Student Evaluation of Clinical Education Environment (SECEE): Instrument development and validation.

This paper describes the refinement and testing of the Student Evaluation of Clinical Education Environment (SECEE) inventory, an instrument designed to measure nursing student perceptions of the clinical learning environment. Although a quality student clinical experience is considered critical to nursing education, no comprehensive instruments measuring the clinical learning environment have been published. The SECEE inventory contains 29 forced-choice items divided among four scales: Communication and Feedback, Learning Opportunities, Learning Support, and Department Atmosphere. Items were included based on nursing students and faculty input, a review of the literature and sample clinical agency contracts, and data resulting from administration of the original version of the SECEE instrument. Items requesting students to identify aspects of the clinical setting that helped as well as hindered learning were also included. A convenience sample of nursing students from two small liberal arts institutions (SMW and SMA) and one large university (LMA) completed the SECEE inventory at the end of the spring 1998 semester. A sub-sample of students completed the inventory twice during the semester, for test-retest reliability determination. Data analysis indicated that students responded consistently to the instrument as a whole and to the four scales. Rearrangement of four items within scales resulted in further improvements in reliability. Test-retest correlations for all scales were statistically significant. Correlations between individual student evaluations of two distinct clinical sites were not significant for any of the four scales, indicating that students responded differently to the instrument when evaluating different clinical sites. Significant differences between scale scores were found between institutions for all scale scores. Differences were also found between academic levels of students within each institution, and between clinical site groups within institutions SMW and SMA. Student narrative comments supported inclusion of the majority of forced-choice items and allowed identification of items that may be beneficial to include in future inventory revisions. Overall, the SECEE inventory appears to be a reasonably valid and reliable measure. Minor revisions are suggested for future revisions