The Quality of the Clinical Learning Environment among nursing students experiencing delayed graduation: a secondary analysis.

introductionA large body of evidence has highlighted the importance of a supportive clinical learning environment and mentorship. However, little is known about how these may contribute to delays in graduation. This study aims (a) to describe the perceived clinical learning quality among nursing students experiencing delayed graduation and (b) to explore whether it differs according to the preceptorship model reported by the student.

designA cross-sectional study was conducted based on a secondary analysis of data from a multi-campus cross-sectional study.

methodsA convenience sample of undergraduate nursing students was recruited from several campuses of the same university located in different cities in Central Italy. Students were considered eligible if they had regular administrative status, were delaying graduation, and had completed an internship before data collection. Students' perceptions of clinical learning quality were measured using the Clinical Learning Quality Evaluation Index. Reported preceptorship models were classified as continuous or discontinuous. Independent samples t-tests were used to compare Clinical Learning Quality Evaluation Index scores between groups. Crude and multivariable linear regression models, adjusted for relevant sociodemographic covariates, were then estimated to assess whether the association persisted after accounting for potential confounding.

resultsA total of 282 nursing students were enrolled. The overall score on the Clinical Learning Quality Evaluation Index was 1.84 out of 3 (± 0.79). Quality of the learning environment (2.08 ± 0.88) and Safety and quality of care (2.07 ± 0.79) factors showed highest scores. The Self-directed learning (1.49 ± 1.02) and the Quality of tutorial strategies (1.58 ± 0.98) factors showed lowest scores. Significant differences emerged between students who reported supervision under a continuous preceptorship model and those who reported a discontinuous model. These associations remained statistically significant after adjustment for sociodemographic covariates.

conclusionsNursing students experiencing delayed graduation reported lower perceived clinical learning quality than that described in previous literature involving regularly progressing students, particularly in the domains of tutorial strategies and self-directed learning. Moreover, in the reported continuous preceptorship model, the preceptorship relationship was consistently linked to more favorable perceptions of the clinical learning environment, highlighting the potential relevance of stable supervisory models for academically vulnerable students, although causal interpretations should be made with caution. CLINICAL TRIAL NUMBER: Not applicable.