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Abstract
Riassunto
Background. Gli ambienti di apprendimento clinico sono definiti come una rete di fattori interagenti nel contesto, in grado di influenzare gli esiti dell'apprendimento degli studenti. La soddisfazione degli studenti è considerata un indicatore del raggiungimento degli esiti dell'apprendimento ed è determinante a partire dalla prima esperienza di tirocinio. Scopo. Analizzare l'esperienza di apprendimento clinico degli studenti infermieri del primo anno di corso dopo il primo tirocinio clinico ed identificare i principali determinanti della soddisfazione degli studenti. Metodo. Lo studio osservazionale è stato realizzato in cinque sedi universitarie italiane del Corso di Laurea in Infermieristica. 420 studenti hanno compilato la versione italiana della "Clinical Learning Environment, Supervision and plus Nurse Teacher (CLES+T) scale" al termine del primo tirocinio clinico. Risultati. I punteggi medi assegnati alle dimensioni della scala variano da 4.02 (clima di apprendimento) a 3.30 (relazione di tutorato). La maggior parte degli studenti è soddisfatto della propria esperienza di tirocinio (75.6%), ma sono emerse differenze in relazione alle diverse sedi di tirocinio clinico (F = 4.210, p-value = 0.002). Discussione. I principali determinanti della soddisfazione sono lo stile di leadership del coordinatore infermieristico e l'integrazione teoria-pratica nella relazione fra tutor clinico, universitario e studente. Conclusioni. I risultati dello studio contribuiscono alla comprensione della prima esperienza di tirocinio degli studenti. Tuttavia, sono necessarie ulteriori ricerche per determinare le variabili organizzative specifiche e i modelli tutoriali in grado di aumentare la soddisfazione degli studenti, per sviluppare strategie formative basate sull'integrazione tra tutor universitari e guide di tirocinio.
Parole chiave. Ambiente di apprendimento clinico, formazione infermieristica, tirocinio clinico, soddisfazione.
Abstract
Background. Clinical learning environments are defined as an interactive network of forces within the clinical context that influence students' learning outcomes. Nursing students' satisfaction could be strictly related to their learning outcomes. Aim. To analyze the first year nursing students' clinical learning experience and to identify the main determinants of students' satisfaction. Methods. The observational study was carried out in five Italian nursing degree courses. 420 students filled out the validated Italian version of the "Clinical Learning Environment and Supervision plus Nurse Teacher (CLES+T) scale" after the conclusion of their first clinical placement. Results. The mean values of the main sub-dimensions of CLES+T varied from 4.02 (pedagogical atmosphere) to 3.30 (supervisory relationship). Students were mainly satisfied with their clinical placement, however the findings showed statistical significantly differences among the five nursing courses (F = 4.210, p-value = 0.002). Discussion. The main determinants of the overall students' satisfaction are the nurse manager's leadership style and the integration between theoretical knowledge and everyday practice of nursing through the relationship among students, clinical tutors and nurse teacher. Conclusion. Our results may contribute to better understand nursing students' perception of their first clinical placement. However, further research are needed to evaluate which organizational factors and clinical training models may enhance the clinical learning experience.
Keywords. Clinical learning environment, nurse education, clinical placement, personal satisfaction.
Dettagli dell'articolo
Riferimenti
- Chan, D. (2001). Development of an innovative tool to assess hospital learning environments. Nurse Education Today, 21 (8), 624-631.
- Chan, D. (2002). Associations between student learning outcomes from their clinical placement and their perceptions of the social climate of the clinical learning environment. International Journal of Nursing Studies, 39 (5), 517-524.
- Chan, D. (2003). Validation of the Clinical Learning Environment Inventory. Western Journal of Nursing Research, 25 (5), 519-532.
- Chan, D. & Ip, W.Y. (2007). Perception of hospital learning environment: a survey of Hong Kong nursing students. Nurse Education Today, 27 (7), 677-684.
- Cicolini, G., Comparcini, D., Simonetti, V. (2013). Workplace empowerment and nurses' job satisfaction: a systematic literature review. Journal of Nursing Management, DOI: 10.1111/jonm.12028.
- Dante, A., Valoppi, G., Saiani, L., & Palese, A. (2011). Factors associated with nursing students' academic success or failure: A retrospective Italian multicenter study. Nurse Education Today, 31(1), 59-64.
- Duchscher, J. E. (2009). Transition shock: the initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing, 65 (5), 1103-1113.
- Dunn, S.V. & Burnett, P. (1995). The development of a clinical learning environment scale. Journal of Advanced Nursing, 22 (6), 1166-1173.
- Fraser, B. J. (1994). Research on classroom and school climate. In Gabel D (a cura di), Handbook of research on science teaching and learning. New York.
- Hosoda, Y. (2006). Development and testing of a Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students. Journal of Advanced Nursing, 56 (5), 480-490.
