Vol. 3 No. 4 (2024): caring for nurses
Articles

The Clinical Learning Environment Experience of the Student Nurse of the Generation Z: a Convergent Parallel Mixed Method Study

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  • Marzia Lommi,
  • Giuliana Covelli ,
  • Dhurata Ivziku,
  • Giorgia Barretta ,
  • Gianluca Pozzuoli ,
  • Barbara Porcelli ,
  • Luca Guarente,
  • Simona Ricci
Marzia Lommi
Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
Giuliana Covelli
Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
Dhurata Ivziku
Sapienza University of Rome, Rome, Italy
Giorgia Barretta
Salesian Pontifical University, Rome, Italy
Gianluca Pozzuoli
Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
Barbara Porcelli
Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
Luca Guarente
Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
Simona Ricci
Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
DOI: https://doi.org/10.36253/if-3157

Published 2024-12-31

Keywords

  • Nursing Student,
  • Generation Z,
  • Motivation,
  • Experience,
  • Clinical Learning Environment,
  • Mixed Method,
  • Influences
    • ...More
    Less

Copyright (c) 2024 Marzia Lommi, Giuliana Covelli , Dhurata Ivziku, Giorgia Barretta , Gianluca Pozzuoli , Barbara Porcelli , Luca Guarente, Simona Ricci

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background. The internship represents an experience that incorporates numerous meanings and values that involve nursing students globally, particularly for those belonging to Generation Z.

Aims. 1) to assess the students' perceptions of the clinical learning environments, 2) to identify the elements that contribute to determining the clinical learning environment, and 3) to compare quantitative and qualitative results to highlight key elements that can support the development of targeted educational strategies for nursing students.

Design. Convergent parallel mixed-method study

Participants. Students attending the first, second and third years of the bachelor degree in nursing.

Methods. Quantitative and socio-demographic data were collected with a questionnaire that included the Clinical Learning Environment and Supervision plus Nurse Teacher (CLES-T) scale. Qualitative data were collected with the internship diaries. The qualitative data transformed into dummy variables were finally correlated with the quantitative data using a biserial point correlation to explore their relationships.

Results. We received answers from 63 students, half of them females, who reported experiencing a positive clinical learning environment. Simple linear regressions showed that the variables age, course year, being a student worker or with health care work experience, previous volunteering are all positively correlated with the total scale and with each dimension of the CLES-T. The content analysis of the internship diaries revealed 7 main categories describing the experience of the clinical learning environment of nursing students of Generation Z. Finally, it was possible to outline a summary scheme that describes the key elements that contribute to the success of the internship and the learning experience.

Conclusions. The key success factors emerging from the study include meaningful relationships with tutors, staff, and peers, effective management of emotional aspects, development of professional identity, intrinsic motivation, and the acquisition of practical skills through feedback and support. A positive and well-organized clinical learning environment facilitates these outcomes, promoting role awareness and responsibility. These findings can be applied to nursing education by developing targeted educational strategies such as structured mentoring programs, emotional training, and practical simulations. Integrating these elements enables educators and institutions to overcome challenges in clinical internships, enhancing students' preparation and fostering the development of competent and confident nurses.

