Challenges Experienced by Nursing Students in the Clinical Learning Environment: A Cross-sectional Study in Hospitals within Koforidua, Eastern Region of Ghana

Challenges Experienced by Nursing Students in the Clinical Learning Environment: A Cross-sectional Study in Hospitals within Koforidua, Eastern Region of Ghana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Challenges Experienced by Nursing Students in the Clinical Learning Environment: A Cross-sectional Study in Hospitals within Koforidua, Eastern Region of Ghana Ebenezer Quayson, Hannah Okyere-Boateng, Emmanuella Boafo, Comfort Akua Acquah, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4201477/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Nursing students have a crucial role to play in healthcare services while they are in training. It is an essential step in their professional practice preparation. Unfortunately, nursing students often experience obstacles such as bullying behavior which makes some of them drop out of nursing education, regardless of their geographic location. With the increasing brain drain of nurses in Ghana, the nurse-patient ratio is likely to rise further if the phenomenon is not given attention. Therefore, it is crucial to thoroughly evaluate nursing students' bad experiences in the clinical learning environment for a remedy. Hence, the researchers aim to analyze the obstacles faced by nursing students during their clinical attachments in hospitals located in Koforidua, Ghana's Eastern Region. A cross-sectional survey was conducted using a convenient sampling technique to select 130 nursing students from specific clinical learning environments. The study found that male nursing students (OR = 3.27 [95% CI: 1.67–4.88], p < 0.01), nursing students who are married (OR=-0.89 [95% CI: -2.57-0.80], p = 0.30), and Muslim nursing students (OR=-0.68 [95% CI: -2.27-0.41], p = 0.17) were more likely to be dissatisfied with their clinical learning environment compared to female, unmarried, and Christian nursing students, respectively. Male nursing students, Muslim nursing students, married nursing students, and nursing students who were relatively old were more likely to drop out of nursing school due to their intolerance of bullying and disrespect in the clinical environment, which led to dissatisfaction with their clinical experience. Nursing clinical learning environment clinical learning experience nursing students Figures Figure 1 INTRODUCTION Nursing students have a significant role to play in healthcare services as a part of their training that prepares them for their professional practice. However, their clinical practice experiences may vary depending on factors such as age, experience, and personality traits. Unfortunately, bullying behavior is not uncommon in the nursing profession regardless of the geographical location [ 1 ]. According to research conducted on healthcare workers, bullying is more prevalent in the nursing profession compared to other occupations [ 2 ]. A study conducted in Europe among nurses discovered that bullying behavior is prevalent and is linked to burnout. In recent years, workplace bullying, and its effects have emerged as key research topics [ 3 ]. It has been observed that many Sub-Saharan African countries, Ghana included, tend to teach children to not question authority [ 4 ]. British nurses, who established a senior-junior relationship, trained the first nurse trainees in colonial Ghana, and these norms have become a part of nursing curricula [ 5 ]. Juniors were expected to obey before complaining and had limited independence and work responsibilities [ 6 ]. During clinical placements, student nurses in Ghana are expected to demonstrate submissiveness to more experienced nurses [ 7 , 8 ]. When nursing students in Ghana complain about being bullied or having negative experiences during their clinical practicum, they are often labeled as rude or insincere. Instead of addressing the issue, they are expected to adapt to bullying behavior, particularly from senior nurses. The new generation of nurses in Ghana has diverse reactions to this issue. Some believe that bullying is wrong and should not be tolerated under any circumstances, while others advise students to embrace such behaviors as a normal part of their clinical experience, which will eventually end once they become fully qualified nurses [ 7 , 8 ]. A recent study in Ghana found that nursing students frequently experience negative clinical encounters, including bullying from patients' relatives [ 9 , 10 ]. A study conducted in Ghana found that over half of nursing students, 52.2%, had experienced verbal abuse in a clinical setting [ 10 ]. The study found that 12% of nursing students had experienced sexual harassment by medical doctors, which was one of their most negative clinical experiences [ 11 ]. During their clinical attachment, several nursing students reported being limited to monitoring vital signs only, regardless of their level [12 All of these negative experiences that nursing students have can