The nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in clinical practicum : a European cross-sectional study of graduating nursing students

Funding Information: This study deepened the knowledge base of European NT cooperation, which has been rarely investigated []. As the results show, NT cooperation varies both between European countries and on the national level. NT cooperation appeared to influence the GNSs’ final clinical practicum experiences positively; those GNSs who had an NT cooperating with them reported more positive experiences than GNSs without this cooperation. This finding is supported by earlier studies [, ] and may indicate the importance of the student-centric [, ] and supportive CLE []. However, NT cooperation has been a priority, especially in Iceland and Spain, where the NT has been assigned with a clear clinical role: In Iceland, a nurse NT (called Clinical Instructors, CIs) consistently meets students on a weekly basis during the clinical practicum, i.e. provides feedback on clinical work, engages in clinical reasoning, encourages independence, and fosters critical thinking based on evidence []. In Spain, NTs (called Academic Mentors) act as a “bridge” between the university and the clinical institution, helping students to integrate concepts and guide their reflection during mentoring sessions. Academic Mentors meet both students and nurses in clinical settings and take part in the students’ learning and assessing process. Conversely, Ireland is in a unique position with both a Clinical Placement Coordinator (CPC) and an NT involved in the supervision of nursing students, albeit the NT is without any clear clinical role. According to the Nursing and Midwifery Board of Ireland, [] the CPC is a registered nurse who promotes the CLE by supporting, facilitating and monitoring the clinical learning of students. The CPC’s role is highly valued as a form of Practice-Based Teachers who support both the mentors and students in clinical practice. Moreover, the clinical role of the NT is diverse in Ireland; some HEIs have a clear NT role while other HEI teachers attend the clinical placements when there is a need to offer support in relation to the assessment of a clinical practicum or when a student fails a clinical practicum. Publisher Copyright: © 2022, The Author(s).Background: A supportive clinical practicum experience may enhance the successful transition and socialization to working life of graduating nursing students. Nurse teachers have the main responsibility of supporting and guiding nursing students with their pedagogical expertise during the students’ clinical practicum. Thus, the clinical role of nurse teachers is seen as an essential part of a high-quality clinical practicum. Nursing students appreciate the nurse teacher’s cooperation with students, but it is often reported to be unattainable. The aim of this study was to explore and compare graduating nursing students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision in their final clinical practicum, and to analyze factors associated with these experiences in six European countries. Methods: A cross-sectional comparative international survey design was used. The modified Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) Scale, with a new subscale measuring the nurse teacher’s pedagogical cooperation with students, was used. A convenience sample of graduating nursing students in Finland, Germany, Iceland, Ireland, Lithuania and Spain completed the online survey in 2018–2019. The data were analyzed using a Chi-Square test, Pearson’s correlation coefficients, and linear models. Results: A total of 1796 (response rate 49%) nursing students completed the survey. Overall, students had positive experiences of the nurse teacher’s pedagogical cooperation, the clinical learning environment and supervision in their final clinical practicum. Students in Spain had the most positive experiences. Educational background factors appeared to be associated with the students’ experiences of the nurse teacher’s pedagogical cooperation with students, the clinical learning environment and supervision. The relationships between the subscale Nurse teacher’s pedagogical cooperation with students and the Clinical Learning Environment and Supervision Scale were perceived as weak to strong depending on the country. Conclusions: This study reveals that nurse teachers play an essential role in supporting and guiding nursing students’ final clinical practicum. In this light, researchers, educators, and leaders should collaborate seamlessly between educational institutions and healthcare organizations to establish the nurse teachers’ pedagogical cooperation role within the clinical learning environment.Peer reviewe