Nursing students' experiences and expectations of clinical learning: A qualitative study

BACKGROUND: it is in my view that nursing education relates to the process of teaching and learning, given by nurse educators and clinical facilitators to nursing students. The teaching and learning process is conducted in a special Clinical Environment (CLE) entailing theoretical and practical learning. In addition to the teaching personnel, the clinical facilitators are responsible for placement of students in positive learning facilities for practical orientation in the clinical learning outcomes. It is these interactive processes that determine the state of readiness of the students in regards to their suitable attitudes required to provide nursing care. AIM OF THE STUDY: The purpose of this study is to describe nursing students’ experiences of clinical learning and clinical supervision at a private nursing college in eThekwini, in order to achieve improvements. METHODOLOGY: This study is influenced and guided by the quantitative, descriptive cross-sectional survey. It was done among student nurses (n = 120) at a private nursing college in eThekwini which offers the bridging course leading to registration as a Registered Nurse (R683) (South African Nursing Council 2006). In this study, data was gathered using the Clinical Learning Environment and Supervision (CLES) questionnaire developed by Mikko Saarikoski (2002), and it was analyzed by means of IBM SPSS statistics version 21. RESULTS: According to the study a general consensus has provided meaningful situations in the clinical learning environment. The clinical managers should give feedback to student nurses as it enhances their learning process. DISCUSSIONS: Findings in this study revealed that most participants were motivated and optimistic, and according to them, there was a positive clinical atmosphere; which is the most important features of a good clinical environment. RECOMMENDATIONS: It is encouraged that the clinical facilitators make more visits to the wards where the students are allocated for greater learning ability by the students. Professional nurses in the wards are to create a positive learning environment and use the presence of the students to maintain trust and prevent confusion.

BackgroundThe clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. This study aimed to assess the student nurses and midwives’ experiences and perception of the clinical learning environment in Malawi.MethodsA concurrent triangulation mixed methods research design was used to collect data from nursing and midwifery students. Quantitative data were collected using a Clinical Learning Environment Inventory, while qualitative data were collected using focus group discussions. The Clinical Learning Environment Inventory has six subscales of satisfaction, involvement, individualisation, innovation, task orientation and personalisation. The focus group interview guide had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression and qualitative data were thematically analysed.ResultsA total of 126 participants completed the questionnaire and 30 students participated in three focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed a statistically significant association between satisfaction with clinical learning environment and personalization (β = 0.50, p = < 0.001), and task orientation (β =0.16 p = < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment.ConclusionAlthough satisfaction with clinical learning environment subscale had the highest mean score, nursing and midwifery students encountered multifaceted challenges such as lack of resources, poor relationship with staff and a lack of support from clinical teachers that negatively impacted on their clinical learning experiences. Training institutions and hospitals need to work together to find means of addressing the challenges by among others providing resources to students during clinical placement.

Practice education learning environments: The mismatch between perceived and preferred expectations of undergraduate health science students

IntroductionEstablishing a supportive clinical environment is paramount for enhancing nursing students’ engagement in clinical practice, their clinical proficiencies, and satisfaction. The increase in nursing student enrollment at the Nursing College, driven by the collaborative efforts between Abu Dhabi Health Services Company (SEHA) and universities, has given rise to concerns regarding the quality of education and clinical instruction. These concerns are primarily due to the increased student-to-instructor ratio. Furthermore, the unsupportive clinical settings and learning tensions underscore the need to understand students’ learning experiences and address research gaps within the field of clinical learning in the United Arab Emirates (UAE).ObjectivesThe purpose of this study is to investigate the undergraduate nursing students’ perceptions of their clinical learning environment, with a focus on perceived benefits and challenges.MethodsThis study used a cross-sectional survey design. The researchers administered a five-point Likert scale questionnaire, which had been adapted and contextualized, to a convenience sample of 217 third and fourth-year nursing students who willingly participated in this study.ResultsDespite the presence of positive aspects, such as diverse clinical experiences and strong support from both clinical instructors and peers, several challenges affect the students’ clinical learning. These challenges encompass disparate perceptions of supervision among staff nurses, learning tensions related to student academic workload, insufficient clinical supervision, and difficulties in finding assistance when needed.ConclusionThere is a clear need to enhance the overall ward learning environment to optimize students’ academic motivation and clinical skills. Several measures can be taken to achieve this goal, including incentivizing and reducing the workload of staff nurses, investing in the professional development of clinical instructors, promoting peer interactions and group learning, and adopting a block pattern of education in years three and four for better clinical knowledge assimilation and reduced theoretical workload.

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. 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. Cross-sectional, correlational study. 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. 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. 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. 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.