cause some students to leave the nursing profession and pursue other careers. The nurse-patient ratio is likely to increase further in Ghana due to the growing brain drain of nurses. To address this issue, nursing students’ experiences must be thoroughly evaluated to find a remedy. However, there is little research on this phenomenon in various regions of Ghana, particularly in the Eastern Region. Therefore, the researchers aim to analyze the obstacles faced by nursing students during their clinical attachments in hospitals located in Koforidua, Ghana's Eastern Region. METHODS Study Design The research utilized a descriptive cross-sectional survey as part of a quantitative study design.. Study Area The study took place in two hospitals located in Koforidua, a town in Ghana's Eastern Region. The hospitals were St. Joseph Hospital and Koforidua Regional Hospital. These two hospitals were chosen because they were where nursing students were placed for their clinical practicum in Koforidua. St. Joseph Hospital is located in Koforidua-Effiduase, closer to Effiduase prison. It is a secondary healthcare facility that offers services such as medical and surgical care, outpatient department care, theatre-related care, maternity care, and specialized clinics for diabetes, HIV, and other conditions. Koforidua Regional Hospital is located closer to the city campus of All Nations University. It is also a secondary healthcare facility that provides similar services to St. Joseph Hospital. Research Population The study aimed to examine nursing students who had completed their clinical experience in specific healthcare facilities. This included all students who underwent their clinical practicum in the mentioned areas, regardless of whether they were pursuing a degree, diploma, or certificate. Sample Size and Sampling Technique It was estimated that a total of 80 nursing students attended clinical practicum at St. Joseph Hospital, while about 95 attended clinical practicum at Koforidua Regional Hospital. Thus, the estimated target population was 175. After calculating the sample size, it was determined to be 122 nursing students. The convenience sampling method was used to select 122 nursing students who met the inclusion criteria. Data Collection Instrument The researchers used an anonymous self-administered questionnaire to collect data within a week. They chose to use the Clinical Learning Environment Inventory (CLEI) questionnaire to assess nursing students' perceptions of the hospital as a learning environment. The CLEI questionnaire has 42 items, with each of the 6 scales comprising 7 items. These scales include Personalization, Student Involvement, Task Orientation, Innovation, Satisfaction, and Individualization. The survey responses are provided on a 4-point Likert scale of agreement. Data Collection Procedure The participants were fully informed about the purpose of the study before administering the questionnaires. Consent was obtained from them by allowing them to sign a consent form. To ensure confidentiality, participants were not required to provide any personal information. The administering of the questionnaires was done in two ways. First, an instant collection of answered questionnaires was done. Second, if the participants were unable to respond at the time, they were given the questionnaires to complete at a later time. Data Processing and Analysis The information obtained from the participants was analyzed using IBM Statistical Package for Social Sciences (SPSS) version 25 software. The data was inputted into IBM SPSS Statistics 25 and summarized using descriptive statistics such as frequency tables and charts, logistic regression, and linear regression. Ethical Considerations An introductory letter was requested from the Head of the Nursing Department at All Nations University (ANU). The letter was then sent to the administrators of St. Joseph Hospital and Koforidua Regional Hospital, as well as the preceptors and heads of various units. Clearance to conduct the study in these healthcare facilities was obtained from the administrators of the hospitals. Before handing out the questionnaire, a comprehensive verbal explanation was given to the respondents about the purpose of the study. Verbal and written consent were obtained by allowing them to sign a consent form for the study. For confidentiality, respondents were not required to write their names on the questionnaire. They were informed that they had the right to withdraw from participating in the study, even after they had already consented to do so, without it affecting them in any way. Data elicited from respondents were treated as private by securing the software with a password and the hard copy under lock and key. RESULTS AND DISCUSSION The following Table 1 provides data on the demographic features of 130 participants. It is worth noting that the nursing profession is female-dominated, as 74.6% of the participants were females and only 25.4% were males. Out of the 130 undergrad nursing students sampled, 26.2% were in level 