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Introduction
Nursing is an art and therefore it requires an exclusive
devotion and a hard preparation. Nursing is a practice-based
profession. The quality of nursing education depends
largely on the quality of the clinical experience. Here
comes the significance of an effective clinical learning
environment. In the clinical learning environment, there
are varieties of influences that can significantly promote
and hinder the clinical learning. It is therefore vital
that valuable clinical time be utilised effectively
and productively.
Need for the Study
A supportive clinical learning environment is vital
to the success of the teachinglearning process. Many
nursing students perceive their clinical learning environment
as anxiety provoking. Campbell (1994) revealed that
clinical learning experience requires difficult adjustments
for students as they come from a different. Masserweh
(1999) indicated that student activities are unplanned
in the clinical area. Nursing student’s frequently feel
vulnerable in the clinical learning environment, so
it’s not surprising that learning in the clinical area
presents a bigger threat to students than learning in
the classroom. Various studies, Harth (2008)
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and Dunn (2007), have shown that not all practice settings
are able to provide student nurses with a positive learning
environment. So it is high time to assess the student’s
perception of effectiveness of existing clinical learning
environment in nursing institutions.
The objective of the present study was, (i) to assess
the perception of effectiveness of existing clinical
learning environment of under graduate nursing students,
(ii) to assess the satisfaction of under graduate nursing
students in the context of existing clinical learning
environment, (iii) to assess the students perception
related to selected aspects in clinical learning, and
(iv) to find association between selected demographic
variables and student satisfaction in the context of
existing clinical learning environment.
Literature Review
The clinical learning environment is a multidimensional
entity with a complex social context. Harth (2008) in
his study on the quality of student - tutor interactions
in the clinical learning environment concluded that,
while two-thirds of tutors were regarded as friendly
and helpful, the remaining were perceived as unconcerned
and hostile.
Another study by Chan (2001) to assess the student’s
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perception of social climate of clinical learning environment
suggested that there were significant differences between
student’s perception of actual clinical learning environment
with and preferred clinical learning environment. The
literature review used for this study reflects the idea
that positive clinical learning environment is essential
for enhancing clinical learning,
Methodology
A descriptive design was used and the study was carried
out in a selected college of Nursing. Simple random
sampling was adopted and the sample size was 100. The
instrument used was 5-point Likert scale questionnaire.
It consisted of two sections.
Section A: Demographic data including Age,
Sex, year of Study & Religion.
Section B: Questionnaire includes the factors
influencing the clinical learning environment.
Scoring Key : Scores ranged from 21
to 105. The score was interpreted as : 21-37 : Highly
ineffective
38-54 : Moderately ineffective
55-71 : Moderately effective
72-88 : Effective
89-105 : Highly effective.
Ethical Consideration : The study was
conducted only after the approval of administrative
authorities. Informed consent |
was obtained from the students. All information about
the samples was kept confidential.
Data Collection Procedure : A pilot study
was conducted among 10 undergraduate nursing students;
the mean score was 74.21 and the study was found to be
feasible.
In the actual study, 100 students were included and self
report with the help of questionnaire was used to collect
the information.
Data Analysis & Interpretation
Among the total sample, each batch represented 25 percent
of the total population; 42 percent of the students were
between the age group of 19-20 years and the majority
(89%) were females.
Majority of the sample (51%) perceived the present clinical
learning environment as only moderately effective and
49 percent of the sample perceives the present clinical
learning environment as an effective one.
Majority of the students (44%) were moderately satisfied
with the existing clinical learning environment, whereas
31 percent of the students were satisfied with the existing
clinical learning environment.
In the study, 49 percent of the respondents reported that
presence of teachers in clinical environment enhances
clinical learning. ,
The diagram indicates, majority of the nursing students
(56%) experienced good interpersonal relationship among
participants in the clinical learning environment.
Association Findings : There |
is significant association between age and the students’
satisfaction regarding clinical learning environment.
The calculated value is 26.619 and the table value is
21.03, at 0.05 level of significance.
Result & Discussion
Major findings of the study
 51 percent of the sample perceived
their present clinical learning environment as moderately
effective.
44 percent of students were moderately
satisfied with the clinical learning environment.
There was no association between
the year of study and satisfaction of students with the
present clinical learning environment.
Majority of the students (44%) reported that they are
moderately satisfied with the existing clinical learning
environment. A similar finding reported by Dunn & Hansford
in 1997 concluded that the student satisfaction was less
in the context of clinical learning environment. This
correlates with the present study findings.
In this study, 56 percent of nursing students experience
good interpersonal relationship among participants in
clinical learning environment. A similar finding was reported
by Chan (2001). The study concluded that inter personal
relationship among participants in the clinical learning
environment is crucial to the development of positive
learning environment.
Also, 41 percent of the students expressed that support,
motivation and encouragement from both teachers and |
staff members is essential in enhancing clinical learning.
Leino Kilpi in 2005 reported that 67 percent of the students
expressed that encouragement and motivation from the teachers
enhances the clinical learning. This correlates with the
present study.
Implications
Nursing education: As elements of clinical
environment can influence the student learning, interventions
if appropriately conceived and implemented can and will
make a difference.
Nursing practice: Provision of an effective
clinical learning environment to nursing students is crucial
in enhancing quality-based nursing practice.
Nursing Research: There should be ongoing
research upon factors that characterise clinical learning
environment which is beneficial in improving clinical
learning.
Nursing administration: Nurse Administrators
should take initiative in providing the students an effective
clinical learning environment.
Recommendations
The study can be conducted in a
larger sample.
The study can be replicated by
including samples from different nursing colleges in Kerala.
The study can be conducted for
assessing other variables influencing the clinical learning
environment.
Conclusion
Service to mankind is the pri- |
mary function of the nurse, and also the reason for existence
of nursing profession. As nursing profession is undergoing
continuous evolution, to hold on during these changes
nursing students should be provided with an effective
clinical learning environment to enhance the quality of
nursing education. The success of clinical learning is
largely dependent on clinical learning environment, or
more poetically ‘the soul and spirit of medical education’.
References
1. Harth SC, Bavanandan S, Thomas KK (2009). The Quality
of Student Tutor Interaction in Clinical Learning Environment.
Medical Education, 26 pp 321-326. |
2. Jeanette Lancaster, (1999). Nursing Issues in Leading
and Managing Change. Missouri: Mosby Publishers. pp 476
3. Chan DS (2001). Development of the Clinical Learning
Environment Inventory. Using the Theoretical Framework
of Learning Environment Studies to Assess Nursing Students’
Perceptions of the Hospital as a Learning Environment.
41(2): 69-75
4. Campbell IE (1994). Learning to nurse in the clinical
setting. Journal of Advanced Nursing, 20 : 125- 1131 5.
Fretwell JE (1980). An enquiry into the ward learning
environment. Nursing Times Occasional Papers,
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76 : 69-75
6. Massarweh L J (1999). Promoting a positive clinical
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