STUDENT EVALUATION OF CLINICAL EDUCATION ENVIRONMENT

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experience in a wide variety of clinical agencies, with only one to three senior students placed at each site. Student response consistency (Cronbach alpha coefficient) for the forced-choice inventory items was .897, with question two removed from analysis as it contained nominal data. According to Burns and Grove, (1993), alpha levels of .8 to .9 demonstrate response consistency for the instrument. The range of correlations of individual items with the total ranged from .468 to.789, except for the single item related to the adequacy of orientation, which had a correlation of .161 with the total. Factor analysis was also used to determine reliability of the evaluation instrument. Analysis with varimax rotation resulted in two factors with eigenvalues over 1.0. The reliability coefficient alpha for factor 1 (learning environment) was .831 and the alpha for factor 2 (agency or department atmosphere) was .774. Within factor 1, however, there appeared to be two sub- scales. The coefficient alpha for sub-scale 1 (learning opportunities) was .799 and the alpha for sub-scale 2 (staff/preceptor issues) was .790. Five of the eleven items included in the factor analysis loaded above .35 on both identified factors, although they generally loaded somewhat higher on one factor. Several steps were taken to demonstrate validity of the SECEE instrument. Review of the tool by both nursing education faculty and experts in evaluation contributed to the validity of content. In addition, analysis of variance was performed to discern the discrimination ability of the instrument. In order to conduct the ANOVA procedure, agency sites identified by fewer than six respondents were combined into site categories or groups, according to similarity of the type of nursing care provided at the sites. The resulting ten site groups varied in number of respondents from seven to twenty-seven, with the majority including thirteen to eighteen student 34
espondents. Analysis of item responses by site groups demonstrated significant differences between groups for all scaled items (p < .05). Follow-up testing with the Duncan test confirmed significant differences between several site groups within each item. Some general trends were evident across items, with two clinical areas being generally rated more favorably and three sites being rated least favorably. Student responses to the open-ended questions appeared to corroborate the ANOVA results. Sites rated significantly lower than others in the comparative analysis also received fewer positive comments in response to the open-ended item that requested students to identify the strengths of having a clinical experience at the agency and were the only sites mentioned as having “no strengths”. As mentioned previously, the open-ended questions were included in the SECEE instrument in order to provide support for existing forced-choice items and to determine whether students would identify any significant clinical environment issues that were not addressed by the forced-choice portion of the instrument. One item asked students to describe the impact of other health professional students being present at the clinical agency on their experience. Generally, the comments were global in nature and either positive (e.g., enhanced the student experience) or neutral. Information about the impact of other students in the setting on the nursing student learning experience could be more efficiently gained through a forced-choice question. Students were also asked to describe the strengths and limitations of having a clinical experience at the identified agency. The most frequently identified strengths and limitations had already been addressed in the forced-choice portion of the SECEE instrument, supporting content validity of the instrument. The issues of variety of patients in the setting and time 35
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 and 40: Although the above-mentioned learni
Page 41: The original two-page SECEE instrum
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
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 and 110:
6. Add a fifth response item to the
Page 111 and 112:
with individual patients, and are a
Page 113 and 114:
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
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
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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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