100, 30% were in level 200, 20% were in level 300, and the least was level 400 (23.1%). This is partly because those who were not available to participate in the study may be engaged in their project work. It is documented that Ghana is a Christian-dominated nation, so it was not surprising to notice that 82.3% of the participants were Christians while the remaining were Muslims. The majority (87.75%) of the undergraduate students were not married, with only 12.3% being married. Table 1 Data on participants’ demographic features Demographic features N Frequency Percentage Gender 130 Male 33 25.4% Female 97 74.6% Level of education 130 Level 100 34 26.2% Level 200 40 30.8% Level 300 26 20% Level 400 30 23.1% Religion 130 Christian 107 82.3% Muslim 23 17.7% Marital status 130 Single 114 87.7% Married 16 12.3% Figure 1 and Table 2 show data related to the age of the participants. The minimum age was 18 years, which is expected for an undergraduate program. However, it is worth noting that the oldest participant among the sampled undergraduate nursing students was 35 years old. The age distribution of the participants was positively skewed, with a mean age of 23.75 and a standard deviation of 3.9. This suggests that the number of participants who were over 30 years old was relatively low. Table 2 Data on age of the participant Descriptive Statistics Age Valid 130 Missing 0 Mean 23.75 Std. Deviation 3.90 Minimum 18 Maximum 35 Table 2 presents data on factors that personalize the experiences of respondents in the clinical learning environment. Alarmingly, nearly half (39.9%) of the respondents reported no opportunities for students to express their opinions in the wards. Additionally, 33.9% of the nursing students expressed dissatisfaction with what is done in the wards. Only 13.5% of the respondents agreed that the identified personalized factors had no negative impact on their clinical learning environment. Meanwhile, a combined 24.7% of nursing students reported that the identified personalized factors were having a detrimental effect on their clinical learning environment. Table 2 Data on respondents’’ personalize factors that influence their experiences in the clinical learning environment Statement N Frequency (percentage) SA A D SD Personalization Clinical students are satisfied with what is done in the ward 130 12 (9.2%) 74 (56.9%) 40 (30.8%) 4 (3.1%) Students seem to do the same type of tasks in every shift 130 31 (24.4%) 67 (50.4%) 32 (25.2%) There are opportunities for students to express their opinions in this ward 130 12(9.4%) 67 (50.7%) 45 (35.2%) 6 (4.7%) The preceptor helps the student who is having trouble with the work 130 19 (15.2%) 94 (71.8%) 17 (13%) Getting a certain amount of work done is important for the ward 130 18 (13.8%) 86 (66.2%) 26 (20%) Workload allocation in the ward is carefully planned 130 16 (12.3%) 87 (66.9%) 21 (16.2%) 6 (4.6%) There is little opportunity for a student to pursue his or her particular interest in the ward 130 15 (11.6%) 87 (66.9%) 26 (20%) 2 (1.5%) Total 910 123 (13.5%) 562 (61.8%) 207 (22.7%) 18 (2%) SA = strongly agree, A = agree, D = disagree, SD = strongly disagree Table 3 presents data on the factors that influence the clinical learning environment experiences of nursing students in terms of student involvement. The data suggests that almost half (47.6%) of the respondents stated that their clinical placement was boring. Similarly, slightly more than half (50.4%) of nursing students disagreed that clinical teachers talked to them individually. Overall, 29.1% of nursing students reported that their involvement in clinical practices was insufficient to facilitate their learning. Table 3 Data on factors influencing nursing students’ clinical learning environment experiences with student involvement Statement N Frequency (percentage) SA A D SD Student involvement Preceptors consider the feelings of students’ nurses 130 18 (14%) 70 (53.4%) 38 (29.5%) 4 (3.1%) There are few opportunities for student to pursue their interest in the ward 130 28 (21.9%) 75 (57.3%) 24 (18.5%) 3 (2.3%) Students in the ward pay attention to what others are saying 130 19 (15%) 90 (68.5%) 21 (16.5%) - The clinical teacher talks individually with students 130 11 (8.7%) 52 (40.9%) 58 (43.5%) 9 (6.9%) The clinical placement is not boring 130 10 (7.7%) 58 (44.6%) 44 (33.8%) 18 (13.8%) New and different ways of teaching to the students are seldom used in the ward 130 11 (8.5%) 93 (71.5%) 25 (19.2%) 1 (0.8%) The clinical teacher helps the student who is having trouble with work 130 20 (15.4%) 91 (70%) 18 (13.8%) 1 (0.8) Total 910 117 (12.9%) 529 (58.1%) 228 (25.1%) 36 (4%) SA = strongly agree, A = agree, D = disagree, SD = strongly disagree The data presented in Table 4 highlights the various factors that affect the satisfaction levels of nursing respondents with their clinical learning environment. The majority of the respondents, which amounts to 57.7%, disagreed with the notion that their preceptor showed interest in addressing their concerns. They also reported that the