CT disposition (44.7 ± 4.68). The general characteristics (age, gender, and school) were not significantly associated with CT (p > 0.05). However, CT was positively associated with LE (UCB = 0.064 & p < 0.001) and EI (UCB = 1.522 & p < 0.001). Moreover, CT seems to be associated in a higher degree (R² change adj = 0.036 & p < 0.001) with emotional intelligence (UCB = 1.522) than with learning environment (UCB = 0.064).

CONCLUSIONS

Our findings suggest a different more optimal pathway for educators to improve the CT of their students through EI and not with LE as believed till now. By focusing on improving EI, educators may help their students become critical thinkers, who will provide better quality of care.

Linking Learning Environment and Critical Thinking through Emotional Intelligence: A Cross-Sectional Study of Health Sciences Students

Background: Health sciences educators should increase the critical thinking of their students as this may improve the quality of care. However, this is rarely considered as a critical point in teaching, despite studies identifying factors such as the learning environment and emotional intelligence as increasing critical thinking at an undergraduate level. Thus, there is a need to better explore these factors and investigate interrelations and ways of improving critical thinking, especially in the critical field of healthcare students (nursing and medicine). Objectives: The present study aimed to examine the potential relationships between critical thinking with emotional intelligence and the learning environment. Method: This was a descriptive cross-sectional study with 208 first year health sciences university students of two nursing departments and one medicine department from three universities in Greece. The Critical Thinking Disposition Scale, Dundee Ready Education Environment Measure, and Trait Emotional Intelligence-Short Form questionnaires were used to assess critical thinking, the education environment, and emotional intelligence, respectively. Results: The results demonstrate that critical thinking was positively related to emotional intelligence (β = 0.82, p < 0.001), but not to the learning environment (β = 1.06, p = 0.30). However, a structural equation modeling analysis supported the indirect relationship between the learning environment and critical thinking through emotional intelligence (M = 1.10, CI = 0.13–2.17, p < 0.05). Conclusions: Emotional intelligence may be the underlying mechanism for achieving critical thinking if it is well applied and cultivated in a learning environment. Therefore, universities could modify their curricula and place emotional intelligence at the epicenter of teaching.

The Arabic Nurse Professional Competence-Short Version Scale (NPC-SV-A): Transcultural Translation and Adaptation with a Cohort of Saudi Nursing Students

BACKGROUND

There is broad consensus that assessing and improving the competence of nurses is a crucial element of nursing education and practice. Numerous national and international nursing research studies have used the 35-item Nurse Professional Competence Scale (NPC-SV) to measure the self-reported competence of nursing students and registered nurses. To increase its usage in Arabic-speaking nations, however, a culturally adapted Arabic version of the scale with the same level of quality was necessary.

OBJECTIVES

The study aimed to develop a culturally adapted Arabic version of the NPC-SV and evaluate its reliability and validity (construct, convergent, and discriminant types).

METHODS

Methodological descriptive cross-sectional design was utilized. A convenience sampling technique was employed to recruit 518 undergraduate nursing students from three Saudi Arabian institutions. The translated items were appraised by a panel of experts, who considered the content validity indexes. The structure of the translated scale was examined using exploratory and confirmatory factor analysis, structural equation modelling, and the Analysis of Moment Structure method.

RESULTS

When utilized with nursing students in Saudi Arabia, the Arabic short version of the Nurse Professional Competence Scale (NPC-SV-A) was shown to be reliable and valid in terms of its content, construct, convergent, and discriminant validity. Cronbach's alpha for the entire NPC-SV-A scale was 0.89 and varied from 0.83 to 0.89 for each of the six subscales. Exploratory factor analysis (EFA) revealed six significant factors with 33 items that accounted for 67.52 percent of the variance. The scale was congruent with the suggested six-dimensional model, as confirmed by confirmatory factor analysis (CFA).