- Knowles, M. (2007). Quando l'adulto impara. Pedagogia e andragogia. Franco Angeli, Milano.
- Kolb, D. A., & Fry, R. (1975). Towards an applied theory of experiential learning. In Cooper CL (a cura di), Theories of Group Processes. John Wiley & Sons, London.
- Last, L., & Fulbrook, P. (2003). Why do student nurses leave? Suggestion from a Delphi study. Nurse Education Today, 23 (6), 449-458.
- Leducq, M., Walsh, P., Hinsliff-Smith, K. & McGarry, J. (2012). A key transition for student nurses: the first placement experience. Nurse Education Today, 32 (7), 779-781.
- Midgley, K. (2006). Pre registration student nurses perception of the hospital-learning environment during clinical placement. Nurse Education Today, 26 (4), 338-345.
- Moos, R. H. (1974). The social climate scale: an overview. California Consulting Psychologist Press, Palo Alto.
- Papp, I., Markkanen, M. & Von Bonsdorff, M. (2003). Clinical environment as a learning environment: student nurses perceptions concerning clinical learning experiences. Nurse Education Today, 23 (4), 262-268.
- Perli, S. & Brugnolli, A. (2009). Italian nursing students perception of their clinical learning environment as measured with the CLEI tool. Nurse Education Today, 29 (8), 886-890.
- Prystowsky, J.B. & Bordage, G. (2001). An outcomes research perspective on medical education: the predominance of trainee assessment and satisfaction. Medical Education, 35 (4), 331-336.
- Saiani, L., Bielli, S., Marognolli, O., Brugnolli, A. & Gruppo di lavoro (2009). Documento di indirizzo su standard e principi del tirocinio nei corsi di Laurea delle Professioni Sanitarie, Conferenza Permanente dei Corsi di Laurea delle Professioni Sanitarie. Data accesso 18 dicembre, 2012, da http://cplps.altervista.org/blog/wp-content/uploads/2011/06/Cons-Conf-Tirocinio-10-settembre.pdf.
- Sand-Jecklin, K. (2009). Assessing nursing student perceptions of the clinical learning environment: refinement and testing of the SECEE inventory. Journal of Nursing Measurement, 17 (3), 232-246.
- Saarikososki, M., Isoaho, H., Warne, T. & Leino-Kilpi, H. (2008). The nurse teacher in clinical practice: developing the new sub-dimension to the Clinical Learning Environment and Supervision (CLES) Scale. International Journal of Nursing Studies, 45 (8), 1233-1237.
- Tomietto, M., Saiani, L., Palese, A., Cunico, L., Cicolini, G., Watson, P. & Saarikoski, M. (2012). Clinical learning environment and supervision plus nurse teacher (CLES+T) scale: testing the psychometric characteristics of the Italian version. Giornale Italiano di Medicina del Lavoro ed Ergonomia Supplemento B, Psicologia, 34, B72-B80.
- Tomietto, M., Saiani, L., Saarikoski, M., Fabris, S., Cunico, L., Campagna, V. & Palese, A. (2009). La valutazione della qualití degli ambienti di apprendimento clinico: studio di validazione del Clinical Learning Environment and Supervision (CLES) nel contesto italiano. Giornale Italiano di Medicina del Lavoro ed Ergonomia Supplemento B, Psicologia, 31 (3), B49-B55.
- Tomietto, M., Saiani, L., Saarikoski, M., Valoppi, G., Fabris, S., Cunico, L., & Palese, A. (2008). Gli strumenti di valutazione degli ambienti di apprendimento clinico: revisione della letteratura. Tutor, 8 (1-2), 16-22.
- Warne, T., Johansson, U.B., Papastavrou, E., Tichelaar, E., Tomietto, M., Van den Bossche, K., Moreno, M.F. & Saarikoski, M. (2010). An exploration of the clinical learning experience of nursing students in nine European countries. Nurse Education Today, 30 (8), 809-815.
- Watkins, M. (2000) Competency for nursing practice. Journal of Clinical Nursing, 9 (3), 338-346.
Riferimenti
Chan, D. (2001). Development of an innovative tool to assess hospital learning environments. Nurse Education Today, 21 (8), 624-631.
Chan, D. (2002). Associations between student learning outcomes from their clinical placement and their perceptions of the social climate of the clinical learning environment. International Journal of Nursing Studies, 39 (5), 517-524.
Chan, D. (2003). Validation of the Clinical Learning Environment Inventory. Western Journal of Nursing Research, 25 (5), 519-532.
Chan, D. & Ip, W.Y. (2007). Perception of hospital learning environment: a survey of Hong Kong nursing students. Nurse Education Today, 27 (7), 677-684.
Cicolini, G., Comparcini, D., Simonetti, V. (2013). Workplace empowerment and nurses' job satisfaction: a systematic literature review. Journal of Nursing Management, DOI: 10.1111/jonm.12028.