Factors associated with student learning processes in primary health care units: A questionnaire study

Objectives: This study aimed to investigate the perceptions of International Islamic University Malaysia (IIUM) Kuantan nursing students, clinical nurse instructors, and staff nurses of the support offered to student nurses during learning in a clinical setting. Methodology: A cross-sectional study was carried out on undergraduate nursing students (n=118), and clinical instructors (n=8) at the faculty or Kulliyyah of Nursing, IIUM, using the Clinical Learning Environment, Supervision and Nurse Teacher (CLES-T) survey. Descriptive analysis was used to investigate the sociodemographic data, and further statistical tests were conducted with regard to their levels of perception. Results: Overall, the participants perceived the clinical learning environment to be good. There was no difference in perception between nursing students and the clinical nurse instructors (p&gt;0.05). There was no significant difference in terms of gender and levels of perception (p&gt;0.05). This study did find a significant relationship between level of study and area of posting for students and perception levels (p&lt;0.05). Conclusion: This study showed that the majority of the students had positive perceptions of the clinical learning environment, supervision, and nurse teachers. The school provided sufficient support within the clinical learning environment in term of supervision and nurse teachers. These results will help the nursing school in terms of upgrading the clinical learning environment and encouraging collaboration with hospital management to provide a good clinical learning experience for students.

This study is an exploration of nursing students' experiences within the clinical learning environment (CLE) and supervision provided in hospital settings. A total of 357 second-year nurse students from all universities in Cyprus participated in the study. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher instrument. The dimension "supervisory relationship (mentor)", as well as the frequency of individualized supervision meetings, were found to be important variables in the students' clinical learning. However, no statistically-significant connection was established between successful mentor relationship and team supervision. The majority of students valued their mentor's supervision more highly than a nurse teacher's supervision toward the fulfillment of learning outcomes. The dimensions "premises of nursing care" and "premises of learning" were highly correlated, indicating that a key component of a quality clinical learning environment is the quality of care delivered. The results suggest the need to modify educational strategies that foster desirable learning for students in response to workplace demands.

This study examined the clinical learning evaluation, self-efficacy, and practice readiness of nursing students in a selected school in Quezon City and determined the relationships among these variables. Anchored on Benner’s Novice to Expert Theory, Roy’s Adaptation Model, and Bandura’s Social Learning Theory, the study viewed nursing readiness as a product of clinical exposure, adaptation to learning demands, and confidence in one’s capabilities. A quantitative descriptive-comparative design was used. The respondents were 293 second-, third-, and fourth-year nursing students officially enrolled during the second semester of academic year 2024–2025. Data were gathered through a self-administered questionnaire covering profile characteristics, clinical learning evaluation, competency self-efficacy, and practice readiness, and were analyzed using frequency, percentage, weighted mean, standard deviation, t-test, one-way ANOVA, and Pearson r. The findings showed that the respondents had highly positive evaluations of their clinical learning environment, particularly in learning experiences, availability of learning objectives, and effectiveness of clinical learning. Self-efficacy in the clinical learning environment was rated high, with strongest confidence observed in respect, patient advocacy, safety principles, and teamwork. Practice readiness was rated positively in clinical problem-solving, learning techniques, and professional identity, while trials and tribulations yielded an undecided result, indicating continuing difficulties in areas such as electronic documentation, ethical concerns, prioritization, and recognition of patient changes. The study further revealed strong to very strong statistically significant relationships between practice readiness and clinical learning evaluation, and between practice readiness and self-efficacy. The study concludes that a supportive, structured, and feedback-rich clinical learning environment strengthens nursing students’ confidence and readiness for professional practice. It recommends enhancing simulation and skills-based training, reflective practice, digital health competencies, mentorship, and curriculum review to better align academic preparation with clinical realities. The study supports SDG 3, SDG 4, and SDG 8 by promoting safe healthcare practice, quality nursing education, and readiness for professional work. Its sustainability impact lies in strengthening educational quality, institutional responsiveness, and the long-term preparedness of the nursing workforce.

AAIM Recommendations to Promote Equity in the Clerkship Clinical Learning Environment

IntroductionOn entry into the clinical environment, nursing students are confronted with many challenges. It is a common problem throughout the world, including Iran. Although many studies have been conducted on...

Background: Feedback from students regarding their clinical learning environment and clinicians teaching attributes should be evaluated regularly to monitor students' learning experiences which can affect learning outcomes, the readiness for professional practice, and the level of satisfaction with the profession. Differences may exist in this feedback from students based on their institution, level of study, and characteristics of the clinicians. Aim: To evaluate physiotherapy students’ perception of their clinical learning environment and clinicians’ teaching attributes. Methods: This cross-sectional study utilised 258 participants from two academic institutions, which offer physiotherapy training in southeast Nigeria. A self-structured questionnaire, the McGill Clinical Teacher Evaluation tool (MCGill CTE) and the Dundee Ready Educational Environment Measure (DREEM) were used to collect the data. Descriptive statistics of mean and standard deviation were used to present the mean scores obtained on the DREEM questionnaire and McGill CTE tool. The Mann-Whitney U test was used to determine the difference in the students’ perception of their clinical learning environment and clinicians' teaching attributes based on their institution of learning and level of study. In addition, the Mann-Whitney U test also determined the difference in the students' perception of their clinicians teaching attributes based on the clinicians' gender, while the Kruskal Wallis test determined the difference in the students' perception of their clinician's teaching attributes based on their last clinical posting unit and the highest educational level of the clinicians. Results: The students perceived their learning environment to be “more positive than negative”. The highest-rated domain in the DREEM questionnaire was "perception of learning", while the lowest was "social perception". The highest-rated attribute for clinicians in the McGill CTE tool was "clinical interest in helping students to learn", while the lowest was "emphasises concept rather than factual recall". A significant difference was observed in the students rating of their clinical learning environment based on their institution and level of study. Conclusion: There is a need for regular evaluation of students' perception of their clinicians’ teaching attributes and the clinical learning environment to ensure the desired learning outcomes are attained and that students are ready for professional practice after training.

