Critical Care Students’ Perceptions, Satisfaction, and Reflections on Their Clinical Learning Environment: A Step for Quality Improvement

Background: The primary goal of nursing education programs is to provide educational opportunities for nursing students to successfully achieve the competencies leading to initial entry to practice as qualified registered nurses able to provide high-quality and safe patient care. Continuous improvement in the quality of nursing education could be achieved by keeping pace with continuous changes in the clinical learning environment (CLE) through continuous attention to the students' feedback and reflections. Aim: To assess nursing students’ perceptions, satisfaction, and reflections on their clinical learning environment as a step toward quality improvement. Methods: A mixed-research design was used to conduct the current study. A cross-sectional online survey was used to collect quantitative data and focus group discussions were used to collect qualitative data.  Results: Statistical analysis of the five dimensions of the students' perceptions and satisfaction scale found two findings: On the one hand, the majority of the sample moderately perceived and agreed that the CLE was supportive, conducive to learning, and enhanced their academic success. On the other hand, slightly more than half of the students were moderately satisfied with their CLE, and there was a significant positive correlation between the students’ perceptions and satisfaction with (P <  0.001 and r = 0.65. and r = 0.65). Furthermore, analysis of the sub-dimensions of the scale showed that the most common sub-dimensions that threaten the quality of nursing education were problems with clinical teaching, clinical placements, and clinical supervision and these findings were almost identical with the findings of the students' narrations extracted via FGDs. Three challenges emerged: psychological burdens (stress & anxiety), limitations in the clinical placements & lack of guidance, support, and competence of novice clinical supervisors. Conclusion: Among the five dimensions of the students’ perceptions and satisfaction, the majority of the students moderately perceived that CLE is supporting, conducive to learning, and enhances academic success. Moreover, slightly above half of the study sample were moderately satisfied with the critical care learning environment. Recommendations: Partnerships with healthcare institutions should be developed, a module of virtual critical care learning environment using simulation, in particular, high-fidelity simulation, should be considered in the teaching methods, a mentorship program for the suspected/ novice clinical supervisors to prepare them for academic life, and a feedback to the student should be provided clearly and objectively, and should be delivered privately.