Improving Learning in the Clinical Nursing Environment: Perceptions of Senior Australian Bachelor of Nursing Students

Abstract

Learning in the clinical environment has traditionally formed an integral part of nursing education programs in Australia. In tertiary-based nursing courses today, students can spend equal or more hours learning in the clinical workplace as they do in their classroom-based studies. Developing ways to improve teaching and learning in the clinical environment can help to develop a more positive workplace culture, which in turn, has been identified as producing more effective learning outcomes for students. This quantitative study used the Clinical Learning Environment Inventory (CLEI) questionnaire (Chan, 2002) as a platform for data collection to investigate Avondale College's (an Australian tertiary education institution) senior Bachelor of Nursing (BN) students' perceptions of their clinical learning environment. It was highlighted that even though the students perceived that their clinical experiences were generally positive, they indicated that there was still room for improvement. With respect to the five domains of the clinical environment identified by the CLEI (personalisation, student involvement, teacher innovation, task orientation and individualisation), the students identified the personalisation and student involvement domains as the most important in generating appropriate clinical environments, and even though the students expected less in the areas of task orientation, teaching innovation and individualisation, these were the areas they saw a need for greatest improvement. Students also suggested that the development of a positive relationship with the clinical teaching staff was paramount in generating the ideal clinical environment. Finally, the study indicated that student satisfaction is increased when there is an ongoing student involvement, that is, in the words of Lave and Wenger (1991), when they become an integral part of the 'community of practice' in their clinical nursing placement.