title: The impact and importance of clinical learning experience in supporting nursing students in end-of-life care: cluster analysis.
abstract: BACKGROUND
  Nursing students are often expected to provide end-of-life care to patients during clinical practice. Little research has been conducted to examine the heterogeneity of the students and how learning outcomes are affected by their education experience and other demographic factors.
  
  
  OBJECTIVE
  The aim of this study was to identify and compare groups of nursing students based on their demographics, clinical experience, knowledge, perceived competency, and attitude towards end-of-life care.
  
  
  METHODS
  A group of 253 nursing students was asked to complete a cross-sectional survey to explore their clinical experience, knowledge, attitude, and perceived competency towards end-of-life care. Cluster analysis was used to determine whether specific groups of students could be identified within the study cohort.
  
  
  RESULTS
  Three distinct clusters were identified. Students from the three clusters showed no significant differences in end-of-life knowledge. Significant differences were identified in clinical experience amongst the three clusters and in attitude and perceived competency within the clusters. The cluster of students that had greater clinical experience demonstrated higher perceived competency and a more positive attitude towards end-of-life care.
  
  
  CONCLUSIONS
  Clinical experience was found to be crucial in enhancing the perceived competency and attitude of nursing students in end-of-life care.
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong. Electronic address: susan.chow@polyu.edu.hk.
authors.forename: Susan Ka Yee
authors.initials: SK
authors.lastname: Chow
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong.
authors.forename: Lina T W
authors.initials: LT
authors.lastname: Wong
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong.
authors.forename: Yik Kam
authors.initials: YK
authors.lastname: Chan
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong.
authors.forename: Tin Yu
authors.initials: TY
authors.lastname: Chung
mesh_terms: D001291:Attitude of Health Personnel; D002982:Clinical Clerkship; D002983:Clinical Competence; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D015402:Nursing Education Research; D020377:Self Efficacy; D013338:Students, Nursing / Q000523:psychology*; D013727:Terminal Care
keywords: Attitude; Clinical experience; End-of-life care; Perceived competency