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References

  1. Flint B. Supporting nursing degree apprentices: advice for higher education institutions and employers. Nursing Management. 2023;30(4).
  2. Celma-Vicente M, López-Morales M, Caballero-Gálvez MDC. Analysis of clinical practices in the Nursing Degree: Vision of tutors and students. Enferm Clin (Engl Ed). 2019;29(5):271-279.
  3. Cotichelli G. Della formazione infermieristica. tra identità professionale e coscienza scientifica. Lettere dalla facoltà. Università Politecnica delle Marche, Facoltà di Medicina e Chirurgia. 2021;(1).
  4. Dimitriadou M, Papastavrou E, Efstathiou G, Theodorou M. Baccalaureate nursing students' perceptions of learning and supervision in the clinical environment. Nurs Health Sci. 2015;17(2):236-242.
  5. Souza MS, Karkada SN, Parahoo K, Venkatesaperumal R. Perception of and satisfaction with the clinical learning environment among nursing students. Nurse Educ Today. 2015;35(6):833-840.
  6. Dewey J, Cappa F. Esperienza e educazione. Milano: Raffaello Cortina Editore; 2014.
  7. Saarikoski M, Kaila P, Lambrinou E, et al. Students' experiences of cooperation with nurse teacher during their clinical placements: an empirical study in a Western European context. Nurse Educ Pract. 2013;13(2):78-82.
  8. Lommi M, De Benedictis A, Ricci S, et al. Appraisal and Evaluation of the Learning Environment Instruments of the Student Nurse: A Systematic Review Using COSMIN Methodology. Healthcare (Basel). 2023;11(7):1043.
  9. Formenti L. La formazione autobiografica. Milano: Guerini; 1998.
  10. Demetrio D, Ciantar A. Scritture erranti: l'autobiografia come viaggio del sé nel mondo. Italia: EdUP; 2003.
  11. Tollini M, Barolo A, Cunico L. Parole e gesti di gratitudine dei pazienti. Le esperienze degli studenti in infermieristica nel tirocinio clinico. Tutor. 2022;21(2).
  12. Bobbo N, Camuccio A, Opportuni I, Bottacin M. Studenti di infermieristica: tirocinio clinico in rianimazione e medicina narrativa. Tutor. 2017;1(17):5-20.
  13. Garrino L, Ruffinengo C, Mussa V, et al. Diari di bordo: l’esperienza di tirocinio pre-triage COVID-19 degli studenti in infermieristica. J Health Care Educ Pract. 2021;3(1):67-79.
  14. Seemiller C, Grace M. Generation Z Goes to College. San Francisco, CA: Jossey-Bass; 2016.
  15. Whitehead D, Dittman PW, McNett M. Essentials of Nursing Leadership and Management. 3rd ed. Philadelphia, PA: F.A. Davis Company; 2020.
  16. Lommi M, Ricci S, Ivziku D, et al. Factors influencing Generation Z Bachelor of Nursing students’ decision to choose nursing as a career: A pilot study. SAGE Open Nurs. 2024; 10:23779608241242246. doi:10.1177/23779608241242246.
  17. Turner A. Generation Z: Technology and social interest. The Journal of Individual Psychology. 2015;71(2):103-113. doi:10.1353/jip.2015.0021.
  18. Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs—principles and practices. Health Serv Res. 2013;48(6pt2):2134-2156.
  19. Altman DG, Simera I, Hoey J, Moher D, Schulz K. EQUATOR: reporting guidelines for health research. Lancet. 2008;371(9619):1149-1150.
  20. World Medical Association Declaration of Helsinki (2013): Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013; 310:2191. doi:10.1001/jama.2013.281053.
  21. Warne T, Johansson UB, Papastavrou E, et al. An exploration of the clinical learning experience of nursing students in nine European countries. Nurse Educ Today. 2010;30(8):809-815.
  22. Tomietto M, Saiani L, Saarikoski M, et al. Assessing quality in clinical educational setting: Italian validation of the clinical learning environment and supervision (CLES) scale. G Ital Med Lav Ergon. 2009;31(3 Suppl B): B49-55.
  23. Aleandri G. Scritture adulte. Armando Editore; 2012.
  24. Aleandri G, Russo V. Autobiographical questionnaire and semi-structured interview: Comparing two instruments for educational research in difficult contexts. Procedia-Social and Behavioral Sciences. 2015;197:514-524.
  25. Aleandri G, Russo V. L’autobiografia come metodo educativo, autoeducativo e di ricerca nella prospettiva del «lifelong learning»: progetto per una indagine esplorativa. Journal of Educational, Cultural and Psychological Studies (ECPS Journal). 2017;(16):295-316.
  26. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-115.
  27. IBM Corp. IBM SPSS Statistics for Windows, version 26.0. Armonk, NY: IBM Corp; 2019.
  28. Lumivero. NVivo for Windows, version 10.0. www.lumivero.com; 2014.
  29. Vargiu S, Aviles Gonzalez CI, Pitre G, Tortello A, Pisu M. L’utilizzo della scala Clinical Learning Environment, Supervision and Plus Nurse Teacher (CLES+T) in studenti tirocinanti. Ital J Prev Diagn Ther Med. 2018;1(1):36-47.