CONCLUSION

The Arabic version of the NPC-SV, which was reduced to 33 items, showed good psychometric properties, with a six-factor structure accounting for 67.52% of the total variance. When used alone, this 33-item scale can allow for more in-depth evaluations of self-reported competence among nursing students and licensed nurses.

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.

Exploring the social accountability challenges of nursing education system in Iran

BACKGROUND

Nursing education in Iran is one of the disciplines of medical sciences and it needs a design tailored to the community needs in terms of theoretical and clinical approaches. This system is currently faced with various challenges. This study aims to explore the challenges of Iranian nursing education system to address community needs.

METHODS

A study was carried out through an exploratory descriptive qualitative design with content analysis method. In-depth semi-structured interviews were conducted with 21 participants from the nursing society, selected through purposive sampling. The interviews were continued until data saturation. Data analysis was performed simultaneous with data collection by using Graneheim & Lundman approach.

RESULTS

Based on the interviews and simultaneous analyses, a total of 471 codes, 14 subcategories, six main categories, and two themes were extracted. The first theme, "system structure," consisted of three categories: "the need for ongoing revision of curriculum," "the need to recruit qualified students," and "the need for a proportionate educational environment." The second theme was "the education process" with three categories "the need for purposive educational design," "the need for purposive monitoring and feedback," and "the need for appropriate and early interaction with the community." The participants emphasized the continuous revision of the educational curriculum based on the current needs of the community and community-based nursing education.

CONCLUSIONS

In general, the results showed that Iranian nursing education system is faced with many challenges in the educational system structure and processes. It is necessary to make appropriate plans to enhance the status of the educational system structure and develop educational designs to address community needs using a hospital/community-based approach.

A Multisite Assessment of Saudi Bachelor Nursing Students' Perceptions of Clinical Competence and Learning Environments: A Multivariate Conceptual Model Testing

Background: It is thought that students’ perceptions of educational and clinical learning environments improve the effectiveness of curricula and professional standards. It is essential to examine the educational and clinical learning environments in which nursing students learn, as well as how nursing students evaluate particular factors of these environments. Objectives: The objectives of this study were to (1) identify nursing students’ perceptions on professional competence and learning environments in the classroom and clinical settings and (2) test a hypothetical model of variables that influence and predict students’ perceptions of learning environments and professional competencies. Methods: The study employed a descriptive cross-sectional methodological design. Five hundred and eighteen undergraduate nursing students were recruited from three Saudi Arabian universities using a convenient sampling technique. Using valid and reliable self-reported questionnaires, including the Dundee Ready Educational Environment Measure (DREEM), the modified Clinical Learning Environment Inventory (CLEI), and the Nurse Professional Competence Scale-Short (NPCS-SF), data were collected. Results: Perceptions of professional competence and learning environments were positive among nursing students. With satisfactory fit indices, the final model found that students’ perceptions of clinical competence were significantly predicted by their perceptions of the clinical environment (B = 0.43, p < 0.001), students’ perceptions of university environments (B = 0.29, p < 0.001), ward type (B = 0.12, p < 0.001), and students’ year of study (B = 0.11, p < 0.001). The students’ perceptions of clinical environments were significantly predicted by their perceptions of the university environment (B = 0.31, p < 0.001), gender (B = 0.13, p < 0.001), students’ year of study (B = 0.12, p < 0.001), and ward type (B = 0.11, p < 0.001). Moreover, the students’ perceptions of the university environment were significantly predicted by gender (B = 0.11, p < 0.001) and length of training (B = 0.12, p < 0.001). Conclusions: A range of factors might influence students’ perceptions of their professional competence and learning environments. Improving the learning environments and clinical experiences of students could enhance their clinical competence. This study’s findings provide evidence for how to enhance the learning environments in the classroom and clinical settings in order to improve students’ clinical competence, which will ultimately result in better patient outcomes. It is a top priority for nursing educators all around the world to improve classroom and clinical learning settings that foster students’ learning and professional competencies.