preceptor was not friendly and considerate towards them. In total, the responses indicate that almost half (48.3%) of the participants were not satisfied with their clinical learning environment. Table 4 Data on factors affecting nursing respondents’’ satisfaction with the clinical learning environment Statement N Frequency (percentage) SA A D SD Satisfaction After the shift, the students have a sense of satisfaction 130 8 (6.2%) 86 (66.2%) 34 (26.2%) 2 (1.5%) Students put effort into what they do 130 32 (25%) 85 (66.4%) 11 (8.6%) It is the preceptor who decides the students’ activities in the ward 130 21 (16.7%) 61 (48.4%) 41 (32.5%) 3 (2.4%) Students have a say in how the shift is spent 130 7 (5.5%) 35 (27.6%) 67 (52.8%) 18 (14.2%) The preceptor is interested in the students’ problems 130 9 (6.9%) 33 (25.4%) 75 (57.7%) 13 (10%) The preceptor often gets sidetracked instead of sticking to the point. 130 9 (6.9%) 33 (25.4%) 75 (57.7%) 13 (10%) The preceptor is friendly and considerate towards students 130 9 (6.9%) 33 (25.4%) 75 (57.7%) 13 (10%) Total 910 95 (10.4%) 366 (40.2%) 378 (41.5%) 62 (6.8%) SA = strongly agree, A = agree, D = disagree, SD = strongly disagree The following data is presented in Table 5 and it indicates the experiences of respondents in the clinical learning environment concerning task orientation factors. The findings suggest that slightly more than one-quarter (35.4%) of the respondents expressed dissatisfaction with the preceptors' activities for the students, as they found the activities uninteresting. Furthermore, over 30% of nursing students disagreed with the notion that clinical teachers considered their feelings while assigning tasks. In summary, more than 20% of the responses indicated that task orientation factors had a negative impact on their clinical learning experience in the clinical learning environment. Table 5 Data on respondents’ clinical learning environment experiences with task orientation factors Statement N Frequency (percentage) SA A D SD Task Orientation The preceptor goes out of his/her way to help students 130 16 (12.6%) 74 (58.3%) 34 (26.8%) 3 (2.4%) Students look forward to coming to clinical placement 130 31 (24.2%) 78 (60.9%) 17 (13.3%) 2 (1.6%) The preceptor often thinks of interesting activities for the students 130 12 (9.4%) 64 (50.4%) 45 (35.4%) 6 (4.7%) The preceptor thinks up innovative activities for students 130 6 (4.6%) 77 (59.2%) 37 (28.5%) 10 (7.7%) Ward assignments are clear so students know what to do 130 15 (11.6%) 86 (66.7%) 27 (20.9%) 1 (0.8%) Students ‘clock watch’ in this ward ( can’t wait till the end of the shift) 130 26 (20%) 59 (45.4%) 41 (31.5%) 4 (3.1%) The clinical teacher considers students' feelings 130 9 (6.9%) 75 (57.7%) 40 (30.8%) 6 (4.6%) Total 910 115 (12.6%) 513 (56.4%) 241 (26.5%) 32 (3.5%) SA = strongly agree, A = agree, D = disagree, SD = strongly disagree Table 6 presents data on factors that affect respondents’ clinical learning experience with teaching innovation in the clinical learning environment. The data indicate that the majority (69.5%) of the nursing students disagreed that students were allowed to work at their own pace. Moreover, half (50%) of the respondents disagreed that all staff in the ward did the same work in the same way. Again, almost half (49.4%) of the respondents disagreed that the same ward staff member worked with the students for most of their placement. Overall, over 40% of the responses suggested that the factors of teaching innovation negatively affected their clinical experience in the clinical learning environment. Table 6 Data on factors that affect respondents’ clinical learning experience concerning teaching innovation in the clinical learning environment. Statement N Frequency (percentage) SA A D SD Teaching Innovation Teaching approaches allow students to proceed at their own pace. 130 10 (7.7%) 92 (70.8%) 26 (20%) 2 (1.5%) Students are generally allowed to work at their own pace 130 5 (3.9%) 34 (26.6%) 78 (60.9%) 11 (8.6%) The preceptor talks rather than listens to the students 130 16 (12.6%) 61 (48%) 47 (37%) 3 (2.4%) All staff in the ward are expected to do the same work in the same way 130 16 (12.3%) 49 (37.7%) 55 (42.3%) 10 (7.7%) Teaching approaches allow students to proceed at their own pace 130 18 (13.8%) 74 (56.9%) 35 (26.9%) 3 (2.3%) The same ward staff member works with the student for most of this placement 130 9 (6.9%) 57 (43.8%) 58 (44.6%) 6 (4.6%) It is the clinical instructor who decides the students’ activities in the ward 130 23 (17.7%) 75 (57.7%) 29 (22.3%) 3 (2.3%) Total 910 97 (10.7%) 442 (48.6%) 328 (36%) 38 (4.2%) SA = strongly agree, A = agree, D = disagree, SD = strongly disagree The following data is presented in Table 7 , which examines the relationship between clinical involvement and satisfaction with clinical experiences among the respondents. The data indicate a direct proportional (0.484) relationship between the two, which means that students are more likely to be satisfied when they are involved in clinical practices in the learning