STUDENT EVALUATION OF CLINICAL EDUCATION ENVIRONMENT

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comprehensive tool that concisely measured student perceptions of the clinical learning environment in nursing. Multiple inventories exist to assess student perceptions of the traditional classroom environment, but most are designed for use with elementary and secondary level students, and none address the factors identified in the nursing literature as critical to an assessment of the applied clinical environment. The purpose of this research endeavor was to develop and test an instrument that measures student perceptions of the clinical learning environment in the variety of agencies and sites used in nursing education. Preliminary Investigation The initial Student Evaluation of Clinical Education Environment (SECEE) instrument was developed as a tool for student evaluation of their clinical environments (Sand-Jecklin, 1997). Attention to the validity of content was addressed from the initial steps in inventory development. Items were selected based on a review of the literature, nursing faculty and senior nursing student perceptions of important aspects of the clinical environment, and a review of sample university–agency contracts and unpublished course evaluations. Senior nursing student and nursing faculty at a large mid-Atlantic university were requested to identify characteristics of the clinical education environment that they felt should be addressed by an evaluation instrument via group discussion with researcher facilitation. A table of specifications was developed, including criteria identified through each of these sources. Item content was taken directly from the table, with particular attention to criteria identified by several sources, supporting validity of instrument content. An additional criterion considered in tool development was the need for a brief survey that could be completed by students in a short time frame. Instrument revisions were made based on review of the instrument by evaluation and nursing experts. 32
The original two-page SECEE instrument consisted of thirteen forced-choice items relating to the clinical learning environment, of which eleven were presented in a four point Likert format (a copy of the instrument appears in Appendix A). Content of the forced-choice items included issues related to (a) student orientation; (b) nursing staff/preceptor availability, communication, role modeling, and workload; (c) resource availability including patients, equipment, and references; and (d) student opportunity for hands on care (Peirce, 1991; Perese, 1996). In addition, two questions contained dichotomous (yes/no) choices related to staff preparation to serve as a resource and the presence of other students at the site during clinical time. Four open-ended items requested students to describe both the strengths and limitations of the clinical experience at a particular agency, to describe the impact of other health professional students at the clinical site on the student’s experience, and to comment further on either the clinical experience or the evaluation tool. Data were collected at the end of the 1996 spring semester. All students enrolled in the undergraduate nursing program at the main campus of a large mid-Atlantic university were included in data collection. Nursing faculty at the university distributed and collected the inventories during the last two weeks of the semester. From the group of 218 sophomore, junior and senior nursing students at the main university campus, 148 questionnaires were completed, representing a 68% response rate. Response rates were similar across the three levels of students. A total of 41 specific clinical learning environments were evaluated by students, with each student evaluating only one site experienced during the spring semester. The number of clinical sites was rather large due to senior level students participating in a precepted clinical 33
Page 1 and 2: STUDENT EVALUATION OF CLINICAL EDUC
Page 3 and 4: significant for any of the four sca
Page 5 and 6: Table of Contents List of Tables vi
Page 7 and 8: Tables List of Tables 1. Identifica
Page 9 and 10: Student Evaluation of Clinical Educ
Page 11 and 12: development of different skills and
Page 13 and 14: Examples of applied learning enviro
Page 15 and 16: hear about a topic, but must contac
Page 17 and 18: with others and participation in a
Page 19 and 20: ideal applied learning environment
Page 21 and 22: contingencies present in the learni
Page 23 and 24: that many aspects of the clinical e
Page 25 and 26: The second instrument-based clinica
Page 27 and 28: Empirical Investigations of the Tra
Page 29 and 30: etween 18 and 31% of variance in sc
Page 31 and 32: .32 for the student actual form and
Page 33 and 34: significantly differentiated betwee
Page 35 and 36: were lower than preferred scores fo
Page 37 and 38: Table 1. Identification and Frequen
Page 39: Although the above-mentioned learni
Page 43 and 44: espondents. Analysis of item respon
Page 45 and 46: sites having few respondents. If in
Page 47 and 48: Chapter 3 Methods The following sec
Page 49 and 50: added, based on the applied cogniti
Page 51 and 52: Limiting the number of items while
Page 53 and 54: clinical sites, for the purposes of
Page 55 and 56: Descriptive Analysis Data from the
Page 57 and 58: 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
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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 and 110:
6. Add a fifth response item to the
Page 111 and 112:
with individual patients, and are a
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separately at each item pertaining
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Conclusion The applied learning asp
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References American Association of
Page 119 and 120:
Fraser, B. J. & O’Brien, P. O. (1
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Reilly, D. E. & Oerman, M. H. (1992
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Appendix A Original SECEE Instrumen
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Key: 1 = very seldom 2 = sometimes
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Inventory Scale Item Number Communi
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Appendix C Revised SECEE Instrument
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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
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Appendix E 129
Page 139 and 140:
Appendix F 131
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KARI SAND-JECKLIN 2003 White Oak Dr
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Staff Nurse: employed part-time at
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STUDENT EVALUATION OF CLINICAL EDUCATION ENVIRONMENT

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