The Perception of Indonesian Nursing Students on the Learning Environment in Clinical Practice

Pepin Nahariani, Fahruddin Kurdi, Ratna Puji Priyanti

Abstract views = 1487 times | downloads = 582 times


Introduction: The clinical practice environment students have multiple roles as learners and service providers. At this time students are faced with a fluctuating, complex environment and far from the predictions and controls of academic teachers. The aim of this study was to evaluate nursing student satisfaction and perception of the learning environment in clinical practice.

Methods: This study used correlational analytic survey methods with cross-sectional approach. A total of 164 nursing student were selected using a convenience sampling. The data were collected in three schools of nursing in East Java. Data were obtained using the Bahasa version of the Clinical Learning Environment, Supervisions and Nurse Teacher (CLES+T). The instrument showed good validity and reliability. The data were analyzed using descriptive analytic, Spearman rho correlation and logistic regression.

Results: Respondents were 164 students, clinical learning practice is mainly determined by the role of nurse teacher (M = 3.82; SD = 0.496). Student satisfaction obtained at 56.7%. There was a significant relationship between clinical practice learning and student satisfaction with p-value 0.000. The highest correlation value is the role of lecturer nurse (r = 0.544), with value R2 = 0.377, the coefficient of β adjusted highest to 2.075.

Conclusion: According to student perceptions, the content of supervisory relations, the pedagogy atmosphere in the ward/room and the role of the nurse lecturer contributed greatly to creating a conducive clinical learning environment.


Clinical Learning Environment; Nursing Education; Nursing Students

Full Text:



Allan, H. T., Smith, P., & O’Driscoll, M. (2011). Experiences of supernumerary status and the hidden curriculum in nursing: a new twist in the theory–practice gap? Journal of Clinical Nursing, 20(5‐6), 847–855.

Antohe, I., Riklikiene, O., Tichelaar, E., & Saarikoski, M. (2016). Clinical education and training of student nurses in four moderately new European Union countries: Assessment of students’ satisfaction with the learning environment. Nurse Education in Practice, 17, 139–144.

Chan, C. K. L., So, W. K. W., & Fong, D. Y. T. (2009). Hong Kong baccalaureate nursing students’ stress and their coping strategies in clinical practice. Journal of Professional Nursing, 25(5), 307–313.

Chan, D. (2001). Development of an innovative tool to assess hospital learning environments. Nurse Education Today, 21(8), 624–631.

Chan, D. S. K. (2003). Validation of the clinical learning environment inventory. Western Journal of Nursing Research, 25(5), 519–532.

Clayton, G. M., Broome, M. E., & Ellis, L. A. (1989). Relationship between a preceptorship experience and role socialization of graduate nurses. Journal of Nursing Education, 28(2), 72–75.

Dimitriadou, M., Papastavrou, E., Efstathiou, G., & Theodorou, M. (2015). Baccalaureate nursing students’ perceptions of learning and supervision in the clinical environment. Nursing & Health Sciences, 17(2), 236–242.

Elisabeth, C., Christine, W.-H., & Ewa, P. (2009). Teaching during clinical practice: Strategies and techniques used by preceptors in nursing education. Nurse Education Today, 29(5), 522–526.

Elliott, M. (2002). Clinical environment: a source of stress for undergraduate nurses. Australian Journal of Advanced Nursing, 20(1), 34–38.

Epstein, J., Santo, R. ., & Guilemin, F. (2015). Epstein, J., Santo, R. M., & Guillemin, F. A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus. Journal of Clinical Epidemiology, 68(4), 435–441.

Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4.

Flott, E. A., & Linden, L. (2016). The clinical learning environment in nursing education: a concept analysis. Journal of Advanced Nursing, 72(3), 501–513.

Happell, B. (2009). A model of preceptorship in nursing: Reflecting the complex functions of the role. Nursing Education Perspectives, 30(6), 372–376.

Hoffman, K. G., & Donaldson, J. F. (2004). Contextual tensions of the clinical environment and their influence on teaching and learning. Medical Education, 38(4), 448–454.

Ip, W. Y., & Chan, D. S. K. (2005). Hong Kong nursing students’ perception of the clinical environment: a questionnaire survey. International Journal of Nursing Studies, 42(6), 665–672.

Kurdi, F., Nahariani, P., & Priyanti, R. P. (2018). Komponen evaluasi lingkungan belajar klinik, supervisi dan dosen perawat. Journal of Health Sciences, 11(1).

Mikkonen, K., Elo, S., Kuivila, H.-M., Tuomikoski, A.-M., & Kääriäinen, M. (2016). Culturally and linguistically diverse healthcare students’ experiences of learning in a clinical environment: A systematic review of qualitative studies. International Journal of Nursing Studies, 54, 173–187.

Moscaritolo, L. M. (2009). Interventional strategies to decrease nursing student anxiety in the clinical learning environment. Journal of Nursing Education, 48(1), 17–23.

Myrick, F., & Yonge, O. (2005). Nursing preceptorship: Connecting practice and education. Lippincott Williams & Wilkins.

Papastavrou, E., Lambrinou, E., Tsangari, H., Saarikoski, M., & Leino-Kilpi, H. (2010). Student nurses experience of learning in the clinical environment. Nurse Education in Practice, 10(3), 176–182.

Papp, I., Markkanen, M., & von Bonsdorff, M. (2003). Clinical environment as a learning environment: student nurses’ perceptions concerning clinical learning experiences. Nurse Education Today, 23(4), 262–268.

Priyanti, R. P., & Nahariani, P. (2016). Skala evaluasi lingkungan belajar klinik, supervisi dan dosen perawat (Clinical Learning Environment, Supervision and Nurse Teacher–CLES+T) versi bahasa indonesia: Validitas dan reliabilitas. Journal of Health Sciences, 9(2).

Saarikoski, M. (2002). Clinical learning environment and supervision. Development and validation of the CLES evaluation scale. University of Turku.

Saarikoski, M., Isoaho, H., Warne, T., & Leino-Kilpi, H. (2008). The nurse teacher in clinical practice: developing the new sub-dimension to the clinical learning environment and supervision (CLES) scale. International Journal of Nursing Studies, 45(8), 1233–1237.

Saarikoski, M., Warne, T., Kaila, P., & Leino-Kilpi, H. (2009). The role of the nurse teacher in clinical practice: an empirical study of Finnish student nurse experiences. Nurse Education Today, 29(6), 595–600.

Sugiyono. (2008). Metode penelitian pendidikan: (pendekatan kuantitatif, kualitatif dan R & D). Alfabeta. Retrieved from

Udlis, K. A. (2008). Preceptorship in undergraduate nursing education: An integrative review. Journal of Nursing Education, 47(1), 20–29.

Warne, T., Johansson, U.-B., Papastavrou, E., Tichelaar, E., Tomietto, M., Van den Bossche, K., … Saarikoski, M. (2010). An exploration of the clinical learning experience of nursing students in nine European countries. Nurse Education Today, 30(8), 809–815.


  • There are currently no refbacks.

Copyright (c) 2019 Jurnal Ners

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

This journal is indexed by:





This journal is published by:


          Faculty of Nursing Universitas Airlangga in Collaboration with Indonesian National Nurses Association


Creative Commons License

This journal (p-ISSN:1858-3598; e-ISSN:2502-5791) is licensed under a Creative Commons Attribution 4.0 International License


Current Stats

Previous Stats