An Exploratory Psychometric Assessment of the Clinical Learning Environment and Supervision Evaluation Scale (CLESES) for Nursing Undergraduates in Sri Lanka.

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.