Perception Of The Clinical Learning Environment And Supervision Among Nursing Students In Adeleke University, Ede Osun State

Perception Of The Clinical Learning Environment And Supervision Among Nursing Students In Adeleke University, Ede Osun State

Abstract

This study was carried out onthe perception of nursing students towards the clinical learning environment and supervision in Adeleke University, Ede Osun State. To achieve this, four significant research objectives were formulated. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of nursing students in year 4 & 5 in in Adeleke University, Ede Osun State. In determining the sample size, the researcher conveniently selected 235 respondents while 220 were received, and 210 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency, and mean score tables. The result of the findings reveals that the nursing students are satisfied with the integration of theory and practice in their clinical learning environment. Also, the study discovered that the nursing students perceive the quality of supervision provided in the clinical learning environment to be very effective. And the nursing students’ perceive the leadership style of the ward-manager in the clinical learning environment to be ineffective. In regard to the findings, the study recommends that allocating students to preceptors with a patient/ client caseload would be a means towards improving students’ perception of ward and workload organization; the importance of helping students feel valued and interpersonal relationships in the clinical area need to be highlighted in the preceptor preparation programmes.

Chapter One

Introduction

1.1 Background of the Study

The clinical learning environment is important in facilitating students to achieve their learning outcomes. Studies have shown that high quality of clinical learning environment and supervision has significant influence on the development of professional identity and competency1 and clinical skills2 among students. An effort to develop the quality experience within a supportive and pedagogically adjusted clinical learning environment is a concern for educational institutions2 . Relevant studies revealed that quality of clinical learning environment usually depends on the quality of curriculum3, supportive relationship between student and mentor, peer support and sense of belonging4 among students. If students are welcomed, incorporated and appreciated in the clinical setting then the experience of clinical learning environment and supervision is considered as positive.

The clinical learning environmentand supervision is an interactive forces’ network within the clinical setting that influence the leaning outcomes. It comprises everything that surrounds students and affects their professional development in the clinical setting4.When the students enter the unfamiliar area of the clinical setting, the atmosphere of this particular setting can have enduring influences on their learning experience2. The clinical learning environment can have a great influence in the development of the attitude, knowledge, skills, and problem solving ability of students who engage into this situation3. In addition, one to one supervision in the clinical setting has significantly increased students satisfaction. Although the basic premises for supervision include implementation, adequacy and effectiveness of supervision along with sufficient resources are dependent on the pedagogical premises of the work unit. Quality supervision is essential in which the individual learning needs and goals of the student are met6.

In this context, development of decent learning environment depends on five distinctive constructs: the ward’s pedagogical atmosphere includes teamwork and personnel’s interest in students’ learning needs; the supervisory relationship constructs reflect the sense of trust, student/mentor equality and continual feedback. The third construct is leadership style which represents the relationship between ward managers, staff and the students. The premises of nursing on the ward refers to the organization of the nursing care and the role of teacher in clinical practice reflects the teacher’s ability to minimize the theory practice gap.7

Mostly studies have been done in the hospital setting to explore the attitude, satisfaction and perception of health care students regarding clinical learning environment8. Nursing is a respectable profession and the acceptability of male nurses in the hospital setting has increased over the years. A study showed that the male nurses’ student expressed discomfort in the beginning, low acceptance and more role strain than the females especially while providing care to the mothers in the obstetrical and gynecological ward9.Itis beneficial to understand expectation of the students for their clinical experience to provide a positive CLE and proper supervision6. Hence, the investigators felt the need to assess the nursing students’ perceptions with their clinical learning environment and supervision in a selected college of Nursing of Adeleke University, Ede Osun State.

1.2 Statement of the Problem

As shown by a plethora of studies, the quality of nursing learning environments is crucial to discovering how nursing students perceive their clinical learning environments (CLEs) [10-13]. Nursing students were found to engage smoothly in the practicum experience if they were motivated in the profession [14,&15]. The positive ward atmosphere and the supervisory relationship were factors that influenced students’ perceptions of CLEs [12]. Conversely, the characteristics of challenging CLEs were unwelcoming nursing staff, clinical faculty’s lack of expertise in the clinical area or a lack of fit between students’ abilities and patient acuity [16]. In the last decade, significant changes in undergraduate nursing education have emphasized students’ experiences and learning in the clinical environment [17,18].

Certainly, classroom learning is insufficient for students to become competent nurses who can meet the healthcare workforce’s expectations [19,20]. Instead, practice in CLEs offers nursing students the opportunity to integrate their theoretical classroom knowledge with the practical skills required to make clinical decisions and provide care in the clinical ward [21]. Therefore, clinical practicum is a valuable learning tool for improving nursing students’ academic knowledge and concepts through practical application [22]. In fact, the clinical practicum is essential for filling the gap between abstract, theoretical knowledge and development of practical skills and competence [23]. Within nursing education, the CLE is well recognized for its importance in curricula because it provides a real-life context for nursing practice and supports meaningful learning, socialization and professional development opportunities for nursing students [24]. In view of the above, this study seek to ascertain the perception of nursing students towards the clinical learning environment and supervision in Adeleke University, Ede Osun State

1.3 Objectives of the Study

The general focus of this study is to assess the perception of nursing students towards the clinical learning environment and supervision in Adeleke University, Ede Osun State. However, the specific objectives which falls inline with the overall aim of this research are outlined below;

1. Ascertain whether nursing students are satisfied with the integration of theory and practice in their clinical learning environment.
2. Ascertain nursing students perception of the quality of supervision provided the clinical learning environment.
3. Ascertain students perception of the leadership style of the ward-manager in the clinical learning environment.
4. Ascertain students perception on the challenging factors in the clinical learning environment.

