Engagement in clinical learning environment among nursing students: Role of nurse educators

DOI: 10.4236/ojn.2013.31004   PDF   HTML   XML   12,638 Downloads   22,758 Views   Citations


Student engagement in a clinical learning environment is a vital component in the curricula of pre-licensure nursing students, providing an opportunity to combine cognitive, psychomotor, and affective skills. This paper is significant in Arab world as there is a lack of knowledge, attitude and practice of student involvement in the new clinical learning environment. The purpose of this review article is to describe the experiences and perspectives of the nurse educator in facilitating pre-licensure nursing students’ engagement in the new clinical learning environment. The review suggests that novice students prefer actual engagement in clinical learning facilitated through diversity experiences, shared learning opportunities, student-faculty interaction and active learning. They expressed continuous supervision, ongoing feedback, interpersonal relationship and personal support from nurse educators useful in the clinical practice. However, the value of this review lies in a better understanding of what constitutes quality clinical learning environment from the students’ perspective of engagement in evidence-based nursing, reflective practice, e-learning and simulated case scenarios facilitated by the nurse educators. This review is valuable in planning and implementing innovative clinical and educational experiences for improving the quality of the clinical teaching-learning environment.

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D’Souza, M. , Venkatesaperumal, R. , Radhakrishnan, J. and Balachandran, S. (2013) Engagement in clinical learning environment among nursing students: Role of nurse educators. Open Journal of Nursing, 3, 25-32. doi: 10.4236/ojn.2013.31004.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Quality and safety education for nurses (2012) Overview. http://qsen.org/about/overview/
[2] Hickey, M.T., Forbes, M. and Greenfield, S. (2010) Integrating the institute of medicine competencies in a baccalaureate curricular revision: Process and strategies. Journal of Professional Nursing, 26, 214-222. doi:10.1016/j.profnurs.2010.03.001
[3] Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P. and Warren, J. (2007) Quality and safety education for nurses. Nursing Outlook, 55, 122131. doi:10.1016/j.outlook.2007.02.006
[4] Boshuizen, H.P.A. (1996) The shock of practice: Effects on clinical reasoning. Annual Meeting of the American Educational Research Association, New York, 8-14 April 1996, 47.
[5] Pascarella, E.T., Palmer, B., Moye, M. and Pierson, C.T. (2001) Do diversity experiences influence the development of critical thinking? Journal of College Student Development, 42, 257-271.
[6] Pascarella, E.T., Cruce, T., Umbach, P.D., Wolniak, G.C., Kuh, G.D., Carini, R.M., Hayek, R.M. and Zhao, G.C. (2006) Institutional selectivity and good practices in undergraduate education: How strong is the link. Journal of Higher Education, 77, 251-285. doi:10.1353/jhe.2006.0016
[7] Cole, P.G. and Chan, L.K.S. (1994) Teaching principles and practice. Prentice Hall, New York.
[8] Campbell, I.E. (1994) Learning to nurse in the clinical setting. Journal of Advanced Nursing, 20, 1125-1131. doi:10.1046/j.1365-2648.1994.20061125.x
[9] Massarweh, L.J. (1999) Promoting a positive clinical experience. Nurse Educator, 24, 44-47. doi:10.1097/00006223-199905000-00016
[10] Harth, S.C., Bavanandan, S. and Thomas, K.K. (2009) The quality of student tutor interaction in clinical learning environment. Medical Education, 26, 321-326. doi:10.1111/j.1365-2923.1992.tb00176.x
[11] Dunn, S.V. (2007) Undergraduate nursing students perception of their clinical learning environment. Journal of Advanced Nursing, 25, 1299-1306. doi:10.1046/j.1365-2648.1997.19970251299.x
[12] Kember, D. (2009) Promoting student-centered forms of learning across an entire university. High Education, 58, 1-13. doi:10.1007/s10734-008-9177-6
[13] Kolb, D. (1984) Experiential learning: Experience as the source of learning and development. Prentice Hall, Englewood Cliffs.
[14] Eggen, P. and Kauchak, D. (2004) Educational psychology: Windows, classrooms. Pearson Prentice Hall, Upper Saddle River.
[15] Giddens, J., Brady, D., Brown, P., Wright, M., Smith, D. and Harris, J. (2008) A new curriculum for a new era of nursing education. Nursing Education Perspectives, 29, 200-204.
[16] Chan, D.S. (2001) Development of the clinical learning environment inventory. Using the Theoretical Framework of Learning Environment Studies to Assess Nursing Students’ Perceptions of the Hospital as a Learning Environment, 41, 69-75.
[17] Ramsden, P. (1992) Learning to teach in higher education. Routledge, New York. doi:10.4324/9780203413937
[18] Ramsden. P. (1994) Using research on student learning to enhance educational quality. In: Gibbs, G., Ed., Improving Student Learning—Theory and Practice, Oxford Centre for Staff Development, Oxford.
[19] Black-Branch, J.L. and Lamont, W.K. (1998) Essential elements for teacher wellness: A conceptual framework from which to study support services for the promotion of wellness among student and preserve nurse educators. Journal of Collective Negotiations, 22, 243-261.