Learning experience of nursing students in a clinical partnership model: An exploratory qualitative analysis

IntroductionThe newly introduced National Ultrasound Training Programme within the NHS Scotland Academy provides an alternative clinical learning environment for postgraduate medical ultrasound learners. Learners during academic year 2022/23 were supported with up to five weeks of clinical education within the NHS Scotland Academy, as an alternative to their local Health Board. This study explores the perceptions and experiences of the first cohort of learners and their practice educators. MethodsAn interview guide was developed comprising questions to explore learners and practice educator experiences and perceptions of the National Ultrasound Training Programme. Ten semi-structured interviews were conducted (Learners n = 5 and Practice Educators n = 5). Thematic analysis was performed by two independent researchers following an established six-stage process. ResultsThree themes emerged:1. Importance of the Clinical learning environment, 2. Relationships and 3. Skills and confidence. Organisational challenges within the NHS Health Boards pose barriers to Learners and Practice Educators supporting clinical education. Learners benefitted from both the clinical learning environments while practice educators recognise the advantage of alternative clinical education for their Learner and wider ultrasound services. Further collaboration to capitalise on knowledge exchange was identified for enhancement. ConclusionThe NHS Scotland Academy can play a pivotal role in delivering learner-centred, protected clinical education as an adjunct to traditional models of practice education. Implications for practiceEmployers and Practice Educators must identify and acknowledge barriers to postgraduate medical ultrasound education. Protected learning time, recognising roles of Learners and Educators and a supportive clinical learning environment are paramount. Learner-centred best practice clinical education can be successfully delivered within the NHS Scotland academy as an adjunct to acute health board clinical education and adopting a collaborative approach will provide enhancements for stakeholders.

Competency self-efficacy (CSE) in clinical nursing practice is necessitated to be attained by the undergraduate nursing students. It is a significant indicator of the work's acceptance and commitment to nursing roles. Self-efficacy in nursing experience enhances nursing student's abilities to achieve the clinical tasks independently, mainly in wide range field of care like Medical-Surgical Nursing. Some factors are affecting competency self-efficacy in the clinical nursing practice; the most evident factor is the nursing student’s impressions with their clinical learning environment (CLE). In the light of educational preparation for nursing undergraduates, the Faculties of Nursing emphasize to preserve a high quality of clinical learning environment for clinical nursing essentials. The clinical learning environment has an apparent function in building up students' confidence, and competency self-efficacy, particularly, during clinical skills achievement. The current paper aimed to determine undergraduate nursing student's satisfaction about the clinical learning environment and their competency self-efficacy, and then investigate the relationship between both variables. Thus, the study conducted through a descriptive, correlative research design with all nursing students who enrolled in third and fourth academic semesters (second year) during their clinical training in Medical-Surgical Nursing course, Faculty of Nursing, Alexandria University, Egypt. A triple-section questionnaire was used for data collection: First; nursing student’s sociodemographic profile, Second: Clinical Learning Environment Inventory (CLEI) which was constructed by Chan in 2002. Third: Nursing Competency Self Efficacy Scale (CSES) which was developed by Kennedy in 2013. The results showed that the undergraduate nursing students at Medical-Surgical training, Faculty of Nursing, Alexandria University, have a high satisfaction level about the clinical learning environment concerning all components of the clinical placement. As well, they have a high competency self-efficacy level in all nursing activities and tasks in the clinical training. Further, there is an obvious parallel correlation between nursing student's satisfaction about clinical learning environment and their competency self-efficacy which is significant. Conclusion &amp; Recommendations: Adequate and planned arrangements should be settled in the nursing curricula for the nursing clinical training setting. Too, the clinical instructors should encourage students' trials to do difficult nursing tasks in a successful manner which tends to increase the student's competency self-efficacy. Further researches are required to investigate the factors affecting clinical learning environment satisfaction and competency self-efficacy among nursing students in their clinical placement. Additionally, another research is necessary about; developing an educational program about student's competency self-efficacy to guide nursing instructors in clinical training.