Nepal Bijeta, Taketomi Kikuko, Ito Yoichi M, Kohanawa Masashi, Kawabata Hidenobu, Tanaka Michiko, Otaki Junji
Department of Medical Education and General Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
Center for Medical Education, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
Nurse Educ Today. 2016 Apr;39:181-8. doi: 10.1016/j.nedt.2016.01.006. Epub 2016 Jan 27.
Clinical practice enables nursing students to acquire essential professional skills, but little is known about nursing students' perceptions of the clinical learning environment (CLE) in Nepal.
To examine Nepalese nursing students' perceptions regarding the CLE and supervision.
A cross-sectional questionnaire design was used.
Government and private hospitals in Nepal where the undergraduate nursing college students undertook their clinical practice.
Students with clinical practice experience were recruited from years 2-4 of the B.Sc. nursing program in Nepal (n=350). The final sample comprised 263 students.
A self-administered questionnaire including demographic characteristics, latest clinical practice site, and general satisfaction was administered February-March 2014. The previously validated Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale was used in the questionnaire. The analytical approach used exploratory factor analysis, assessments of the scale and sub-dimension reliability, correlations of factors between scale sub-dimensions, and multiple regression analysis.
Students' practicum satisfaction level at government hospitals was significantly higher than those at private hospitals (p<0.0001). Five factors explained 85.7% of the variance, with minor factorial structure differences compared with the original scale. Reliability was confirmed (Cronbach's alpha=0.93 for total scale, 0.76-0.92 for sub-dimensions). Inter-correlations between the five original sub-dimensions were 0.27-0.68 (p<0.0001). Students undertaking their practicum in private hospitals evaluated their clinical placements significantly more negatively on most sub-dimensions than those in government hospitals. Multiple regression analysis revealed a significant positive relationship between satisfaction and pedagogical atmosphere (p<0.0001).
This is the first study to investigate nursing students' perceptions of the CLE in undergraduate nursing programs in Nepal. Students were satisfied with the CLE overall, but satisfaction varied by practicum hospital sector. The most influential factor explaining satisfaction was pedagogical atmosphere.
临床实践能让护理专业学生获得重要的专业技能，但对于尼泊尔护理专业学生对临床学习环境（CLE）的看法却知之甚少。
调查尼泊尔护理专业学生对临床学习环境和督导的看法。
采用横断面问卷调查设计。
尼泊尔的政府和私立医院，本科护理专业学生在这些医院进行临床实习。
从尼泊尔护理学理学学士课程第2至4年中招募有临床实习经验的学生（n = 350）。最终样本包括263名学生。
2014年2月至3月发放一份包括人口统计学特征、最新临床实习地点和总体满意度的自填式问卷。问卷中使用了先前经过验证的临床学习环境、督导和护士教师评价量表。分析方法包括探索性因素分析、量表及子维度信度评估、量表子维度间因素的相关性分析以及多元回归分析。
学生在政府医院的实习满意度显著高于私立医院（p < 0.0001）。五个因素解释了85.7%的方差，与原始量表相比，因子结构差异较小。信度得到确认（总量表的Cronbach's α = 0.93，子维度的Cronbach's α = 0.76 - 0.92）。五个原始子维度之间的相互相关性为0.27 - 0.68（p < 0.0001）。在大多数子维度上，在私立医院进行实习的学生对其临床实习安排的评价明显比在政府医院实习的学生更负面。多元回归分析显示满意度与教学氛围之间存在显著正相关（p < 0.0001）。
这是第一项调查尼泊尔本科护理专业学生对临床学习环境看法的研究。学生总体上对临床学习环境感到满意，但满意度因实习医院部门而异。解释满意度的最具影响力因素是教学氛围。
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