The relationship between Clinical Learning Environment and Clinical Learning Experience of Undergraduate Nursing Students in West Bank Universities/ Palestine: A Mixed-Methods Study رسالة دكتوراة

Abstract

Clinical learning environment (CLE) plays a vital role in clinical nursing education and has an important effect on clinical learning experience (CL experience) of nursing students as they train in these clinical environments. CL experience of nursing students impacts the quality of care delivered to patients and determines the nursing students' competency in their future career. Purpose: The purpose of this study was to explore the relationship between the CLE and the CL experience of undergraduate nursing students at Palestinian universities. Method: A mixed-method study was used to identify and explore the CL experiences of undergraduate nursing students at three different governmental, public, and private universities. Quantitative data were collected from 306 second, third-, and fourth-year nursing students through a self-administered questionnaire using convenience sampling. Qualitative data were collected using a focus group consisting of 14 fourth year nursing students through semi-structured interviews. Analysis: The quantitative data were analyzed by the statistical package of Social Sciences (SPSS) version (25) using frequencies, means, standard deviation (SD), percentages, t-test, ANOVA, Post hoc and regression. The qualitative data were analyzed using inductive content analysis. VII Results: The results showed differences in the means of the CLE and the CL experience levels, statistically significant differences in the mean of the CL experience in relation to the type of the training site and the training ward at the level of p value ≤ .05 (p = .032, p = .019) respectively, and a strong correlation between CLE and CL experience (r = .758). The CLE variables also predict the CL experience mainly; the "pedagogical atmosphere" and the "supervisory relationship" variables predict the CL experience at the level of p value ≤ .001, ≤ .005 (p = .000, p = .001) respectively. The type of training site predicts the CL experience at the level of p value ≤ .05 (p = .034). The qualitative data resulted in an emergence of four themes, namely perceptions of CL experience, facilitators of CL experience, barriers of CL experience, and strategies to improve CL experience. Seventeen categories related to clinical environment, students, instructors, nursing staff, assignments, opportunities, and training conditions were also created. Conclusion: The study answered the research questions in which there was a strong correlation between the CLE and CL experience, differences in the means of CLE and CL experience levels, significant differences in the means of the type of the training site and the training ward and CL experience. The "pedagogical atmosphere" and the "supervisory relationship" variables predicted the CL experience. In addition, four themes were emerged that were related to CL experience perception, facilitators of CL experience, barriers of CL experience, and strategies of CL experience. The results contributed to the existing body of knowledge by providing specific results related to the Palestinian context that formed a base line for scholars. The study recommended VIII further research to have more insight about the CLE and the CL experiences of undergraduate nursing students in different schools for various clinical courses in other clinical settings.