[20] Dev, P.C. (1997) Intrinsic motivation and academic achievement: What does their relationship imply for the classroom teacher? Remedial and Special Education, 18, 12-19. doi:10.1177/074193259701800104
[21] Kushman, J.W., Sieber, C. and Heariold-Kinney, P. (2000) This isn’t the place for me: School dropout. In: Capuzzi, D. and Gross, D.R., Eds., Youth at Risk: A Prevention Resource for Counselors, Nurse Educators, and Parents, 3rd Edition, American Counseling Association, Alexandria.
[22] Wood, R.E., Mento, A.J. and Locke, E.A. (1987) Task complexity as a moderator of goal effects: A meta-analysis. Journal of Applied Psychology, 72, 416-425. doi:10.1037/0021-9010.72.3.416
[23] Kuh, G.D., Pace, R. and Vesper, N. (1997) The development of process indicators to estimate student gains associated with good practices in undergraduate education. Research in Higher Education, 38, 435-454. doi:10.1023/A:1024962526492
[24] Carini, R.M., Kuh, G.D. and Klein, S.P. (2006) Student engagement and student learning: Testing the linkages. Research in Higher Education, 47, 1-24. doi:10.1007/s11162-005-8150-9
[25] Biggs, J.B. (1999) Teaching for quality learning at university: What the student does? Society for Research into Higher Education and Open University Press, Buckingham.
[26] Kember, D. (2005) Best practices in outcomes based teaching and learning at the Chinese University of Hong Kong. Centre for Learning Enhancement and Research. http://www.cuhk.edu.hk/clear
[27] Cabrera, A., Crissman, J., Bernal, E., Nora, A., Terenzini, P. and Pascarella, E.T. (2002) Collaborative learning: Its impact on college students’ development and diversity. Journal of College Student Development, 43, 20-34.
[28] Windsor, A. (1987) Nursing student’s perception of clinical experience. Journal of Nursing Education, 26, 150155.
[29] Chickering, A.W. and Gamson, Z.F. (1987) Seven principles for good practice. AAHE Bulletin, 39, 3-7.
[30] Astin, A. (1993) What matters in college: Four critical years revisited. Jossey-Bass, San Francisco.
[31] McKeachie, W.J. (1996) Student ratings of teaching. American Council of Learned Societies Occasional Paper No. 33. http://www.acls.org/op33.htm#McKeachie.
[32] Johnson, D.W., Johnson, R. and Smith, K. (1998) Active learning: Cooperation in the college classroom. Interaction Book Company, Edina.
[33] Tanner, C.A. (2006) The next transformation: Clinical education. Journal of Nursing Education, 45, 99-100.
[34] Godefrooij, M.B., Diemer, A.D. and Scherpbie, A.J.J.A. (2010) Students’ perceptions about the transition to the clinical phase of a medical curriculum with preclinical patient contacts; a focus group study. BMC Medical Education, 10, 28. doi:10.1186/1472-6920-10-28
[35] Gurin, P. (1999) The compelling need for diversity in education. Expert report. http://www.umich.edu/~urel/admissions/legal/expert/gurintoc.html
[36] Haas, B.K., Deardorff, K.U., Klotz, L., Baker, B., Coleman, J. and Dewitt, A. (2002) Creating a collaborative partnership between academia and service. Journal of Nursing Education, 41, 518-523.
[37] Cockrell, K.S., Caplow, J.A.H. and Donaldson, J.F. (2000) A context for learning: Collaborative groups in the problem-based learning environment. The Review of Higher Education, 23, 347-363. doi:10.1353/rhe.2000.0008
[38] Tinto, V. (2005) Moving from theory to action. In: Seidman, A., Ed., College Student Retention: Formula for Student Success, ACE & Praeger, Washington DC.
[39] Vygotsky, L.S. (1978) Mind and society: The development of higher psychological processes. Harvard University Press, Cambridge.
[40] Bernstein, P., Tipping, J., Bercovitz, K. and Skinner, H.A. (1995) Shifting students and faculty to a PBL curriculum: Attitudes changed and lessons learned. Academic Medicine, 70, 245-247. doi:10.1097/00001888-199503000-00019
[41] Koh, L.C. (2002) The perceptions of nursing students of practice-based teaching. Nurse Education in Practice, 2, 35-43. doi:10.1054/nepr.2002.0041
[42] Dunn, S.V. and Hansford, B. (1997) Undergraduate nursing students’ perceptions of their clinical learning environment. Journal of Advanced Nursing, 25, 1299-1306. doi:10.1046/j.1365-2648.1997.19970251299.x
[43] Hart, G. and Rotem, A. (1995) The clinical learning environment: Nurses perceptions of professional development in clinical settings. Nurse Education Today, 15, 310. doi:10.1016/S0260-6917(95)80071-9
[44] Saarikoski, M. (2002) Clinical learning environment and supervision: Development and validation of the CLES evaluation scale. Doctoral Dissertation, University of Turku, Turku.
[45] Saarikoski, M. and Leino-Kilpi, H. (2002) The clinical learning environment and supervision by staff nurses: Developing the instrument. International Journal of Nursing Studies, 39, 259-267. doi:10.1016/S0020-7489(01)00031-1
[46] Ewan, C. and White, R. (1996) Teaching nursing. 2nd Edition, Chapman and Hall, London.
[47] Quinn, F.M. (2000) Principles and practice of nurse education. 4th Edition, Nelson Thornes Limited, Cheltenham.
[48] Reece, I. and Walker, S. (2000) Teaching, training and learning a practical guide. 4th Edition, Business Education Publishers Limited, Sunderland.
[49] Oliver, R. and Endersby, C. (1994) Teaching and assessing nurses: A handbook for preceptors. Baillière Tindall, London.

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