title: Factors associated with student learning processes in primary health care units: a questionnaire study.
abstract: BACKGROUND
  Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models.
  
  
  OBJECTIVE
  The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units.
  
  
  METHODS
  The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above.
  
  
  RESULTS
  The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction.
  
  
  CONCLUSIONS
  These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management.
authors.affiliation: Center for Family Medicine, Department of Neurobiology, Care Sciences, and Society, Huddinge, Sweden. Electronic address: elisabeth.bos@sll.se.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bos
authors.affiliation: Karolinska Institutet, Center for Family Medicine, Department of Neurobiology, Care Sciences, and Society, Huddinge, Sweden.
authors.forename: Hassan
authors.initials: H
authors.lastname: Alinaghizadeh
authors.affiliation: University of Turku, Department of Nursing Science, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Saarikoski
authors.affiliation: Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.
authors.forename: Päivi
authors.initials: P
authors.lastname: Kaila
mesh_terms: D000328:Adult; D004506:Education, Nursing; D005260:Female; D006801:Humans; D007857:Leadership; D007858:Learning; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009745:Nursing, Supervisory; D011231:Preceptorship; D011320:Primary Health Care; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden; D055815:Young Adult
keywords: Clinical learning environment; Motivation; Nursing students; Primary health care; Professional role model; Satisfaction