environment. The data suggests that a unit increase in students' involvement in clinical practice in the clinical learning environment results in a 0.509 increase in their satisfaction level, accounting for a 23.4% change. This change was significant (p < .001) and observed at t = 6.258 (95% CI: 0.340–0.670). Table 7 Data on the relationship between respondents’ clinical involvement and their satisfaction with clinical experiences Model Unstandardized Standard Error Standardized t P 95% CI R R 2 Lower Upper H₀ (Intercept) 2.406 0.032 75.273 < .001 2.343 2.469 H₁ (Intercept) 1.293 0.180 7.178 < .001 0.936 1.649 Students’ involvement 0.509 0.081 0.484 6.258 < .001 0.340 0.670 0.484 0.234 The data presented in Table 8 shows a relationship between the age of respondents and personal factors that affect their clinical experiences. The data suggests that as students get older, they are more likely to be negatively affected by these personal factors. The relationship is direct and proportional, with a value of 0.124. This means that even a small increase in age (1.5%) can cause a slight increase in dissatisfaction with clinical experiences (0.01), but this increase is not statistically significant (p < .161). The t-value for this relationship is 1.409, with a 95% confidence interval between − 0.004 and 0.025. Table 8 Data on the relationship between respondents’ age and the personal factors influencing their clinical experiences Model Unstandardized Standard Error Standardized t p 95% CI R R 2 Lower Upper H₀ (Intercept) 2.135 0.029 73.936 < .001 2.078 2.192 H₁ (Intercept) 1.887 0.178 10.589 < .001 1.535 2.240 Age 0.010 0.007 0.124 1.409 0.161 -0.004 0.025 0.124 0.015 Table 9 presents data on how personal factors affect the clinical experiences of nursing students based on their age and gender. The data indicates that male nursing students are about 3 times more likely to be dissatisfied with their clinical environment compared to female nursing students (OR = 3.27 [95% CI: 1.67–4.88], p < 0.01). Married nursing students are also more likely to be dissatisfied with their clinical environment than unmarried nursing students (OR=-0.89 [95% CI: -2.57-0.80], p = 0.30). Additionally, Muslim nursing students are more likely to be dissatisfied with their clinical environment compared to Christian nursing students (OR=-0.68 [95% CI: -2.27-0.41], p = 0.17). Table 9 Data on the relationship between respondents’ age and the personal factors affecting their clinical experiences Demographic features R 2 OR P CI 95% Gender *male 0.23 3.27 < 0.01 1.67–4.88 Marital status *Single 0.02 -0.89 0.30 -2.57-0.80 Religion *Christian 0.02 0.68 0.17 -2.27-0.41 Challenges Faced by Nursing Students During Their Clinical Experiences Personalization emphasizes the opportunity for students to interact with preceptors and raises concerns about their well-being [ 14 ]. The personal aspect of certain factors makes them critical to nursing students' desire to gain valuable clinical experience in the clinical learning environment. As a result, personalization aspects can have a significant impact on nursing students, potentially leading them to leave the nursing profession if negatively impacted. The findings of this study offer stakeholders with the basis to be proactive in ensuring students' welfare and interactions with preceptors are suitable. This is because nearly half of the nursing students reported dissatisfaction with what was done on the wards. The reason for this could be due to a lack of opportunities to perform duties on the wards. Data revealed that around one-quarter of nursing students reported that their tasks on the ward were nearly identical. Student nurses are usually tasked with performing routine duties such as ward dusting, serving bedpans, and bed making during each shift. Apart from these responsibilities, nursing students are rarely allowed to perform additional nursing tasks apart from running errands, during which they often miss observing procedures performed by staff nurses on the ward [ 14 ]. In this situation, many students are unable to achieve the objectives for which they were sent to the clinical learning environment. For instance, the study revealed that some nursing students felt frustrated because they were not allowed to pursue their specific interests (performing duties based on their goals) in the ward. Moreover, almost half of the nursing students were not allowed to express their ideas on the ward but were instead expected to observe and obey without any input or concerns about the practices being followed. When student nurses questioned the practices being followed by clinical nurses, they were often labeled as confrontational or rude, which created an intimidating environment for them. This intimidation stopped student nurses from bridging the gap between theoretical knowledge taught in the classroom and practical knowledge gained in the ward. Although most students did not face any issues in their clinical learning environment, almost a quarter of student nurses who faced problems due to