Nursing and midwifery students’ experiences and perception of their clinical learning environment in Malawi: A mixed method study

Abstract

Background The clinical learning environment is an important part of the nursing and midwifery training as it helps students to integrate theory into clinical practice. However, not all clinical learning environments foster positive learning. The aim of this study was to assess the experiences and perception of nursing and midwifery students of their clinical learning environment in Malawi. Methods A mixed-methods approach was used to collect data from nursing and midwifery students. Data were collected using a questionnaire and focus group discussions. Questionnaire data were collected using the Clinical Learning Environment Inventory (CLEI). Data from focus group discussions were collected using an interview guide which had questions about clinical learning, supervision, assessment, communication and resources. Quantitative data were analysed by independent t-test and multivariate linear regression while qualitative data were analysed by thematic analysis Results A total of 126 participants completed the questionnaire data while 30 students participated in the focus group discussions. Satisfaction subscale had the highest mean score (M = 26.93, SD = 4.82) while Individualisation had the lowest mean score (M = 18.01, SD =3.50). Multiple linear regression analysis showed statistically significant association between Satisfaction with clinical learning environment and Personalization (β = 0.50, p = < 0.001), and Task orientation (β =0.16 p= < 0.05). Teaching and learning resources, hostile environment, poor relationship with a qualified staff, absence of clinical supervisors, and lack of resources were some of the challenges faced by students in their clinical learning environment. Conclusion The findings of this study show that although satisfaction with clinical learning environment had the highest scores, students encountered multifaceted challenges in their clinical learning environment. A collaborative effort from training institutions and hospitals is needed to better support students with their clinical learning.

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