J Korean Acad Nurs Adm.  2015 Sep;21(4):417-425. 10.11111/jkana.2015.21.4.417.

Effects of Clinical Learning Environment on Clinical Practice Stress and Anxiety in Nursing Students

• Kim EY
• Yang SH

• KMID: 2069563
• DOI: http://doi.org/10.11111/jkana.2015.21.4.417

Abstract

PURPOSE
The purpose of this study was to identify factors in the clinical learning environment that affect clinical practice stress and anxiety in nursing students.
METHODS
Participants were 210 senior nursing students from two universities who had completed their clinical experience. Data were collected from self-report questionnaires and analyzed using t-test, ANOVA, and hierarchical multiple regression analysis with the SPSS/WIN 21.0 Program.
RESULTS
The mean scores for the clinical learning environment, the clinical practice stress, and anxiety were 3.16+/-0.68, 2.98+/-0.66, and 43.74+/-10.18 points, respectively. The regression analysis showed that the clinical learning environment contributed to 13% of the stress and 20% of the anxiety in the nursing students with the conditions controlled for general characteristics, department satisfaction and social support.
CONCLUSION
The results of this study suggest that the clinical learning environment should be carefully assessed to reduce nursing students' stress and anxiety from clinical practice. Therefore, collaboration between nursing universities and teaching hospitals is necessary to optimize clinical learning environment.

Keyword

Clinical learning environment; Clinical practice stress; Anxiety; Nursing education

MeSH Terms

Anxiety*
Cooperative Behavior
Education, Nursing
Hospitals, Teaching
Humans
Learning*
Nursing*
Students, Nursing*

Reference

1. American Association of Colleges of Nursing. The essential clinical resource for nursing academic missions [Internet]. Washington. DC: American Association of Colleges of Nursing;2008. cited 2014 March 17. Available from: http://www.aacn.nche.edu/education-resources/ClinicalEssentials99.pdf.

2. Locken T, Norberg H. Reduced anxiety improves learning ability of nursing students through utilization of mentoring triads. J Nurs Educ. 2005; 48(1):17–23.

3. Park JW, Ha NS. Nursing students' clinical experiences. J Korean Acad Psychiatr Ment Health Nurs. 2003; 12(1):27–35.

4. Kim JS, Sun JJ, Kim HS. Clinical practice experiences of nursing students. Qual Res. 2009; 10(1):63–76.

5. Song JH, Kim MW. Study on clinical education for nursing in hospitals in Korea. J Korean Acad Soc Nurs Educ. 2013; 19(2):251–264. DOI: 10.5977/jkasne.2013.19.2.251.

6. Hyoung HK, Ju YS, Im SI. A concept mapping study on clinical stress for nursing students during clinical practice. J Korean Acad Nurs Adm. 2014; 20(4):394–404. DOI: 10.11111/jkana.2014.20.4.394.

7. Papp I, Markkanen M, von Bonsdorff M. Clinical environment as a learning environment: Student nurses' perceptions concerning clinical learning experiences. Nurse Educ Today. 2003; 23(4):262–268. DOI: 10.1016/S0260-6917(02)00185-5.

8. Dunn SV, Burnett P. The development of a clinical learning environment scale. J Adv Nurs. 1995; 22(6):1166–1173. DOI: 10.1111/j.1365-2648.1995.tb03119.x.

9. Midgley K. Pre-registration student nurses perception of the hospital-learning environment during clinical placements. Nurse Educ Today. 2006; 26(4):338–345. DOI: 10.1016/j.nedt.2005.10.015.

10. Choi GY. The relationship between perceptions of nursing college students regarding clinical practice environment and related variables. J Korean Acad Adult Nurs. 2009; 21(1):129–139.

11. Whang SJ. The relationship between clinical stress, self-efficacy, and self-esteem of nursing college students. J Korean Acad Soc Nurs Educ. 2006; 12(2):205–213.

12. Park IS, Kim CS, Kim R, Kim YJ, Park MH. Stress, anxiety and fatigue of nursing students in clinical practice. J Korean Acad Soc Nurs Educ. 2005; 11(2):151–160.

13. Lee AK, You HS, Park IH. Affecting factors on stress of clinical practice in nursing students. J Korean Acad Nurs Adm. 2015; 21(2):154–163. DOI: 10.11111/jkana.2015.21.2.154.

14. Han JY. Nursing students' perceptions of clinical learning environment. J Korean Data Anal Soc. 2010; 12(5):2595–2607.

15. Han JY, Park HS. Effects of teaching effectiveness and clinical learning environment on clinical practice competency in nursing students. J Korean Acad Fundam Nurs. 2011; 18(3):365–372.

16. Kim SL, Lee JE. Relationship among stress, coping strategies, and self-esteem in nursing students taking clinical experience. J Korean Acad Soc Nurs Educ. 2005; 11(1):98–106.

17. Yang YK, Han KS, Bae MH, Yang SH. Social support, academic stress, clinical practice stress in college student of nursing. Korean J Stress Res. 2014; 22(1):23–34. DOI: 10.17547/kjsr.2014.22.1.23.

18. Braskamp LA, Wise SL, Hengstler DD. Student satisfaction as a measure of departmental quality. J Educ Psychol. 1979; 71(4):494.

19. Kim KH, Ha HS. A study of department satisfaction factors of undergraduate students. Korean J Couns. 2000; 1(1):7–20.

20. Brandt PA, Weinert C. The PRQ: A social support system. Nurs Res. 1981; 30(5):277–280.

21. Suh MH, Oh KS. A study of well - being in caregivers caring for chronically ill family members. J Nurs Acad Soc. 1993; 23(3):467–486.

22. Beck DL, Srivastava R. Perceived level and sources of stress in baccalaureate nursing students. J Nurs Educ. 1991; 30(3):127–133.

23. Spielberger CD, Gorsuch RL, Lushene RE. STAI manual for the state-trait anxiety inventory("Self-evaluation questionnaire"). Palo Alto, CA: Consulting Psychologists Press;1970.

24. Kim JT, Shin DK. A study based on the standardization of the STAI for Korea. New Med J. 1978; 21(11):69–75.

25. Saarikoski M, Leino-Kilpi H. The clinical learning environment and supervision by staff nurses: Developing the instrument. Int J Nurs Stud. 2002; 39(3):259–267.

26. Han SY, Lee YM. The relationship between anxiety, anger and fatigue among stress factor of nursing students in clinical practice. J Korea Acad Ind Coop Soc. 2012; 13(2):554–561. DOI: 10.5762/KAIS.2012.13.2.554.

27. Koo HY, IM HS. Comparison of factors influencing satisfaction of clinical practice between associate and bachelor nursing students. J Korea Contents Assoc. 2013; 13(1):311–321. DOI: 10.5392/JKCA.2013.13.01.311.