Clinical Learning Environment And Related Factors In 5-Year Vocational Nursing Students

Objective To explore the clinical learning environment and related factors in 5-year vocational nursing students,thus to provide objective and accurate information to the nursing educators and nursing managers to create a good 5-year vocational nursing students' clinical learning environment and improve the clinical study results.Method A observational study design was used in this study.Five hundred and eighty-two 5-year vocational nursing students who had practiced at hospital for 20 weeks or more were selected and investigated using the Clinical Learning Environment Evaluation Scale and Influcing Factors of Clinical Learning Questionnaire.Date entry and statistical were performed using by the Statistical Package for Social Science(SPSS10.0).Data were analyzed with the following methods:the descriptive analysis's,the one sample t-test,the two sample t-test, analysis of variance,two information independent samples of the Wilcoxon rank sum test,multivariate stepwise regression analysis,αValue was set the level of 0.05 as a standard test,and bilateral probability was used for p value.Result1.5-year vocational nursing students' scores on evaluation of clinical learning environment were relatively high.Students had the highest score at the domain of "working atmosphere and team culture" for 25.64±3.91;followed by the "human relations",a score of 24.61±3.76,while they had the lowest score at the domain of "Personalized" for 22.24±4.33,followed by "innovative" and a score of 22.68±4.27.2.By using of one-sample t test,compared with Zhu Wenxi's study results on 247 baccalaureate students,the 5-year vocational nursing students of this study had higher scores on the domains of participate,creativity,and had lower scores on the other four dimensions.3.Pearson correlation analysis was performed to examine the correlations among 6 diemensions of clinical learning environment.Results showed that there were strong correlations among these dimensions,with correlation coefficient of 0.543 to 0.793.Among them,correlation coefficient between "personalized" and "innovative" ranked as the largest(r=0.793),while the one between "work environment and team culture" and "personalization" was the smallest(r=0.543).4.Investigation on related factors on clinical study environmental showed that the qualifications,job title,work years of the clinical teachers were enhanced compared with the previous studies.For the students,79%of them in their learned their task position very clearly,but 91.9%of them recognized that their own difficulties encountered in practice could not be solve the problem independently,and need teachers' help.The majority of the students(97.6%) reported that the teaching hospitals arranged a reasonable arrangement for theory and(or) skills test,but only 20.1%of them considered patients were willing to receive their services.5.The results of Wilcoxon rank sum tests showed that there were significant differences on the satification of learning environment between students practiced at different levels and naure of the hospitals.Students practices at the third level hospitals has higher satisfaction rate than those in the second level hospital,students studying at general hospital were more satisfied than those at specific hospitals.6.To compare the differences of unit test scores of students from different levels and nature of hospitals,we found that there was no difference the unit test score between students from the third level and the second level of hospitals. However,results showed that students practiced in the general hospitals had higher scores than those practiced at the specific hospitals.7.The results of Spearman correlation analysis showed that there were significant relationships among 6 dimensions of clinical learning environment and students' satisfaction on clinical learning environment evaluation.Among them,"interpersonal relations" had the strongest relationship with students' satisfaction on clinical learning environment evaluation(r=0.427),while "the work atmosphere and culture of the team" had the weakest relationship with students' satisfaction(r=0.283).8.Results of Spearman correlation analysis showed that there were significant correlations among unit test scores and clinical learning environment.Among them,"team atmosphere and culture" had the largest correlation coefficient(r=0.133),while "personalized" had the smallest correlation coefficient(r=0.077).9.From multiple stepwise regression analysis,there were 9 significant related factors for clinical learning environment,including students' awareness of learning tasks(b'=0.162),student's problem solving skills(b'=0.162),the hands-operation opportunities(b'=0.150),holding meeting for interns (b'=0.144),communication with patients(b'=0.132),,the nature of hospitals (b'=0.106),and teachers' teaching attitude(b'=0.122),teachers' educational levels(b'=0.102),and work years(b'=0.094).Among these factors,students' awareness of learning tasks,student's problem solving skills were the most closely related factors.Conclusion1.5-year vocational nursing students had relatively high satisfaction on evaluation of clinical learning environment.2.There were positive correlation between satisfaction and dimensions of clinical learning environment in 5-year vocational nursing students.3.There were positive correlation between unit test scores and dimensions of clinical learning environment in 5-year vocational nursing students.4.There were positive correlation between evaluation of clinical learning environment in 5-year vocational nursing students and 9 significant related factors,including students' awareness of learning tasks,student's problem solving skills,the hands-operation opportunities,holding meeting for interns, communication with patients,the nature of hospitals,and teachers' teaching attitude,teachers' educational levels,and work years.Among these factors, students' awareness of learning tasks,student's problem solving skills were the most closely related factors of clinical learning environment evaluation.