personal concerns required treatment. If these student nurses leave nursing school due to these difficulties, it will have a devastating long-term impact on the nursing profession and public health. It will result in fewer nursing students graduating for employment, and with the continuous brain drain, it will only widen the nurse/patient ratio in Ghana, significantly harming public health and hindering the achievement of the Sustainable Development Goals. Lastly, student involvement in ward activities is critical for their active participation and attentiveness [ 14 ]. Involving student nurses in clinical practice provides experiential learning to bridge the theory-practice gap in nursing [ 14 ]. It has been observed that nursing students who have little or no involvement in clinical practices face difficulties in understanding the relationship between theory and practice. Such students are likely to find the clinical learning environment uninteresting and may lack motivation to study there. Even when they attend the clinical learning setting, it is usually because they fear losing attendance marks rather than a desire to learn. The lack of motivation to attend the clinical learning environment, coupled with preceptors' disregard for their students' feelings and learning needs, can cause these student nurses to spend time in the clinical learning environment without paying attention to the clinical nurses' practice. It is concerning to note that over a quarter of nursing students feel a lack of involvement in clinical practice while in the clinical learning environment, as revealed in the data collected by Gemuhay, Kalolo, Mirisho, Chipwaza, and Nyangena [ 15 ] and According to Kamphinda and Chilemba's [ 15 ] study, student nurses were not able to engage actively in clinical practice due to inadequate resources in healthcare facilities. This lack of resources meant that student nurses did not have access to the necessary tools and equipment required for clinical learning experiences. Satisfaction with the clinical learning environment is measured by the extent to which students enjoy it. [ 14 ]. Nursing students' dissatisfaction with the clinical learning environment can be attributed to their inability to meet their clinical placement objectives, a poor relationship with their preceptors, and insufficient learning resources in the clinical setting [ 14 ]. It has been observed that nursing students' dissatisfaction with the clinical learning environment is often caused by poor relationships with their preceptors. Some preceptors tend to dismiss the students' complaints, including their difficulties in the clinical learning setting. As a result, preceptors fail to recognize bullying of students by other clinical nurses or healthcare workers, which prevents them from finding solutions to improve nursing students' satisfaction with the clinical learning environment, leading to a less effective learning experience. One key issue that could help nursing students feel more comfortable in the clinical learning environment is to consider their schedules and arrange their shifts accordingly. Some students may have to take care of themselves or their family members. If their work schedules conflict with their clinical shifts, such students may become dissatisfied with the clinical shift and choose to prioritize more lucrative work instead. Kalyani, Jamshidi, Molazem et al. [ 14 ] identified that interactions with staff in clinical settings can be a significant stressor for students. According to Kalyani and colleagues [ 14 ], five factors contribute to student stress in a clinical setting: academic challenges, connections with clinical personnel and nursing lecturers, clinical experiences, finances, and patient death. As a result, healthcare workers, particularly ward nurses, play a vital role in the practical instruction of nursing students in hospitals. Even though these staff members do not actively guide students, their actions may indirectly impact the nursing students' learning outcomes. They have the authority to allow students to practice nursing skills and care for their patients. Additionally, they provide equipment and give pupils detailed instructions for completing healthcare operations. Clarity and organization of ward activities refer to task orientation in the clinical learning environment. [ 14 ]. Nursing students may feel confused and find it difficult to learn when nursing duties are not carried out in a logical sequence. This confusion may lead to student nurses becoming uncertain about how to perform a task when assigned to it. It can be even more confusing when nursing students are only allowed to observe and not permitted to discuss their concerns. This is because the practice being observed may be performed differently by different clinical nurses, and there may be a direct conflict between the practice being seen and the theory being taught. To bridge the gap between theory and practice in nursing, student nurses must observe all clinical nurses performing nursing tasks in an