STUDENT EVALUATION OF CLINICAL EDUCATION ENVIRONMENT

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
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