Unravelling the complexities of nursing students' feedback on the clinical learning environment: a mixed methods approach

Background Clinical placement is an essential part of nursing education, and students' experiences on clinical placement can affect the quality of their learning. Understanding nursing students' positive and negative perceptions of clinical placement experience is therefore important. Objectives To describe nursing students' satisfaction with their clinical placement experiences and identify any variations in satisfaction based on demographic characteristics. Design Mixed methods - online survey with qualitative items. Setting Four universities in Australia. Participants Students (n = 213) enrolled in an undergraduate nursing degree. Methods Between 2010 and 2012, students completed online surveys following their clinical placement experiences. The surveys included demographic questions and the Clinical Learning Environment Inventory (CLEI-19), a 19-item tool measuring students' satisfaction with clinical placement. The surveys included two open-ended questions asking students to share their most satisfying and challenging experiences whilst on placement. Descriptive statistics and thematic analyses were undertaken. Results Of the 213 participants, those in health-related employment and those with English as an additional language (EAL) were less satisfied with the clinical facility and with clinical facilitator support respectively, as indicated by the CLEI-19 subscale scores. Qualitative findings showed students were positive about the opportunity to make a difference and be involved in nursing, and negative about clinical facilitator support. Nevertheless, those who were most critical in their written comments about their placement were those who only spoke English at home. Conclusions Although the study found overall satisfaction with clinical placement, the lower satisfaction reported by students in health-related employment, and the mixed findings regarding language spoken and satisfaction, warrant further attention.