Chinese version of the clinical learning environment comparison survey: Assessment of reliability and validity

Abstract

BackgroundSimulation is recommended as a substitute for clinical practice among nursing students. No current guidelines exist regarding the accurate percentage of simulation hours versus clinical practice hours. Comparing simulation with clinical practice is needed so that both strategies can be optimally combined in nursing education. The 29-item Clinical Learning Environment Comparison Survey (CLECS) is validated to compare the traditional and simulated clinical environment in meeting nursing students' learning needs. This type of tool is not available in China. ObjectivesThis study aimed to translate and test the psychometric properties of CLECS for Chinese undergraduate nursing students. DesignThis is a cross-sectional study. SettingsTwo nursing schools in Central and East China. ParticipantsA total of 179 undergraduate nursing students who had participated in both traditional and high fidelity simulated clinical practice were recruited. MethodsA standard procedure with forward translation, back translation, cultural adaptation and pilot testing was followed to test the CLECS (Chinese version). An exploratory factor analysis was used to establish a modified factor structure of CLECS (Chinese version); a confirmatory factor analysis verified its construct validity. Reliability of the CLECS (Chinese version) was estimated using the intraclass correlation coefficients (ICCs) and Cronbach's alpha coefficients. ResultsThe exploratory factor analyses explained 61.43% and 60.11% of the total variances in traditional and simulated clinical environment. The proposed factor solution of the CLECS (Chinese version) obtained satisfactory model fit and nesting model between two nursing schools. In the proposed model, ICCs were 0.61 and 0.93, and Cronbach's alpha coefficients were 0.75 and 0.95 in the traditional and simulated clinical environment. ConclusionsThe CLECS (Chinese version) showed satisfactory reliability and validity among Chinese undergraduate nursing students. Further validation of the CLECS (Chinese version) is needed in a more representative and larger sample. The CLECS (Chinese version) should be further tested as an effective tool to compare the traditional and simulated clinical practice among Chinese nursing schools.