On 2016 Dec 06, University of Kansas School of Nursing Journal Club commented:

Flinn, Sidney., Moore, Nicholas., Spiegel, Jennifer., Schemmel, Alisa, Caedo, Cassandra., Fox, Leana., Hill, RaeAnn., & Hinman, Jill. [Team 1: KUSON Class of 2017]

Introduction

We chose this article because this study focuses on how a clinical learning environment can impact a nursing student’s educational experience. In our Development of a Microsystem Leader course, we have been discussing the clinical microsystems and the elements present in the microsystem environments and their impact on nurses satisfaction. As students, our “work environment” can be considered as the environment in which we learn and are exposed to clinical practice. Within the context of nursing school, we have several learning microsystem environments, including our traditional classroom, as well as our clinical rotations. These separate microsystems each provide us with unique learning experience and opportunities, where we interact with each other throughout our time as a nursing student. In our classroom microsystem, we learn concepts that are applicable to clinical practice, and are encourage to use what we have learned and acquire competency through our clinical experience. Both environments play an important role in our nursing preparation and affect our ability to provide effective care as future nurses. An unsatisfactory clinical experience has the ability to negatively impact our learning and could ultimately determine the outcome of our nursing preparation and influence our practice in the microsystems care setting.

Methods

This article was found using PubMed database. The purpose of this study was to examine if nursing students were satisfied with their clinical setting as learning environments. The study used a quantitative descriptive correlational method using 463 undergraduate nursing students as sample from three universities in Cyprus. Data were collected from the three universities’ nursing program using the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) questionnaire. The CLES+T was used to measure student’s satisfaction with their clinical learning environment. It consists of 34 items classified into 5 dimensions: pedagogical atmosphere on the ward; supervisory relationship; leadership style of the ward manager; premises of nursing on the ward; role of the NT in clinical practice. Out of the total 664 students from the three universities, 463 or 70.3% completed the self-report questionnaire. Along with the questionnaire each student was asked to complete a demographic data sheet that included information such as age, gender, and education level, what hospital and unit they were assigned for clinical rotation. The data was collected in the last laboratory lesson that occurred in the 2012-2013 school year. Quantitative data was derived from the questionnaires through the use of descriptive statistics (Papastavrou, Dimitriadou, Tsangari & Andreou, 2016).

Findings

Results showed that overall, nursing students rated their clinical learning environment as “very good” and were highly satisfactory (Papastavrou et al., 2016, p.9). This was well correlated with all five dimensions indicated in the CLES+T questionnaire including overall satisfaction. The biggest difference in scores were found among the students who met with their educators or managers frequently which is considered as successful supervision. This is considered as the “most influential factor in the students’ satisfaction with the learning environment” (p. 2). Students who attended private institutions were less satisfied, as were those placed in a pediatrics unit or ward. Important aspects of high satisfaction rates included coming from a state university, those with mentors, and those with high motivation. Limitations of the study included some students’ limited amounts of time spent in their clinical environment at the time of the study, and failure to use a “mix methodology” to compare the findings in this study with other similar studies (Papastavrou et al., 2016).

Implications to Nursing Education

This study is important to nursing because our educational and clinical preparation is the starting point of how we are shape to become successful nurses. The clinical learning environment is especially important because this is where we, as students, get the opportunity to use the knowledge and skills we learned in the classroom and apply it in the patient care setting. We get to actively practice assessments, apply hands-on skills, and interact with other medical professionals while becoming empowered to participate in practice autonomously. As mentioned in the article, a well-established mentorship with the nurses on the floor and with our clinical instructors sets the groundwork for a positive experience during clinical immersion experiences (Papastavrou et al., 2016). This positive relationship and experiences can lead to a healthy workplace that allows nursing students to feel empowered enough to practice their own skills, build trust with their instructors and ask appropriate questions when necessary (Papastavrou et al., 2016). Many of us have had unsatisfactory clinical experiences where we had a disengaged clinical instructor or had a designated nurse mentor who clearly lack mentoring skills to guide student in the learning environment. These situations lead us to feel quite dissatisfied with our clinical experience and hindered our learning experience. It is important for nurses and clinical faculty to be aware of how important these clinical experiences and supervisory relationships are to our preparation. Without them we would not be able to fully grasp the complexities that are associated with nursing practice, and would be inadequately prepared to work as a nurse. In relation to clinical microsystems, this study can be considered to be focusing on a positive clinical microsystem learning experience in nursing school. These experiences become the foundation of how we are being formed to become future frontline leaders, and bring out the confidence in us through their guidance and mentorship. It is crucial that nursing school establish a positive learning environment, both in the classroom and clinical setting that will help nursing students build their competence and development in the clinical setting which they can carry after graduation and applied in practice (Papastavrou et al., 2016). Creating a positive learning environment in nursing school will help bring students’ positive attitudes to the workplace where they can be a part of an empowered microsystems. This article provided us with a well-defined guidelines on how to empower nursing students and creating a healthy learning and work environment.