Storylines, metaphors, and solutions in the work-readiness literature: A frame analysis

AIM

To investigate how the literature frames the reported poor work-readiness of new graduate nurses and the solutions it recommends.

DESIGN

Critical frame analysis of work-readiness literature storylines.

METHODS

Deductive and inductive analysis of work-readiness literature published 2016-2019.

RESULTS

The three systematic reviews, literature review, and analysis of transition guidelines reinforced the belief that nursing graduates should be work-ready. In addition, the articles summarized service and academic innovations intended to assist newly qualified nurses transition to practice.

CONCLUSION

The literature attributes perceived graduates' poor work-readiness to divergent faculty and employer expectations, personal deficiencies, defective learning environments, and poor workplace support. Internships, mentorship, academic-service partnerships, and curricular and pedagogical innovation are the dominant recommendations for reform. Workplace clinical education and training are not mechanisms for correcting graduates' work performance but essential activities for sustaining the nursing workforce.

IMPACT

The study should encourage more use of frame analysis in nursing education research. Fact-checking storylines must be a priority for future studies. Research that clarifies the fault lines between advocates of work-readiness and dissident academic leaders has the potential to promote dialogue. Work-ready, theory-gap, and other deficit metaphors must be put aside for the debate because universities must not relinquish their responsibility for educating students for the 21st century.

Nurse students' perception of the academic learning environment in Tunisian institutes of nursing sciences: A multisite cross-sectional study

BACKGROUND

A learning environment is an important determinant of students' learning behaviours, professional competencies, and academic performances. It is also an essential indicator of the quality of teaching programmes. To date, there is not a Tunisian study, that analysed nurse students' perceptions of the educational environment.

AIMS

This study aimed to assess the perception of Tunisian higher nursing institutes students regarding the quality of the learning environment, and identify the factors associated with it.

DESIGN

Multi-site cross-sectional survey.

SETTING

Five universities of nursing sciences in Tunisia.

PARTICIPANTS

Undergraduate nursing students (n = 736).

METHODS

A cross-sectional descriptive study was conducted during the academic year 2019-2020. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was used to describe the students' perceptions of the learning environment. The participants were recruited using a convenience sampling method. Statistical analyses were performed using SPSS version 20. One-way analysis of variance and t-test were used to compare the DREEM scores and socio-demographic/academic characteristics. A p-value of less than 0.05 was considered significant.

RESULTS

The mean overall DREEM score was 110.92 ± 20.55, indicating a positive perception of the learning environment. The year of study was significantly associated with total DREEM scores, with first-year students scoring higher than third- and second-year students (p = 0.035). The perception of the learning environment varied significantly among the five institutes (p < 10^-3). Demotivated atmosphere, lack of a support system, poor timetable organisation, and teacher-centred learning were revealed as problematic areas that needed improvement (individual score < 2). Our adapted version of the DREEM obtained acceptable internal consistency (Cronbach's alpha coefficient of 0.881).

CONCLUSIONS

The study reported positive perceptions of the students regarding their academic learning environment. However, the DREEM scores reflected a traditional learning environment. It is essential to re-engineer the curriculum and shift the teaching paradigm towards 'student-centred curriculum' to enhance both the effectiveness and the efficiency of the learning environment.

Evaluation of learning environment among Nursing undergraduates in state universities, Sri Lanka

BACKGROUND

The learning environment is a vital part of the undergraduate curriculum which enable to delivery of quality education in the stipulated time. Therefore, this study aimed to evaluate the learning environment among BSc. Nursing undergraduates in Sri Lankan state universities.

METHODS

A descriptive cross-sectional study was conducted among 161 final year BSc. Nursing undergraduates in six state universities. Socio-demographic characteristics were collected using a self-administered questionnaire. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was used to evaluate the learning environment in Perception of learning (SPL), Perceptions of teaching (SPT), Academic self-perceptions (SASP), Perceptions of the atmosphere (SPA), and Social self-perceptions (SSP). Based on the SPL, SPT, SASP, SPA, and SSP domains, the overall score of learning environment was ranged from 0 to 200 and then the overall score was classified into four categories such as poor (0-50), many problems (51-100), more positive than negative (101-150) and excellent (151-200). One-way Analysis of Variance (ANOVA) and t-test were used to determine the difference in the subscales and the overall scale.

