title: Developing an instrument to measure effective factors on Clinical Learning.
abstract: BACKGROUND
  Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students.
  
  
  METHODS
  This is a mixed methods study performed in 2 steps. First, the researchers defined "clinical learning" in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14.
  
  
  RESULTS
  To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55%) was defined by the first 3 factors while the rest of the total variance percentage (59.45%) was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93) confirmed the high internal consistency of the questionnaire.
  
  
  CONCLUSIONS
  Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it involves 41 expressions and properties such as instrument design based on perception and experiences of the nursing students about effective factors on clinical learning, definition of facilitator and preventive factors of the clinical learning, simple scoring, suitable validity and reliability, and applicability in different occasions.
authors.affiliation: Medical Education Research Center (MERC), Guilan University of Medical Sciences, Rasht, Iran; ; Department of E-learning in Medical Education, Virtual School, Center of Excellence for E-learning in Medical Education, Tehran University of Medical Sciences (TUMS), Tehran, Iran;
authors.forename: Ideh
authors.initials: I
authors.lastname: Dadgaran
authors.affiliation: Department of E-learning in Medical Education, Virtual School, Center of Excellence for E-learning in Medical Education, Tehran University of Medical Sciences (TUMS), Tehran, Iran; ; Education Development Center, Medical Education Department, Tehran University of Medical Sciences, Tehran, Iran; ; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden;
authors.forename: Mandana
authors.initials: M
authors.lastname: Shirazi
authors.affiliation: Department of E-learning in Medical Education, Virtual School, Center of Excellence for E-learning in Medical Education, Tehran University of Medical Sciences (TUMS), Tehran, Iran;
authors.forename: Aeen
authors.initials: A
authors.lastname: Mohammadi
authors.affiliation: Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ravari
keywords: Clinical; Learning; Nursing student; Teaching