Abstract
BackgroundKnowledge concerning nursing students’ experiences of the clinical learning environment and how supervision is carried out is largely lacking. This study compares nursing students’ perceptions of the clinical learning environment and supervision in two different supervision models: peer learning in student-dedicated units, with students working together in pairs and supervised by a “preceptor of the day” (model A), and traditional supervision, in which each student is assigned to a personal preceptor (model B).MethodsThe study was performed within the nursing programme at a university college in Sweden during students’ clinical placements (semesters 3 and 4) in medical and surgical departments at three different hospitals. Data was collected using the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, CLES+T, an instrument tested for reliability and validity, and a second instrument developed for this study to obtain deeper information regarding how students experienced the organisation and content of the supervision. Independent t-tests were used for continuous variables, Mann-Whitney U-tests for ordinal variables, and the chi-square or Fischer’s exact tests for categorical variables.ResultsOverall, the students had positive experiences of the clinical learning environment and supervision in both supervision models. Students supervised in model A had more positive experiences of the cooperation and relationship between student, preceptor, and nurse teacher, and more often than students in model B felt that the ward had an explicit model for supervising students. Students in model A were more positive to having more than one preceptor and felt that this contributed to the assessment of their learning outcomes.ConclusionsA good learning environment for students in clinical placements is dependent on an explicit structure for receiving students, a pedagogical atmosphere where staff take an interest in supervision of students and are easy to approach, and engagement among and collaboration between preceptors and nurse teachers. This study also indicates that supervision based on peer learning in student-dedicated rooms with many preceptors can be more satisfying for students than a model where each student is assigned to a single preceptor.
Highlights
Knowledge concerning nursing students’ experiences of the clinical learning environment and how supervision is carried out is largely lacking
The preceptor’s role Students supervised in model A had more positive experiences of the preceptor’s role and gave higher ratings for the items “it is beneficial to have several preceptors during a teaching period” and “having more than one preceptor contributed to the assessment of my learning outcomes,” as compared with students in model B (Table 3)
A good learning environment for students in clinical placements is dependent on engagement and collaboration between preceptors and academic nurse teachers
Summary
Knowledge concerning nursing students’ experiences of the clinical learning environment and how supervision is carried out is largely lacking. The environment should motivate students and contribute to their feeling of security, including when asking questions to achieve learning outcomes [2]. The clinical learning environment and supervision of students play a crucial part in supporting student learning and are highly dependent on the relationship between student, preceptor, and nurse teacher [3]. Nurse teachers have a multifaceted and important role in supervision, including supporting, motivating, problem-solving and monitoring [4]. Students have a responsibility to be active in their own learning [5] and preceptors and nurse teachers are both facilitators of and responsible for the students’ learning in clinical settings
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