ordered and logical manner. This would enable nursing students to understand the necessary stages related to a particular activity, allowing them to accomplish the task in a structured and coherent manner. The process of bridging the theory-practice gap becomes more consolidated when student nurses are allowed to express their concerns about observed or performed tasks, and those concerns are addressed using evidence-based content. However, some nursing students have reported that they found the tasks in the ward disorganized. According to Cherkewa's [ 17 ] study, poor relationships between nursing students and their preceptors can prevent students from raising concerns about practices that do not align with theoretical knowledge. The level of teaching innovation by preceptors can be determined by their ability to plan creative and productive clinical experiences, teaching methods, learning activities, and patient assignments [ 14 ]. Preceptors have the potential to effectively introduce new duties to student nurses by using suitable teaching strategies. This can significantly increase productivity and students would be more engaged in attending clinical learning sessions. The clinical learning environment would then become an efficient location for learning and meeting the objectives of the clinical placement. This, in turn, would help bridge the theory-patient gap in nursing and address the nursing student attrition rate. Ultimately, this would help bridge the nurse/patient ratio and enhance public health in support of SDG goal 3. However, the findings of a recent study revealed that many nursing students believed that educational innovations had a negative impact on their clinical experience in the clinical learning setting. It was discovered that while clinical teachers and staff nurses both mentor student nurses in the clinical learning environment, neither clinical teacher nor staff nurse was eager to teach student nurses. In the study of Kamphinda and Chilemba [ 16 ], all participants reported that clinical preceptors were too occupied to give individual attention to each student. Having too many students in a single ward can make it challenging for the instructor to monitor all the nursing students' activities. When students perform interventional procedures, such as administering injections, changing dressings, or collecting blood samples, which may pose a risk to patients, they must do so under the guidance and instruction of the instructor. However, if the instructor is too busy, then the students may be deprived of the opportunity to perform these treatments on patients. Clinical preceptors play a crucial role in Clinical Learning Environment (CLE) by appropriately distributing assignments and training nursing students on how to conduct procedures safely and effectively [ 18 ]. Relationship between Nursing Students’ Clinical Involvement and their Satisfaction with Clinical Experiences The statistics demonstrate a positive correlation between students' satisfaction and their participation in clinical learning activities. It is predicted that a 23.4% increase in students' involvement in clinical practice would result in a significant improvement in their satisfaction with the clinical learning environment. These findings offer hope to nursing educators, clinicians, and other stakeholders, as they suggest that eliminating factors that impede students' participation in clinical practices may be a direct way to enhance their satisfaction in the clinical learning environment. Some strategies include ensuring that clinical and student nurses have sufficient equipment for practicing. When equipment is scarce, it can negatively impact both clinical and student nurses' participation in clinical practices. For example, Kamphinda and Chilemba's [ 16 ] study observed similar outcomes, where a lack of clinical involvement by student nurses was largely attributed to insufficient equipment in the clinical learnin. Gemuhay, Kalolo, Mirisho, and other researchers [ 15 ] discovered that the hospital where student nurses were training did not have sufficient infrastructure to support their learning. Consequently, student nurses were unable to engage in significant clinical learning activities. The hospital's inability to address these difficulties and enhance the clinical learning environment may lead to an increase in nursing student dropout rates [ 19 ]. Association between Nursing Students’ Demographic Features and Their Factors Affecting Clinical Experiences There is a slight positive relationship between the age of nursing students and their dissatisfaction with clinical experiences due to personal factors. However, this association is not significant as it only accounts for a 1.5% difference. In other words, a unit increase in the age of students is expected to result in a slight increase in their dissatisfaction with clinical experience variables. Additionally, male, Muslim, and married nursing students have expressed their discontent with the clinical learning environment. As per Kalyani et