Abstract:
Clinical learning occupies a paramount point in nursing education. The quality
of the clinical learning environment (CLE) significantly contributes to enhancing
students’ learning outcomes, career ambitions, and perceptions of the nursing
profession. Ongoing evaluation of the CLE would help restructure the learning
environment to ensure a reliable clinical learning experience for nursing undergraduates
(NUGs). Different tools to evaluate the CLE have already been developed
internationally, while Sri Lanka does not have a reliable and validated tool.
This study aimed to validate the Clinical Learning Environment and Supervision
Evaluation Scale (CLESES) in the Sri Lankan context. The CLESES, originally
developed in India, consisted of 53 items and three main domains (A. The learning
environment, B. Role of the clinical instructor, and C. Supervisory relationship).
The adaptation procedure was done following the WHO guidelines after obtaining
permission. Content and face validity were established through expert review
without many changes; 353 NUGs in the second to eighth semesters of the BSc
Nursing degree program, Department of Nursing, Faculty of Allied Health Sciences,
University of Ruhuna, Sri Lanka included in the study. Reliability of the
CLESES was assessed using Cronbach’s alpha (α − −0.931); sub-domains’ α was
also satisfactory, such as A: 0.866, B: 0.881, and C: 0.811 in the 1st administration.
Test-retest reliability of the overall scale was 0.900, and A, B, and C
sub-domains were 0.818, 0.873, and 0.836. Exploratory factor analysis was done
using principal component analysis with varimax rotation; 12 domains extracted,
explaining a cumulative variance of 63.54%. However, the final CLESES consisted
of 11 domains (52 items), had good psychometric properties, making it a valid and
reliable tool to assess the CLE of nursing undergraduates in Sri Lanka; further,
it would provide reliable data on assessing the existing CLE and be helpful for
positive changes in the clinical environment in the future.
