STUDENT EVALUATION OF CLINICAL EDUCATION ENVIRONMENT

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The SECEE inventory contains primarily a priori determined items and scales, as well as limited choice responses. The data indicated that some student perceptions about the clinical education environment were unaddressed by the forced-choice portion of the instrument. However, the inclusion of the open-ended items did assist in identifying potentially significant issues that were overlooked in instrument development. These issues will be addressed in further SECEE inventory revisions. The SECEE instrument reflects only student perceptions of their clinical education environment. No data have been gathered through observation of students as they interact with these environments. There is no absolute assurance that students are accurately reporting their internal state or perceptions about the environment or that student perceptions accurately depict the clinical learning environment (Luce & Krumhansl, 1988). Future instrument validation research might include initial data collection through the SECEE inventory with follow-up observation of students interacting with learning environments that have been perceived positively and those that have been perceived less positively. Similarities between observer data and student evaluations would further support instrument validity. At least one environmental factor that may significantly impact student learning in the clinical nursing environment is not addressed by the SECEE inventory. This instrument does not directly address the impact of the student-patient interaction on student learning, although the investigator recognizes that this interaction may have a significant impact on student perceptions of the learning environment. Student interactions with patients who are unreceptive to attempts to provide care or patient teaching, patients who are confused or angry, and patients who are eager to participate in their plan of care will most likely impact the overall student perception of the clinical experience. However, in many clinical sites students have only short-term contact 102
with individual patients, and are assigned a number of different patients throughout the course of a clinical rotation. Thus, although interaction with patients may impact the student experience either positively or negatively, this factor may vary greatly over the length of a four to six week clinical rotation. In order to fully address the impact of patient interactions on the learning environment, some type of measurement would need to be completed after each discrete clinical experience. However, the SECEE inventory is intended to measure overall student perceptions of the clinical environment, rather than student perceptions of a particular clinical day. Thus, the decision was made not to address patient interaction factors within the instrument. It might be more appropriate for nursing faculty to address this factor informally through conversations with students during the clinical experience, and to take appropriate action (i.e.: alter patient assignments) to reduce any negative impact on learning resulting from patient factors. Another option might be to include a general question about whether patient interactions were perceived positively, or an open-ended question asking students to identify how characteristics of student- patient interactions assisted or hindered their learning. Other limitations of this particular study have been previously discussed: missing or incomplete respondent data, the lower student response rate at LMA institution, and the grouping of large numbers of clinical sites for comparative analysis. Suggestions have also been made to avoid these limiting factors in future research. A final limitation involves current inability to generalize the support for validity and reliability of the instrument to all nursing student populations. Although nursing students from three different institutions were included in this study, further research with other nursing student populations would be necessary before the 103
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STUDENT EVALUATION OF CLINICAL EDUC
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significant for any of the four sca
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Table of Contents List of Tables vi
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Tables List of Tables 1. Identifica
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Student Evaluation of Clinical Educ
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development of different skills and
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Examples of applied learning enviro
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hear about a topic, but must contac
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with others and participation in a
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ideal applied learning environment
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contingencies present in the learni
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that many aspects of the clinical e
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The second instrument-based clinica
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Empirical Investigations of the Tra
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etween 18 and 31% of variance in sc
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.32 for the student actual form and
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significantly differentiated betwee
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were lower than preferred scores fo
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Table 1. Identification and Frequen
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Although the above-mentioned learni
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The original two-page SECEE instrum
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espondents. Analysis of item respon
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sites having few respondents. If in
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Chapter 3 Methods The following sec
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added, based on the applied cogniti
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Limiting the number of items while
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clinical sites, for the purposes of
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Descriptive Analysis Data from the
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Study participants responded “can
Page 59 and 60: Table 2 SECEE Inventory Forced-choi
Page 61 and 62: Item 22. Students helped each other
Page 63 and 64: Table 3 Scale Means and Standard De
Page 65 and 66: sites more favorably (M = 11.81) th
Page 67 and 68: Table 6 Reliability Coefficients fo
Page 69 and 70: assists in reducing the confounding
Page 71 and 72: Table 8 ANOVA Results, Student Leve
Page 73 and 74: Table 10 Scale Score Means and Stan
Page 75 and 76: Sophomore SMA students rated the Le
Page 77 and 78: Support at site group 5 more positi
Page 79 and 80: Table 12 Scale Score Means and Stan
Page 81 and 82: SMA 14 n = 7 Site Group Comm. / 17
Page 83 and 84: Analysis of Narrative Inventory Dat
Page 85 and 86: Analysis of the narrative student c
Page 87 and 88: Student comments reflecting scaled
Page 89 and 90: Table 17 Frequencies of Student Res
Page 91 and 92: Table 18 Frequencies of Student Res
Page 93 and 94: Chapter 5 Discussion and Conclusion
Page 95 and 96: their own clients as a hindrance to
Page 97 and 98: the Department Atmosphere scale, an
Page 99 and 100: end of semester perception of the l
Page 101 and 102: minimal grouping of sites was requi
Page 103 and 104: the instrument, the investigator fe
Page 105 and 106: also may have averted a higher inci
Page 107 and 108: number of students reporting that n
Page 109: 6. Add a fifth response item to the
Page 113 and 114: separately at each item pertaining
Page 115 and 116: Conclusion The applied learning asp
Page 117 and 118: References American Association of
Page 119 and 120: Fraser, B. J. & O’Brien, P. O. (1
Page 121 and 122: Reilly, D. E. & Oerman, M. H. (1992
Page 123 and 124: Appendix A Original SECEE Instrumen
Page 125 and 126: Key: 1 = very seldom 2 = sometimes
Page 127 and 128: Inventory Scale Item Number Communi
Page 129 and 130: Appendix C Revised SECEE Instrument
Page 131 and 132: Key: 1 = Strongly Agree 2 = Agree 3
Page 133 and 134: Key: 1 = Strongly Agree 2 = Agree 3
Page 135 and 136: Table of Specifications for Student
Page 137 and 138: Appendix E 129
Page 139 and 140: Appendix F 131
Page 141 and 142: KARI SAND-JECKLIN 2003 White Oak Dr
Page 143 and 144: Staff Nurse: employed part-time at
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STUDENT EVALUATION OF CLINICAL EDUCATION ENVIRONMENT

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