Multilevel perspectives in clinical learning environments' assessment: An insight on levels involved in planning nursing education

Abstract

Background: Clinical learning in nursing education is workplace-based and it involves both learning and organizational factors. Students could experience these factors both at individual and at group level. This study aimed to assess clinical learning environment as a multilevel phenomenon, by grouping students' perceptions at different organizational levels. Method:A cross-sectional multilevel design has been conducted. 3 Italian Universities, 6 Hospitals and 73 wards have been involved in the study during 2013. Wards with at least 3 attending nursing students have been included. The sample involved 597 nursing students (average age 23.1 years, SD = 4.67 years; 72.6% females; 27.2% attending first year; 31.7% second year; 41.1% third year). Clinical Learning Environment and Supervision plus Nurse teacher (CLES+T) scale has been administered. Intraclass Correlation Coefficients (ICC) have been estimated at ward, at hospital and at University level.Results: All ICCs scores were above 0.10 and they indicated clinical learning environment as a multilevel phenomenon. The most pertinent level to multilevel research was the ward level. The nurse teacher scale was pertinent to Hospital and University level. Conclusions:Clinical learning environment is a multilevel phenomenon. These findings could enhance research development in this field of studies. Practical implications suggest multilevel approach in order to detect the most effective organizational level to improve educational intervention.

Work-engaged nurses for a better clinical learning environment: a ward-level analysis

“…In fact, work engagement and the clinical learning environment are usually approached in research at the individual level (Simpson , Tomietto et al . ).…”

“…, Tomietto et al . ). Specifically, this study demonstrated that work engagement, in nursing work‐teams, is effective in improving students’ clinical learning.…”

“…Accordingly, clinical learning is workplace‐based and it is influenced by organizational variables (Bergjan & Hertel , Tomietto et al . ). Specifically, a clinical learning environment is defined as ‘an interactive network of forces within the clinical setting that influence the students’ learning outcomes’ (Dunn & Burnett ).…”

“…, Tomietto et al . ). Often students within the same ward are exposed to the same organisational and learning climate and to the same relational environment, as well as to the same leadership style of the ward manager and nursing care delivery models.…”

The Clinical Learning Environment: The Attitude of Undergraduate Student Nurses Towards Mentorship at Hospitals in Lithuania

“…In the Lithuanian Bachelors of nursing degree, students are required to perform clinical placements of no less than 50 % of their total education time, in line with the European Council recommendation that the clinical component should comprise 50 % of the nursing education programme and take place in healthcare settings (Directive 2013/55/EU). The clinical learning environment (CLE) is a multilevel phenomenon which consist of a pedagogical atmosphere, the leadership style of the ward manager, the premises of nursing, and supervisory relationships (Tomietto et al, 2014). Nursing programmes and healthcare facility leaders must evaluate the CLE, ensuring learning objectives are met, to better prepare students for practice (Flott & Linden, 2016).…”