Dante, A., Valoppi, G., Saiani, L., & Palese, A. (2011). Factors associated with nursing students' academic success or failure: A retrospective Italian multicenter study. Nurse Education Today, 31(1), 59-64.
Duchscher, J. E. (2009). Transition shock: the initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing, 65 (5), 1103-1113.
Dunn, S.V. & Burnett, P. (1995). The development of a clinical learning environment scale. Journal of Advanced Nursing, 22 (6), 1166-1173.
Fraser, B. J. (1994). Research on classroom and school climate. In Gabel D (a cura di), Handbook of research on science teaching and learning. New York.
Hosoda, Y. (2006). Development and testing of a Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students. Journal of Advanced Nursing, 56 (5), 480-490.
Knowles, M. (2007). Quando l'adulto impara. Pedagogia e andragogia. Franco Angeli, Milano.
Kolb, D. A., & Fry, R. (1975). Towards an applied theory of experiential learning. In Cooper CL (a cura di), Theories of Group Processes. John Wiley & Sons, London.
Last, L., & Fulbrook, P. (2003). Why do student nurses leave? Suggestion from a Delphi study. Nurse Education Today, 23 (6), 449-458.
Leducq, M., Walsh, P., Hinsliff-Smith, K. & McGarry, J. (2012). A key transition for student nurses: the first placement experience. Nurse Education Today, 32 (7), 779-781.
Midgley, K. (2006). Pre registration student nurses perception of the hospital-learning environment during clinical placement. Nurse Education Today, 26 (4), 338-345.
Moos, R. H. (1974). The social climate scale: an overview. California Consulting Psychologist Press, Palo Alto.
Papp, I., Markkanen, M. & Von Bonsdorff, M. (2003). Clinical environment as a learning environment: student nurses perceptions concerning clinical learning experiences. Nurse Education Today, 23 (4), 262-268.
Perli, S. & Brugnolli, A. (2009). Italian nursing students perception of their clinical learning environment as measured with the CLEI tool. Nurse Education Today, 29 (8), 886-890.
Prystowsky, J.B. & Bordage, G. (2001). An outcomes research perspective on medical education: the predominance of trainee assessment and satisfaction. Medical Education, 35 (4), 331-336.
Saiani, L., Bielli, S., Marognolli, O., Brugnolli, A. & Gruppo di lavoro (2009). Documento di indirizzo su standard e principi del tirocinio nei corsi di Laurea delle Professioni Sanitarie, Conferenza Permanente dei Corsi di Laurea delle Professioni Sanitarie. Data accesso 18 dicembre, 2012, da http://cplps.altervista.org/blog/wp-content/uploads/2011/06/Cons-Conf-Tirocinio-10-settembre.pdf.
Sand-Jecklin, K. (2009). Assessing nursing student perceptions of the clinical learning environment: refinement and testing of the SECEE inventory. Journal of Nursing Measurement, 17 (3), 232-246.
Saarikososki, M., Isoaho, H., Warne, T. & Leino-Kilpi, H. (2008). The nurse teacher in clinical practice: developing the new sub-dimension to the Clinical Learning Environment and Supervision (CLES) Scale. International Journal of Nursing Studies, 45 (8), 1233-1237.
Tomietto, M., Saiani, L., Palese, A., Cunico, L., Cicolini, G., Watson, P. & Saarikoski, M. (2012). Clinical learning environment and supervision plus nurse teacher (CLES+T) scale: testing the psychometric characteristics of the Italian version. Giornale Italiano di Medicina del Lavoro ed Ergonomia Supplemento B, Psicologia, 34, B72-B80.
Tomietto, M., Saiani, L., Saarikoski, M., Fabris, S., Cunico, L., Campagna, V. & Palese, A. (2009). La valutazione della qualití degli ambienti di apprendimento clinico: studio di validazione del Clinical Learning Environment and Supervision (CLES) nel contesto italiano. Giornale Italiano di Medicina del Lavoro ed Ergonomia Supplemento B, Psicologia, 31 (3), B49-B55.
Tomietto, M., Saiani, L., Saarikoski, M., Valoppi, G., Fabris, S., Cunico, L., & Palese, A. (2008). Gli strumenti di valutazione degli ambienti di apprendimento clinico: revisione della letteratura. Tutor, 8 (1-2), 16-22.
Warne, T., Johansson, U.B., Papastavrou, E., Tichelaar, E., Tomietto, M., Van den Bossche, K., Moreno, M.F. & Saarikoski, M. (2010). An exploration of the clinical learning experience of nursing students in nine European countries. Nurse Education Today, 30 (8), 809-815.
Watkins, M. (2000) Competency for nursing practice. Journal of Clinical Nursing, 9 (3), 338-346.