Identifying Characteristics of the Clinical Learning Environment That Best Support Student Nurse Learning in a Hospital Setting in New Zealand

Abstract

During the three-year Bachelor of Nursing degree, student nurses in New Zealand are required by the Nursing Council of New Zealand to undertake a minimum of 1100 hours in the clinical learning environment. The successful achievement of learning outcomes for student nurses in the clinical area depends partially upon the quality of the teaching and learning environment in which students are situated. The aim of this research was to explore clinical learning experiences from the student nurse perspective to determine learning opportunities that best support them in hospital settings in New Zealand. This single case study utilised both quantitative (Phase I) and qualitative (Phase II) methods for data collection and subsequent analysis and interpretation. Phase I utilised the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Questionnaire. The questionnaire focused on subgroups that covered supervisory relationships; pedagogical atmosphere and nursing practice on the ward; student nurse educator support; leadership style of the ward manager. Student nurses from year one, two and three (n=238: response rate of 70%) were asked to anonymously complete the CLES+T questionnaire. Ethnicity, length of placement and year of student were reported on. In Phase II, two focus groups were formed, with six participants in each, two year one students, two year two students, two year three students, participants volunteered to be a part of the focus group. Discussions were audiotaped and transcribed to offer rich descriptions of the student nurse’s experience , thus enabling thematic analysis of findings. Themes that emerged from the findings included the impact of the preceptorship model of supervision on student learning outcomes, confidence and self-esteem, as well as students’ learning with regards to feelings of belongingness and feeling welcomed. Furthermore this study identified the positive impact of the patient in student nurse learning. A comparative study was also carried out with a Bachelor of Nursing programme at another site in New Zealand. Student nurses in this study were slightly more satisfied with their integration into the hospital ward. Recommendations from this study include reviewing the model of supervision for student nurses in their first hospital clinical placement, and mandatory preceptorship training. for registered nurses undertaking the preceptorship role. Future research recommendations include reviewing the effectiveness of the Dedicated Education Units in New Zealand and exploring the patient-student nurse relationship with regard to increasing learning opportunities.