The clinical learning environment (CLE) is an important component of the nursing student’s experience. Nursing students in medical-surgical rotations have the opportunity to integrate learning from all areas of coursework at clinical sites in a hospital setting with real patients. In the CLE, students engage in personal interactions with registered nurses, healthcare personnel, hospitalized patients and their families, and nursing faculty who supervise nursing students at the hospital clinical site. These interactions are not a controlled environment like a classroom and can differ in learning opportunities. According to Flott and Linden (2016), the clinical learning environment includes four attribute characteristics including the physical space, psychosocial and interaction factors, organizational culture, and teaching and learning components. Students in a clinical course are at different hospital sites with different nursing faculty and precepting nurses, including units developed as dedicated education units (DEUs). In order to determine the differences in student experiences and attributes of sites, student satisfaction can be measured with the Clinical Learning Environment Inventory (CLEI). Student satisfaction in the working and learning environment is an important element in performance, desire to continue in the profession of nursing, and retention of new graduate nurses (Lovecchio, Dimattio, & Hudacek, 2015).
Purpose
The purpose of this research study is to compare how experiences in the hospital clinical sites affect prelicensure nursing student satisfaction with the clinical learning environment using the CLEI. The three research questions addressed are 1) What are the most important areas of students’ clinical learning experiences that impact satisfaction with a clinical site? 2) What is the difference in nursing students’ satisfaction with learning experiences between clinical sites? and 3) Do DEU clinical sites differ from other clinical sites in students’ satisfaction with learning experiences?
Method
Pre-licensure baccalaureate nursing students at one school of nursing in the third of four semesters are asked to participate. Students complete the CLEI at the end of a medical-surgical clinical experience in one of six different hospital settings. Two of the six hospital settings are DEUs. Approximately 400 students enrolled in the clinical course between Fall 2017 and Spring 2019 are asked to complete the questionnaire. Data analysis of the research questions will include a multiple regression analysis and one-way ANOVA using SPSS©statistics software version 23.0. Psychometric properties of the CLEI will be evaluated and reported.
Instrument
The Clinical Learning Environment Inventory (CLEI) is a survey tool using a 4-point Likert scale developed by Chan (2001). The CLEI is a 42-item measure of psychosocial aspects of a clinical site with six different dimensions including Individualization, Innovation, Involvement, Personalization, Task Orientation, and Satisfaction. Higher student scores on the CLEI indicate higher levels of satisfaction with the CLE.
Global implications
Understanding nursing student satisfaction with the clinical learning environment is an important element of creating positive learning experiences. The attitudes of nursing faculty and precepting nurses working with students may impact the experience and the ability to train and retain a qualified nursing workforce. This study will provide information on the priorities for nursing students in clinical learning experiences as well as comparison information between hospital sites with and without DEU agreements. Evidence about the impact of DEUs for nursing student satisfaction with clinical learning can inform all training programs for registered nurses.
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