The Relationship between Clinical Placement Duration and Students’ Satisfaction with the Quality of Supervision and Learning Environment: A Mediation Analysis.

Abstract

Background: Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified. Nevertheless, there is no evidence on what is the optimum time a nursing student should remain in the different practice settings for achieving the required competencies nor how this duration of the placement may be influenced by other variables.The aim of the study was examine whether the relationship between the clinical placement duration and total satisfaction with clinical training is mediated by supervisory relationship and learning environment.Method: A mediation analysis was conducted using the data from a cross-sectional study conducted in 17 higher educational institutions from nine European countries with the CLES+T scale (n=1903 pre-registration nursing students). Besides, ANCOVA models were used to assess mean differences in total satisfaction by categories of supervision factors, clinical placement duration and participants’ characteristics.Results: A significant increase of total satisfaction was found as better learning environment participant’s perceived, as well as better was their satisfaction with their supervisor (both p<0.001). Students that considered the supervisor the most important person in practical training were significantly more satisfied as compared with those who considered the nurse teacher as the most important [mean 4.15 (0.89) vs 3.23 (1.16)]; p=0.001]. The satisfaction with the supervisor (IE= 0.101 [95% CI 0.016; 0.183]) and a good learning environment (IE= 0.088 [95% CI 0.003; 0.170]) mediated the relationship between clinical placement duration and total satisfaction perceived by the students.Conclusion: Nursing students with longer clinical placement duration were more satisfied with clinical training as a result of both their satisfaction with their supervisor and the good learning environment perceived. The optimal duration a nursing student should remain in the different practice settings to reach a balance between the achievement of fully competent nurses and the maximum level of satisfaction at the practicum ward should be around seven weeks. The role of nurse teachers and supervisors in contributing the acquisition of competences of nursing students needs to be clarified.

Understanding the expectations of nursing students following the first clinical internship: A qualitative study

“…Similarly, Lee and Chiang (2021) noticed that the student‐instructor relationship is crucial for optimal student learning during their internships (Lee & Chiang, 2021). In fact, there are studies that show that the student‐instructor relationship directly impacts student satisfaction with practical learning (Pitkänen et al, 2018); thus, the greater the interaction, the greater is students' satisfaction with their internship (González‐García et al, 2021; Saukkoriipi et al, 2020).…”

“…Even though the literature shows no consensus on the best possible duration of a clinical internship (González-García et al, 2021) Finally, each clinical internship is supervised by a coordinator who oversees the availability of practice places, the individualized assignment to each student, the monitoring of the faculty, and the resolution of conflicts. The coordinator has a managerial role rather than a teaching one.…”

“…Some studies highlight the importance of students' relationships with their clinical instructors as supporting the learning environment and student autonomy (Jokelainen et al, 2013). In environments where there is mutual respect and the students' roles are valued, constructive and fruitful relationships emerge, helping students attain recognition as future nurses (González‐García et al, 2021). Mutual respect generates a positive impact on students' self‐esteem and highlights the acquisition of knowledge in receptive environments as a means to increase students' confidence and reduce their anxiety (Antohe et al, 2016; Borrott et al, 2016; Saukkoriipi et al, 2020).…”

“…Even though the literature shows no consensus on the best possible duration of a clinical internship (González‐García et al, 2021), in Spain, the nursing degree requires 2300 clinical hours, spread over 4 years of university training. Clinical practices are developed in different health centers, mainly hospitals and primary/community health centers (Agència per a la Qualitat del Sistema Universitari de Catalunya, 2017).…”

“…The clinical instructors are nursing professionals who assume this unpaid role, as part of the agreement established between the UAB and the clinical center. Previous studies have shown that providing a supportive clinical learning environment promotes students' satisfaction, identifying the clinical instructor as the most significant figure for students (González‐García et al, 2021). The university faculty in charge of clinical internships contacts clinical instructors to explain and clarify the learning objectives, the expected results, and the evaluation tools.…”