1.4 Research Question

The study will be guided by the following questions;

1. Are the nursing students satisfied with the integration of theory and practice in their clinical learning environment?
2. What is the perception of nursing students towards the quality of supervision provided in the clinical learning environment?
3. What is nursing students’ perception of the leadership style of the ward-manager in the clinical learning environment?
4. What are the challenging factors in the clinical learning environment perceived by the nursing students?

1.5 Significance of the Study

The focus of this study is on the perceptions of clinical learning environment and supervision of student nurses in Adeleke University, Ede Osun State. The findings of this study will reveal the students’ perceptions of a preferred clinical learning environment in the hospital setting, whether the practice settings are able to provide nursing students with a positive learning environment. It will also reveal a better understanding of what constitutes quality clinical education from the students’ perspective. An understanding of the students’ perceptions of their actual and preferred hospital clinical learning environment may reveal aspects of the actual environment that require improvement in order to maximise students’ learning in practice. Findings if published and utilized will also assist in improving the educative quality of students’ clinical education through understanding their perspective of clinical learning environment and the social climate in which they are (ward). It will also help nurse educators, hospital administrators, Nursing and Midwifery Council of Nigeria as well as Ministry of Education in ensuring that the problems identified by students in the clinical area is addressed accordingly by monitoring the activities in the clinical setting. This study will equally serve as a reference for future researchers writing on similar topic. The findings of this study will also contribute to the existing body of knowledge on the clinical learning environment in nursing literature in Nigeria. It is believed that the present study will provide a preliminary data that will fill the gap in the knowledge in nursing literature in this area.

1.6 Scope of Study

This study is delimited to student nurses in Adeleke University, Ede Osun State. This includes fourth and fifth year nursing students in the department of nursing sciences of Adeleke University, Ede Osun State, because they had experienced adequate clinical exposure to be able to comment on a variety of situation. The study is delimited to clinical learning environment and supervision of nursing students. It includes students of both sexes.

1.8 Definition of Terms

Perception – refers to the rating by student nurses of items of the actual and preferred clinical learning environment inventory (CLEI 42 items), contained in the questionnaire. These ratings are based on the observations and experiences and exposures of the student nurses.

Hospital clinical learning environment – refers to student nurses’ clinical experience in the hospital setting.
Clinical learning environment – is defined as an interactive network of forces within the clinical setting that influence the students’ clinical learning outcomes. It includes hospitals, wards, clinics, health departments, hospice units, and other health care settings utilized for student learning such as community visits, nursing homes, and mental health homes among others.

Clinical education – is the teaching learning process which occurs in the context of real health care clinical practice mostly in a hospital setting. It involves practical integration and application of knowledge, skills and attitudes learned at the classroom and it is facilitated with professional support, supervision, feedback and evaluation among others.

Chapter Five

Summary, Conclusion and Recommendation

5.1 Summary

In this study, our focus was on the perception of nursing students towards the clinical learning environment and supervision in Adeleke University, Ede Osun State. The study is was specifically carried out to ascertain whether nursing students are satisfied with the integration of theory and practice in their clinical learning environment, ascertain nursing students perception of the quality of supervision provided the clinical learning environment, ascertain students perception of the leadership style of the ward-manager in the clinical learning environment, and ascertain students perception on the challenging factors in the clinical learning environment.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 210 responses were validated from the enrolled participants where all respondent were nursing students in year 4 & 5 in in Adeleke University, Ede Osun State.

5.2 Conclusion

Based on the findings of this study, the researcher concluded that;

1. The nursing students are satisfied with the integration of theory and practice in their clinical learning environment.
2. The nursing students perceive the quality of supervision provided in the clinical learning environment to be very effective.
3. The nursing students’ perceive the leadership style of the ward-manager in the clinical learning environment to be ineffective.
4. The challenging factors in the clinical learning environment perceived by the nursing students include; unwelcoming nursing staff, clinical faculty’s lack of expertise in the clinical area, lack of fit between students’ abilities and patient acuity, and bad leadership style of ward-manager.

5.4 Recommendation

Based on the responses obtained, the researcher proffers the following recommendations:

1. Allocating students to preceptors with a patient/ client caseload would be a means towards improving students’ perception of ward and workload organization.
2. The importance of helping students feel valued and interpersonal relationships in the clinical area need to be highlighted in the preceptor preparation programmes.
3. Also the ratio of student to clinical instructor/ nursing staff needs to be addressed in order to increase individual interaction with their clinical instructors.
4. Closer liaison between clinical instructor, preceptors, clinical staff and nurse tutors/link lecturers through regular meetings in the practice setting would help ensure that students’ needs remain salient and that preceptors and clinical staff have ongoing network of support.

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