Papastavrou, E., Dimitriadou, M., Tsangari, H., & Andreou, C. (2016). Nursing students’ satisfaction of the clinical learning environment: a research study. BMC Nursing, 15(1), 44. DOI: 10.1186/s12912-016-0164-4

On 2016 Dec 06, University of Kansas School of Nursing Journal Club commented:

Flinn, Sidney., Moore, Nicholas., Spiegel, Jennifer., Schemmel, Alisa, Caedo, Cassandra., Fox, Leana., Hill, RaeAnn., & Hinman, Jill. [Team 1: KUSON Class of 2017]

Introduction

We chose this article because this study focuses on how a clinical learning environment can impact a nursing student’s educational experience. In our Development of a Microsystem Leader course, we have been discussing the clinical microsystems and the elements present in the microsystem environments and their impact on nurses satisfaction. As students, our “work environment” can be considered as the environment in which we learn and are exposed to clinical practice. Within the context of nursing school, we have several learning microsystem environments, including our traditional classroom, as well as our clinical rotations. These separate microsystems each provide us with unique learning experience and opportunities, where we interact with each other throughout our time as a nursing student. In our classroom microsystem, we learn concepts that are applicable to clinical practice, and are encourage to use what we have learned and acquire competency through our clinical experience. Both environments play an important role in our nursing preparation and affect our ability to provide effective care as future nurses. An unsatisfactory clinical experience has the ability to negatively impact our learning and could ultimately determine the outcome of our nursing preparation and influence our practice in the microsystems care setting.

Methods

This article was found using PubMed database. The purpose of this study was to examine if nursing students were satisfied with their clinical setting as learning environments. The study used a quantitative descriptive correlational method using 463 undergraduate nursing students as sample from three universities in Cyprus. Data were collected from the three universities’ nursing program using the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) questionnaire. The CLES+T was used to measure student’s satisfaction with their clinical learning environment. It consists of 34 items classified into 5 dimensions: pedagogical atmosphere on the ward; supervisory relationship; leadership style of the ward manager; premises of nursing on the ward; role of the NT in clinical practice. Out of the total 664 students from the three universities, 463 or 70.3% completed the self-report questionnaire. Along with the questionnaire each student was asked to complete a demographic data sheet that included information such as age, gender, and education level, what hospital and unit they were assigned for clinical rotation. The data was collected in the last laboratory lesson that occurred in the 2012-2013 school year. Quantitative data was derived from the questionnaires through the use of descriptive statistics (Papastavrou, Dimitriadou, Tsangari & Andreou, 2016).

Findings

Results showed that overall, nursing students rated their clinical learning environment as “very good” and were highly satisfactory (Papastavrou et al., 2016, p.9). This was well correlated with all five dimensions indicated in the CLES+T questionnaire including overall satisfaction. The biggest difference in scores were found among the students who met with their educators or managers frequently which is considered as successful supervision. This is considered as the “most influential factor in the students’ satisfaction with the learning environment” (p. 2). Students who attended private institutions were less satisfied, as were those placed in a pediatrics unit or ward. Important aspects of high satisfaction rates included coming from a state university, those with mentors, and those with high motivation. Limitations of the study included some students’ limited amounts of time spent in their clinical environment at the time of the study, and failure to use a “mix methodology” to compare the findings in this study with other similar studies (Papastavrou et al., 2016).

Implications to Nursing Education

This study is important to nursing because our educational and clinical preparation is the starting point of how we are shape to become successful nurses. The clinical learning environment is especially important because this is where we, as students, get the opportunity to use the knowledge and skills we learned in the classroom and apply it in the patient care setting. We get to actively practice assessments, apply hands-on skills, and interact with other medical professionals while becoming empowered to participate in practice autonomously. As mentioned in the article, a well-established mentorship with the nurses on the floor and with our clinical instructors sets the groundwork for a positive experience during clinical immersion experiences (Papastavrou et al., 2016). This positive relationship and experiences can lead to a healthy workplace that allows nursing students to feel empowered enough to practice their own skills, build trust with their instructors and ask appropriate questions when necessary (Papastavrou et al., 2016). Many of us have had unsatisfactory clinical experiences where we had a disengaged clinical instructor or had a designated nurse mentor who clearly lack mentoring skills to guide student in the learning environment. These situations lead us to feel quite dissatisfied with our clinical experience and hindered our learning experience. It is important for nurses and clinical faculty to be aware of how important these clinical experiences and supervisory relationships are to our preparation. Without them we would not be able to fully grasp the complexities that are associated with nursing practice, and would be inadequately prepared to work as a nurse. In relation to clinical microsystems, this study can be considered to be focusing on a positive clinical microsystem learning experience in nursing school. These experiences become the foundation of how we are being formed to become future frontline leaders, and bring out the confidence in us through their guidance and mentorship. It is crucial that nursing school establish a positive learning environment, both in the classroom and clinical setting that will help nursing students build their competence and development in the clinical setting which they can carry after graduation and applied in practice (Papastavrou et al., 2016). Creating a positive learning environment in nursing school will help bring students’ positive attitudes to the workplace where they can be a part of an empowered microsystems. This article provided us with a well-defined guidelines on how to empower nursing students and creating a healthy learning and work environment.

Papastavrou, E., Dimitriadou, M., Tsangari, H., & Andreou, C. (2016). Nursing students’ satisfaction of the clinical learning environment: a research study. BMC Nursing, 15(1), 44. DOI: 10.1186/s12912-016-0164-4