RESULTS

The mean age of the students was 24.9 ± 0.9 years. The overall score of the learning environment was 127.1 ± 14.3. Student's Perception of learning showed the highest mean score of 31.1 ± 3.9 while the social self-perception showed the lowest score (mean 16.4 ± 3.1). A significant group effect was observed in SPL and SPT subdomains among state universities while no significant group effect was observed in other subdomains. Furthermore, participating in extracurricular activities, travelling time to the faculty, and gender were observed as associated factors for the learning environment among BSc. Nursing undergraduates in state universities.

CONCLUSIONS

Although the overall learning environment of BSc. Nursing undergraduates in state universities in Sri Lanka was within more positive than negative category, none of the university reaches to the excellent category. Therefore, each university should have improved their subdomains of learning environment to reach excellent category through addressing the gaps of curricular and extracurricular activities in the future.

Using Invitational Theory to Examine Nursing Students' Experiences of Their Learning Environment

AIM

The aim of this study was to test Purkey's invitational theory to evaluate unique aspects of the learning environment in nursing education.

BACKGROUND

Faculty evaluate student learning but rarely students' unique experiences within learning environments.

METHOD

This interpretive phenomenological analysis explored students' perceptions of their prelicensure learning environments. Twelve participants from two private bachelor of science in nursing programs were interviewed about their experiences.

RESULTS

Students' perceptions of what helped (invited) their learning and hindered (disinvited) their learning included thematic aspects of learning environments based on Purkey's theory: people, places, processes, policies, and programs. Findings illustrate facets of the learning environment often not considered by educators in planning learning environments most conducive to student learning.

CONCLUSION

Purkey's theory is a plausible framework for nurse educators to evaluate learning environments from students' perspectives and may provide valuable data about the unique milieu that promotes or hinders successful learning.

Psychometric properities of the Polish version of clinical learning environment inventory

Background

Clinical experience is a crucial activity for nursing students. The way students` perceive clinical placement exerts an immense influence on the learning process. This study aims to test the psychometric properties of a 19-item version of the Clinical Learning Environment Inventory under Polish clinical conditions.

Method

For this study, Discriminant validity and Cronbach’s alpha reliabilities were computed. In order to measure content validity, the criterion validity Generalized Self Efficacy Scale and the Life Orientation Test - Revised were used.

Results

Cronbach’s Alpha for the Clinical Facilitator Support of Learning Scale and the Satisfaction with Clinical Placement scale is 0.949 and 0.901, respectively. The Spearman’s rank correlation coefficient indicates the existence of a positive correlation between the students’ satisfaction with clinical placement and their [overall] life optimism. Age correlates negatively with perceived teacher support and positively with satisfaction with clinical placement. The sense of self-efficacy correlates negatively with their satisfaction with clinical placement. Clinical Learning Environment Inventory − 19 could be a useful tool to evaluate the quality of the clinical learning process in Polish conditions.

From Learning on Mannequins to Practicing on Patients: Nursing Students' First-Time Experience of Clinical Placement in Jordan

Introduction

Although clinical nursing placement is an indispensable component of student nurses' education, data on students' first clinical experiences is scarce in developing countries.

Objectives

The study aim is to uncover nursing students' first-time clinical placement experience and identify related influencing factors in Jordan.

Methods: Focus group discussions (n=4) were used.

Results

The results showed that the transition from learning with mannequins to practicing on real patients in the clinical placement involved both effective learnings through hands-on practice to dealing with clinical challenges. Students perception of nursing ranged from positive comments such as “humanistic” and “nursing almost medicine” to negative images such as “nursing is all about bedside care” and “nursing has poor social status.”

