Knowledge concerning nursing students’ experiences of the clinical learning environment and how supervision is carried out is largely lacking. This study compares nursing students’ perceptions of the clinical learning environment and supervision in two different supervision models: peer learning in student-dedicated units, with students working together in pairs and supervised by a “preceptor of the day” (model A), and traditional supervision, in which each student is assigned to a personal preceptor (model B). The study was performed within the nursing programme at a university college in Sweden during students’ clinical placements (semesters 3 and 4) in medical and surgical departments at three different hospitals. Data was collected using the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, CLES+T, an instrument tested for reliability and validity, and a second instrument developed for this study to obtain deeper information regarding how students experienced the organisation and content of the supervision. Independent t-tests were used for continuous variables, Mann-Whitney U-tests for ordinal variables, and the chi-square or Fischer’s exact tests for categorical variables. Overall, the students had positive experiences of the clinical learning environment and supervision in both supervision models. Students supervised in model A had more positive experiences of the cooperation and relationship between student, preceptor, and nurse teacher, and more often than students in model B felt that the ward had an explicit model for supervising students. Students in model A were more positive to having more than one preceptor and felt that this contributed to the assessment of their learning outcomes. A good learning environment for students in clinical placements is dependent on an explicit structure for receiving students, a pedagogical atmosphere where staff take an interest in supervision of students and are easy to approach, and engagement among and collaboration between preceptors and nurse teachers. This study also indicates that supervision based on peer learning in student-dedicated rooms with many preceptors can be more satisfying for students than a model where each student is assigned to a single preceptor.

中文翻译：

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护理学生对两种不同监督模式的临床学习环境和监督的感知——比较横断面研究

关于护理学生临床学习环境的体验以及如何进行监督的知识在很大程度上缺乏。本研究比较了护理学生在两种不同的监督模式下对临床学习环境和监督的看法：学生专用单元的同伴学习，学生成对合作并由“当天的导师”（模型 A）监督，以及传统的监督，每个学生被分配到一个私人导师（模型B）。该研究是在瑞典一所大学学院的护理课程中进行的，学生在三所不同医院的医疗和外科部门进行临床实习（第 3 学期和第 4 学期）。使用临床学习环境、监督和护士教师评估量表、CLES+T、一种测试可靠性和有效性的工具，以及为本研究开发的第二种工具，以获取有关学生如何体验监督的组织和内容的更深入信息。独立 t 检验用于连续变量，Mann-Whitney U 检验用于序数变量，卡方或 Fischer 精确检验用于分类变量。总体而言，学生对两种监督模式的临床学习环境和监督都有积极的体验。模式 A 的学生对学生、导师和护士老师之间的合作和关系有更积极的体验，并且比模式 B 的学生更经常认为病房有一个明确的指导学生的模式。模型 A 中的学生对拥有多个导师的态度更为积极，并认为这有助于评估他们的学习成果。临床实习学生的良好学习环境取决于明确的接收学生结构、工作人员对学生监督感兴趣且易于接近的教学氛围，以及导师和护士教师之间的参与和协作。这项研究还表明，与将每个学生分配给一个导师的模型相比，在有许多导师的学生专用房间中基于同伴学习的监督对学生来说更令人满意。一种教学氛围，工作人员对学生的监督感兴趣并且易于接近，以及导师和护士教师之间的参与和协作。这项研究还表明，与将每个学生分配给一个导师的模型相比，在有许多导师的学生专用房间中基于同伴学习的监督对学生来说更令人满意。一种教学氛围，工作人员对学生的监督感兴趣并且易于接近，以及导师和护士教师之间的参与和协作。这项研究还表明，与将每个学生分配给一个导师的模型相比，在有许多导师的学生专用房间中基于同伴学习的监督对学生来说更令人满意。