Perceptions of nursing students, nurse educators and clinicians of the clinical learning environment at selected institutions in Northern Ghana.

Abstract

Aim The aim of the study was to describe the perceptions of nursing students, nurse educators and clinicians of the clinical learning environment at selected institutions in northern Ghana, as a way of assisting to address clinical teaching and learning challenges. Methods A non-experimental quantitative research of the descriptive type was used. A convenient sampling technique was used for the college and the hospital, and stratified random sampling used for the nursing students. There was no sampling for the nurse educators and clinicians and all participated. A scale developed by Chuan & Barnett (2012:194) on student, tutor and staff nurse perceptions of the clinical learning environment was utilised on the respondents (n=215). Section A consisted of three questions on the category of the respondents. Section B consisted of 34 items on the perceptions of the clinical learning environment and section C consisted of two open-ended questions that required respondents to list the factors they believed contributed to student learning in the ward, and the factors they believed hindered students’ learning in the ward. The data obtained was entered onto the computer and analysed using the Statistical Package for Social Science (SPSS), version 23, for descriptive statistics, comparisons using one-way analysis of variance (ANOVA) and reliability. Results A response rate of 96.8 %was obtained from the respondents (n=215) who were representative of the student and nurse educator populations at the selected college. It was however, not representative of the clinicians and not generalizable to other colleges in the country. The mean of the perception score was 103.81(SD=13.97). The range of scores was 72 and 150,out of a possible score of 170. The skewness value was 1.83The majority of the respondents perceived the clinical learning environment to have short comings in the areas of clinical supervision, satisfaction, learning tensions and the translation of learning into clinical practice. Learner friendliness and peer support were positively perceived. Analysis of variance (ANOVA) revealed statistically significant differences between the respondents ’perceptions of five areas of interest in the clinical learning environment, however, there was no statistical difference found for peer support. A Post-hoc test using LSD comparison revealed the specific groups that differed. Cronbach’s alpha coefficient was 0.76. Conclusions and recommendations There were challenges within the clinical learning environment in the areas of supervision, satisfaction, learning tensions and the translation of learning into clinical practice. Learner friendliness and peer support was positively perceived. In order to assist in addressing the challenges, recommendations were made which focused on strengthening guidance and supervision of the students, motivation of clinical instructors and staff nurses, periodic in-service training of staff regarding attributes of professionalism, reviewing and redefining the scheduling of students, collaboration between academic and clinical institutions and the promotion of peer support.