Factors associated with student clinical learning in the Adventist baccalaureate programs in the Philippines

Abstract

The purpose of the sludy was to provide nursing administrators and educators with suggestions for enhancing student clinical learning in the hospital setting. The variables and structure of this study were supported by three theories: Witkin's (1977) FieId-Independent and Field Dependent Cognitive Learning Styles, Facilitative Teaching Model from Bernhard and Walsh (1990), and the Organizational Culture Inventory by Cook and Lafferty (Thomas, Ward, Cborba, & Kumiega, 1990). The Six Dimension Scale of Nursing Performance by Schwirian (1978) provided also a framework for tool design. The tool constructed for this study consisted of a demographic questionnaire and four scales with 87 items, rated on 5-point Likert scale for degree of agreement. The four scales were Cognitive Learning Style, Positive Teacher Behavior, Orqanizational Climate of a Ward, and Student Clinical Learning. Valldity measures included review of the items by a panel of experts, pilot test, and factor analysis. Cronbach alpha coefficient ranged from .74 to .93. Hypotheses were tested by -t- test, ANOVA, Pearson product-moment correlation, and multiple step-wise regression. Significance level was set at alpha < - .05. In this correlative survey, the sample consisted of 91 randomly selected junior and senior nursing students in three Adventist nursing programs in the Philippines. The data analysis was designed to determine relationships between predictor variables and the dependent varlable of student clinical learning. Conclusions were that positive teacher behavior and student field-independent learning style were the most important factors contributing to student clinical learning. Field-independent learninq style is related stronger than field-dependent style under condtion of short clinlcal rotations. Students of teachers with 1-3 years of clinical teaching experiences scored significantly higher than students of more experienced teachers on the Professional Maturlty Subscale of the Student Clinical Learning ScaIe. Students learn leadership better on medical-surgical and pediatric wards. Defensive climate is significantly related in a positive way to student clinical learning in the culture studied. Constructive climate also significantly relate in a positive way to total scale of Student CIinical Learning. Recommendations given for nurse administrators and educators were (a) to support teacher quality assurance through programs designed to maintain and promote clinical cornpetency; (b) to consider longrer clinical rotations strticture in the curriculum where appropriate; and (c) to schedule leadership experience primarily on medlcal-surgical and pediatric wards rather than in intensive care or community settings. However, certain elements of leadership practice could be enhanced in settings other than medical-surgical and pediatric wards. Future studies are needed to determine the relationship of years of teaching experience, ward climate, and student learning style to student clinical learning in a longer clinical rotation setting.