Conclusion

Students' experience in their first clinical placement is multifaceted, and incorporation of student's perspective in the first clinical placement is a crucial component of educational planning.

The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals

AIMS AND OBJECTIVES

To analyse nursing students' perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals.

BACKGROUND

Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace.

DESIGN

Cross-sectional, correlational study.

METHODS

One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students' satisfaction with the clinical learning environment and learning process was measured using a 4-point Likert scale developed by the researchers. The STROBE checklist was used in this paper.

RESULTS

Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction.

CONCLUSIONS

This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies.

RELEVANCE TO CLINICAL PRACTICE

Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.

Magnet hospital attributes in nursing work environment and its relationship to nursing students' clinical learning environment and satisfaction

AIMS

To analyse nursing students' perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated.

DESIGN

This study had a cross-sectional, correlational, design.

METHODS

Data were collected using self-reported questionnaires from 180 nursing students at a university in southeast Spain between September-October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students' satisfaction with the work environment and with the clinical learning process were measured using a four-point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ² test, Mann-Whitney U test, Spearman and phi correlation were used to analyse the data.

RESULTS

Nursing students' perception of greater Magnet-like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22-0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02).

CONCLUSION

Magnet-like features at the work environment lead to superior clinical learning environment and higher students' satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation.

IMPACT

In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.

Nursing students' views and satisfaction of their clinical learning environment in Singapore

Aims

This study aims to investigate final-year nursing students' actual perception of their clinical learning environment in Singapore.

Design

Descriptive cross-sectional survey.

Methods

An online survey based on the clinical learning environment inventory (CLEI; "Actual" version) was administered to final-year (third year) nursing students (N = 301) in a polytechnic in Singapore between May-July 2018.

Results

Most nursing students reported moderate satisfaction with their clinical learning environment, reflecting their positive (although not strongly positive) perceptions. Among the six constructs of the CLEI, the higher scores of the constructs of "Personalization" and "Task orientation" implied their greater contribution to the positive view. Conversely, the lower scores of "Individualization" and "Innovation" implied their lesser contribution. Additionally, the positive correlation between "satisfaction" and the other five CLEI constructs was found to be statistically significant.

Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey

OBJECTIVE

To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type.

BACKGROUND

Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date.

METHODS

The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha.

RESULTS

Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest.

CONCLUSION

The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.

Student engagement in higher education: A cross-sectional study of nursing students' particpation in college-based education in the republic of Ireland

BACKGROUND

Student achievement within the Higher Education Sector is predicated upon engagement with college/university life and engagement is identified as having a major impact on the acquisition of knowledge and cognitive growth. Evidence within the higher education sector identifies factors which impact positively and negatively on student engagement. However, the direct application of this evidence to nursing students whose programmes of study are fundamentally different to other non-professional degrees has not, as yet, been examined.

OBJECTIVES

To explore undergraduate nursing students' engagement in college-based education and their perceptions of how their institutions support student engagement.

DESIGN

Cross-sectional survey design.

SETTINGS

Four Higher Education Institutions (HEIs) in the Republic of Ireland.

PARTICIPANTS

Nursing students in first and final year (n = 634) undertaking a four-year Bachelor of Science Nursing (honours degree).

METHODS

The National Survey of Student Engagement (NSSE) self-report questionnaire, which collects data on four core areas related to student engagement, was used. The statistical package SPSS version 21 was used to analyse the data. Independent t-tests were used to compare differences in engagement between students, depending on year of study (first and final year), institution type, and age.

RESULTS

Students engaged most in activities that are considered core to higher education: higher order learning, collaborative learning and effective learning strategies. Although students perceived that lecturers engaged in effective teaching practices, they reported limited out of class interaction with lecturers.

CONCLUSIONS

The insight gained from this study of the educational realities of contemporary nursing students will provide clarity for nurse educators, regulators, and policymakers in their efforts to support and enhance student engagement.

