Department of Infectious Diseases, Karolinska University Hospital, 141 86 Stockholm, Sweden; Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden; The Swedish Red Cross University College, Stockholm, Sweden.
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Heart, Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden.
Nurse Educ Today. 2022 Jan;108:105211. doi: 10.1016/j.nedt.2021.105211. Epub 2021 Nov 10.
Research has shown that the clinical learning environment can both facilitate and hinder students' learning. Students' perceptions need to be evaluated, preferably using nationally and internationally validated instruments. In Sweden, there is a lack of research about students' evaluation in acute care settings and from the perspectives of different levels of students.
The aim was to explore and compare perceptions of the clinical learning environment of first- and second-cycle nursing students in an acute care setting using the Clinical Learning Environment, Supervision and Nurse Teacher scale (CLES+T).
The design involves cross-sectional data collection with comparisons between groups.
Data were collected from a convenience sample of first- and second-cycle students at the end of their clinical placements in an acute care setting at a university hospital.
A paper version and a web version of the culturally adapted version of CLES+T was filled out by the students. An independent t-test was used to explore the differences between CLES+T scores and distribution methods and educational level. Internal consistency was evaluated using Cronbach's alpha.
Overall, the students (N = 179) were satisfied with the clinical learning environment. There was no significant difference in the total score (m = 4.31, SD = 0.63) between first- and second-cycle students except for the subscale of "Premises of nursing on the ward" and the individual items "The ward's nursing philosophy was clearly defined" and "Patients received individual nursing care", showing that the first-cycle students were more satisfied compared to the second-cycle students. The scale demonstrated high internal consistency (α = 0.97 vs. 0.96) for the paper survey and the web survey, respectively.
Our findings provide initial support for the CLES+T as a useful instrument to evaluate the clinical learning environment at different levels of education and in different contexts regardless of distribution method.
研究表明，临床学习环境既能促进学生学习，也能阻碍学生学习。需要对学生的认知进行评估，最好使用在全国和国际上都经过验证的工具。在瑞典，缺乏关于急性护理环境中以及不同层次学生视角下的学生评估研究。
旨在使用临床学习环境、监督和护士教师量表（CLES+T），探索和比较第一周期和第二周期护理学生在急性护理环境中对临床学习环境的认知。
本研究采用横断面数据收集，并进行组间比较。
数据取自于一所大学附属医院急性护理环境下临床实习结束时便利抽样的第一周期和第二周期学生。
学生填写文化适应后的 CLES+T 的纸质版和网络版。采用独立样本 t 检验探讨 CLES+T 评分、分布方法和教育水平之间的差异。采用 Cronbach's alpha 评估内部一致性。
总体而言，学生（N=179）对临床学习环境感到满意。第一周期和第二周期学生的总分（m=4.31，SD=0.63）没有显著差异，除了“病房护理基础”子量表和“病房护理理念明确”和“患者得到个体化护理”两个条目，表明第一周期学生比第二周期学生更满意。该量表的纸质和网络调查的内部一致性分别为 0.97 和 0.96（α）。
我们的研究结果初步支持 CLES+T 作为一种有用的工具，可以评估不同教育层次和不同背景下的临床学习环境，无论分布方法如何。
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