  30. Comparcini D, Simonetti V, Tomietto M, et al. Percezione degli ambienti di tirocinio e soddisfazione degli studenti infermieri. Prof Inferm. 2014;67(1).
  31. Magnani D, Di Lorenzo R, Bari A, et al. The undergraduate nursing student evaluation of clinical learning environment: an Italian survey. Prof Inferm. 2014;67(1).
  32. Khan A, Begum H, Rehman AU, Khan A. Experiences of healthcare students and the challenges posed by their clinical learning environment. Cent Eur J Nurs Midwifery. 2020;11(1):19-24.
  33. Ekstedt M, Lindblad M, Löfmark A. Nursing students’ perception of the clinical learning environment and supervision. BMC Nurs. 2019;18(1):1-12.
  34. Rosenberg A, Husebø AML, Laugaland KA, Aase I. Nursing students’ experiences of the clinical learning environment in Norwegian nursing homes. Nurs. 2019;9(2):70-78.
  35. Mikkonen K, Elo S, Miettunen J, Saarikoski M, Kääriäinen M. Development and testing of the CALD s and CLES+T scales. J Adv Nurs. 2017;73(8):1997-2011.
  36. Papastavrou E, Dimitriadou M, Tsangari H, Andreou C. Nursing students’ satisfaction of the clinical learning environment. BMC Nurs. 2016;15(1):1-10.
  37. Donley C, Norman K. Nursing student perspectives on a quality learning environment in general practice. Prim Health Care. 2022;32(5).
  38. Bawadi HA, Al-Hamdan ZM, Nabolsi M, et al. Jordanian nursing student and instructor perceptions of the clinical learning environment. Int J Nurs Educ Scholarsh. 2019;16(1):20180037.
  39. Killam LA, Heerschap C. Challenges to student learning in the clinical setting. Nurse Educ Today. 2013;33(6):684-691.
  40. Arkan B, Ordin Y, Yılmaz D. Undergraduate nursing students' experience related to their clinical learning environment. Nurse Educ Pract. 2018; 29:127-132.
  41. Johnson M, Cowin LS, Wilson I, Young H. Professional identity and nursing: contemporary theoretical developments. Int Nurs Rev. 2012;59(4):562-569.
  42. Hensel D, Laux M. Longitudinal study of stress, self-care, and professional identity among nursing students. Nurse Educ. 2014;39(5):227-231.
  43. Wu C, Li S, Cheng F, et al. Self-identity and career success of nurses in infectious disease departments. Front Psychol. 2020; 11:563558.
  44. Kelly SE, Naft M, Bautista A, LoGrippo M. The development of professional self-concept and leadership skills.
  45. Wei LZ, Zhou SS, Hu S, Zhou Z, Chen J. Influences of nursing students’ career planning. Nurse Educ Today. 2021; 99:104781.
  46. Guo B, Zhao L, Gao Y, et al. The status of professional identity and professional self-efficacy of nursing students. Int J Nurs Sci. 2017;4(2):152-157.
  47. Neishabouri M, Ahmadi F, Kazemnejad A. Iranian nursing students' perspectives on transition to professional identity. Int Nurs Rev. 2017;64(3):428-436.
  48. Donmez RO, Ozsoy S. Factors influencing development of professional values. Pak J Med Sci. 2016;32(4):988.
  49. Isopahkala-Bouret U. Graduation at age 50+. J Aging Stud. 2015; 35:1-9.
  50. McCrae N, Askey‐Jones S, Laker C. Merely a stepping stone? Professional identity and career prospects following postgraduate mental health nurse training. J Psychiatr Ment Health Nurs. 2014;21(9):767-773.
  51. Winters JM, Wang H, Duwel LE, Spudich EA, Stanford JS. Developing a backup plan: implementing a career-planning course for undergraduate biology majors. J Microbiol Biol Educ. 2018;19(3):10-1128.
  52. Yilmaz AA, Ilce A, Cicek SC, Yuzden GE, Yigit U. The effect of a career activity on the students' perception of the nursing profession and their career plan: A single-group experimental study. Nurse Educ Today. 2016; 39:176-180.
  53. McConville SA, Lane AM. Using on-line video clips to enhance self-efficacy toward dealing with difficult situations among nursing students. Nurse Educ Today. 2006;26(3):200-208.
  54. Pike T, O’Donnell V. The impact of clinical simulation on learner self-efficacy in pre-registration nursing education. Nurse Educ Today. 2010;30(5):405-410.
  55. Kaddoura MA. New graduate nurses’ perceptions of the effects of clinical simulation on their critical thinking, learning, and confidence. J Contin Educ Nurs. 2010;41(11):506-516.
  56. Lundberg KM. Promoting self-confidence in clinical nursing students. Nurse Educ. 2008;33(2):86-89.
  57. Tapper J. What’s up with Generation Z? The Guardian. 2024
  58. Weissman GV. Evaluating associate degree nursing students' self-efficacy in communication skills and attitudes in caring for the dying patient. Teach Learn Nurs. 2011;6(2):64-72.