Nursing Students’ Perception of the Clinical Learning Environment

Introduction:

Clinical learning environment placements provide opportunities for students to develop their skills, socialize to the profession and bridge the gap between academic and workplace learning. This study was conducted to investigate Saudi nursing students’ perceptions of their clinical learning environment and supervision in the hospital setting.

Methods:

A sample of 90 final year student nurses completing practicums at a tertiary hospital in Riyadh was included in this cross-sectional study utilizing the Clinical Learning Environment and Supervision plus Nurse Teacher scale.

Results:

Overall, students perceived their clinical learning environment positively. Among sub-scores, that for the leadership style of ward manager was the highest. Supervision types, nursing-teacher teacher-visit frequency and grade point average positively and significantly impacted student’s perceptions, while university type and practicum duration did not.

Conclusion:

Students confirmed the ward manager’s leadership style as the most significant influencing their perceptions. However, the nursing teacher’s role had the lowest mean score, suggesting the need for its enhancement and clarification and indicating the need for better communication and collaboration between nursing schools and the clinical training hospital.

What educators could do to facilitate students' use of a deep approach to learning: A multisite cross-sectional design

BACKGROUND

Despite the proliferation of diverse teaching methods, it is uncertain which teaching components have enhanced students' approach to learning and in what way these components have produced positive outcomes.

OBJECTIVES

The aim of the study was to examine how the students' perceptions of learning activities, the acquisition of relevant knowledge, and educators' enthusiasm/supportive attitudes impact on the students' adoption of the deep approach to learning.

DESIGN

A multisite cross-sectional design.

SETTINGS

Two universities in Japan.

PARTICIPANTS

Undergraduate nursing students (n = 154).

METHODS

Questionnaires, which included the Teaching Approach Scale and the Japanese version of the Learning Approach Scale, were given to the students. Data were analysed by path analysis.

RESULTS

The students' perceptions of learning activities were positively related to their use of a deep approach to learning. Moreover, this relationship was completely mediated by their perceptions of knowledge acquisition and educators' enthusiastic and supportive attitudes.

CONCLUSIONS

The findings suggest that learning activities must be reinforced by appropriate educator support that enables students to acquire relevant knowledge and feel that learning is interesting and enjoyable. Without such support, interest and active engagement incurred by learning activities may quickly disappear, and learning activities may not lead to a change in the students' approach to learning.

The effectiveness of partnership models in clinical nursing education - A scoping review

OBJECTIVES

To examine the effectiveness of partnership models in clinical nursing education with regards to cost effectiveness; student employability, work-readiness, confidence, and competence; and stakeholders' satisfaction.

DESIGN

Scoping review.

DATA SOURCES

Research studies published in English were searched electronically through EbscoHost (CINAHL and ERIC), Scopus, Medline (via Ovid), ProQuest Central, and Web of Science databases. Criteria were developed to guide the selection of original studies published in English before 2019 for review.

REVIEW METHODS

Arksey and Malley's framework (2005) and relevant enhancements guided the conduct of the review. An informal appraisal of selected studies was applied.

RESULTS

Two theses and 31 articles with a variation in methodologies, methods, sample sizes, research populations and quality of evidence were included for review. Four themes were identified: (i) Description of partnership models in clinical education, (ii) length of model implementation prior to evaluation, (iii) positive qualitative findings, and (iv) quantitative findings limited by data collection periods and methods.

CONCLUSIONS

Shared among the reviewed studies is stakeholder view of the positive impacts of partnership models on the clinical learning environment, and the increased level of support and individualised instruction for students. However, the use of not fully validated survey instruments and the lack of description about the implementation period before evaluation in many reviewed studies limit the interpretation of quantifiable effect of the partnership models. This review identifies a lack of attention on student employability, work-readiness, cost evaluation, patient perspective, and partnership models in low-income countries. Future research to address these knowledge gaps using high quality data collection methods and rigorous research design is warranted.