Document Type : Original Article

Authors

Department of Community Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran

Abstract

INTRODUCTION: The clinical environment is an essential and irreplaceable resource in preparing
nursing students for their professional role. Despite many changes that occur in the clinical learning
environment (CLE), these environments remain important to nurse training. With regard to the
importance of students’ viewpoints in the evaluation of CLE, this study was performed to the
determination of nursing students’ viewpoint of the actual and preferred CLE at Bushehr University
of Medical Sciences in Iran 2013.
MATERIALS AND METHODS: In this cross‑sectional analytic study, due to the small size of the
research population, all nursing students (86 students) of Bushehr University of Medical Sciences
in Iran who had passed at least one clinical course were selected through the census. Participants
were invited to complete anonymously the actual and preferred Farsi versions of the CLE Inventory
consisting of 42 items originally developed by Professor Chan (2001). Data were analyzed using
frequency distribution, mean, standard deviation, and paired t‑test.
RESULTS: The results indicated that there were significant differences between students’ perceptions
of the actual and the preferred CLE (P < 0.001). The highest and lowest mean scores of actual CLE
belonged to student involvement and individualization, respectively, and the highest and lowest mean
scores of preferred CLE belonged to task orientation and individualization, respectively.
CONCLUSION: In general, students prefer a more positive CLE than what they actually have
experience and would prefer an environment with higher levels of clarification of personalization,
student Involvement, satisfaction, task orientation, innovation, and individualization.

Keywords

1. Abraham R, Ramnarayan K, Vinod P, Torke S. Students’
perceptions of learning environment in an Indian medical school.
BMC Med Educ 2008;8:20.
2. Yazdankhahfard M, Haghani F, Omid A. The Balint group and
its application in medical education: A systematic review. J Educ
Health Promot 2019;8:124.
3. Yazdankhahfard M, Haghani F, Omid A, Scheidt C E. Clinical
teacherâ s experiences of the influence of participation in the
balint group on their work life in clinical settings: A qualitative
study. Ann Med Health Sci Res 2019;9:575‑585
4. Yazdankhah Fard M, Pouladi S, Kamali F, Zahmatkeshan N,
Mirzaei, K, Akaberian S, et al. The stressing factors in clinical
education: The viewpoints of students. Iran J Med Educ
2009;8:341‑9.
5. Chan DS, Ip WY. Perception of hospital learning environment:
A survey of Hong kong nursing students. Nurse Educ Today
2007;27:677‑84.
6. Papastavrou E, Lambrinou E, Tsangari H, Saarikoski M,
Leino‑Kilpi H. Student nurses experience of learning in the clinical
environment. Nurse Educ Pract 2010;10:176‑82.
7. AlHaqwi AI, Taha WS. Promoting excellence in teaching
and learning in clinical education. J Taibah Univer Med Sci
2015;10:97‑101.
8. Nordquist J, Hall J, Caverzagie K, Snell L, Chan MK,
Thoma B, et al. The clinical learning environment. Med Teach
2019;41:366‑72.
9. Henderson A, Tyler S. Facilitating learning in clinical practice:
Evaluation of a trial of a supervisor of clinical education role.
Nurse Educ Pract 2011;11:288‑92.
10. Flott EA, Linden L. The clinical learning environment in nursing
education: A concept analysis. J Adv Nurs 2016;72:501‑13.
11. Papp I, Markkanen M, Bonsdorff MV. Clinical environment as
a learning environment: Student nurses’ perceptions concerning
clinical learning experiences. Nurse Educ Today 2003;23:262‑8.
12. Arkan B, Ordin Y, Yılmaz D. Undergraduate nursing students’
experience related to their clinical learning environment and
factors affecting to their clinical learning process. Nurse Educ
Pract 2018;29:127‑32.
13. Moattari M, Ramezani S. Nursing students’ perspective toward
clinical learning environment. Iran J Med Educ 2009;9:137‑44.
14. Henderson A, Cooke M, Creedy DK, Walker R. Nursing students’
perceptions of learning in practice environments: A review. Nurse
Educ Today 2012;32:299‑302.
15. Sand‑Jecklin K. Student Evaluation of Clinical Education
Environment (SECEE): Instrument Development and Validation.
West Virginia University; 1998.
16. Nazari R, Beheshti Z, Arzani A, Hajihosseni F, Saatsaz S,
Bigeni A.Stressful factors in nursing students clinical teaching
of nursing and midwifery faculty of Babol. J Babol Univer Med
Sci 2007;9:45‑50.
17. Delaram M. Clinical education from the viewpoints of nursing
and midwifery students in Shahrekord university of medical
sciences. Iran J Med Educ 2006;6:129‑34.
18. Shahsavari S, Mosallanejad L, Sobhanian S, Tehranineshhat, B,
Faseleh, M.Study the physical, spiritual and social stress – Related
symptoms in nurses and midwiferies working at educational
and Therapeutic centers affiliated to Jahrom School of Medical
Sciences1382. J Jahrom Med Sch 2005;2:12‑20.
19. Papastavrou E, Dimitriadou M, Tsangari H, Andreou C. Nursing
students’ satisfaction of the clinical learning environment:
A research study. BMC Nurs 2016;15:44.
20. Serena P, Anna B. Italian nursing students’ perception of their
clinical learning environment as measured with the CLEI tool.
Nurse Educ Today 2009;29:886‑90.
21. Chan DS. Associations between student learning outcomes
from their clinical placement and their perceptions of the social
climate of the clinical learning environment. Int J Nurs Stud
2002;39:517‑24.
22. Midgley K. Pre‑registration student nurses perception of the
hospital‑learning environment during clinical placements. Nurse
Educ Today 2006;26:338‑45.
23. Chan DS. Combining qualitative and quantitative methods
in assessing hospital learning environments. Int J Nurs Stud
2001;38:447‑59.
24. Brown T, Williams B, McKenna L, Palermo C, McCall L, Roller L,
et al. Practice education learning environments: The mismatch
between perceived and preferred expectations of undergraduate
health science students. Nurse Educ Today 2011;31:e22‑8.
25. Rezaei K, Kouhestani H, Baghcheghi N. Actual and preferential
perception of clinical learning environment among nursing
students in Arak university of medical sciences, 2009. Iran J Med
Educ 2011;5:457‑66.
26. Zaighami R, Faseleh M, Jahanmiri S, Ghodsbin, F.Nursing
student’s viewpoints about the problems of clinical teaching.
J Qazvin Univer Med Sci Health Serv 2004;8:51‑5.
27. Chan DS. Nursing students’ perceptions of hospital learning
environments – An Australian perspective. Int J Nurs Educ
Scholarship 2004;1:4.