al. [ 14 ], individuals who are older, male, married, or Muslim are less likely to tolerate bullying behavior, which could explain the study's results. Many nursing studies have addressed the issue of bullying culture. Kalyani et al. [ 14 ] observed this behavior in all individuals, including physicians, head nurses, and ward nurses. Nursing students reported being subjected to odd jobs and serving the nurses, which prevented them from performing their duties as intern nurse practitioners and participating in real clinical educational processes [ 14 ]. At CLE, medical students had access to dressing rooms, restrooms, and the library while nursing students were left without access to these basic amenities [ 14 ]. Another study emphasized a similar disparity when the head nurse requested that nursing students provide medical students seats whenever possible [ 15 ]. This was utterly irrational and had the potential to create unfavorable opinions about the nursing profession. Nursing students may have believed that their profession was unworthy of respect and that their true purpose was solely to aid physicians or others. This was a significant challenge for nursing students who aspired to be clinical nurses. The higher risk that could emerge from such unfavorable actions in clinical education was the increasing rate of nursing students (particularly men, Muslims, and married nursing students) who wished to leave the nursing career. This might be explained as they sought a more polite learning environment. Smith, Gillespie, Brown, and Grubb also discovered that 'inadequate,' 'not respected,' and even 'be bullied' were commonly used comments. Learning situations became increasingly complex, and student nurses were no longer self-sufficient in their environment, where they should be the focal point. One of the difficulties that nursing students have throughout the CLE may be due to an unsuccessful interaction between clinical nurses, other stakeholders, and nursing students. According to Amini, Bayat, and Amini [ 20 ], non-cooperation by nursing personnel is a significant barrier to clinical education. Conclusion Male nursing students, Muslim nursing students, married nursing students, and relatively older nursing students were found to be more susceptible to dropping out of nursing school due to their inability to tolerate bullying and disrespect in the clinical environment. This, in turn, led to dissatisfaction with their clinical experience. Declarations Ethical approval to conduct the study was provided by the Review Board of All Nations University. Funding The authors received no financial support for the study, authorship, and/or publication of this article. Acknowledgment We are grateful for the support from friends, colleagues, and all nursing students who participated in the study. Authors’ Contributions Conceptualization, Quayson E.; Methodology, Review & Editing, and Manuscript, all the team members were active. Declaration of Conflicting Interests The authors declare no potential conflicts of interest concerning the study, authorship, and/or publication of this article. References Leidl DM, Ritchie L, Moslemi N. Blended learning in undergraduate nursing education–A scoping review. Nurse Education Today. 2020 Mar 1;86:104318. Karatuna I, Jönsson S, Muhonen T. Workplace bullying in the nursing profession: A cross-cultural scoping review. International journal of nursing studies. 2020 Nov 1;111:103628. Gupta P, Gupta U, Wadhwa S. Known and unknown aspects of workplace bullying: A systematic review of recent literature and future research agenda. Human Resource Development Review. 2020 Sep;19(3):263-308. Scharpf F, Kirika A, Masath FB, Mkinga G, Ssenyonga J, Nyarko-Tetteh E, Nkuba M, Karikari AK, Hecker T. Reducing physical and emotional violence by teachers using the intervention Interaction Competencies with Children–for Teachers (ICC-T): study protocol of a multi-country cluster randomized controlled trial in Ghana, Tanzania, and Uganda. BMC Public Health. 2021 Dec;21:1-5. Amoo SA, Menlah A, Garti I, Appiah EO. Bullying in the clinical setting: Lived experiences of nursing students in the Central Region of Ghana. PloS one. 2021 Sep 23;16(9):e0257620. Austin EE, Do V, Nullwala R, Pulido DF, Hibbert PD, Braithwaite J, Arnolda G, Wiles LK, Theodorou T, Tran Y, Lystad RP. A systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims, or impaired performance. BMJ open. 2021 Aug 1;11(8):e050377. Clarke J, van der Riet P, Bowen L. Nurses and undergraduate student nurses' experiences in collaborative clinical placement programs in acute hospitals: An integrative literature review. Nurse Education Today. 2020 Dec 1;95:104578. González-García M, Lana A, Zurrón-Madera P, Valcárcel-Álvarez Y, Fernández-Feito A. Nursing students’ experiences of clinical practices in emergency and intensive care units. International journal of environmental research and public health. 2020 Aug;17(16):5686. Dapilah E. Workplace bullying among nurses in the Upper West Region of Ghana (Doctoral dissertation, University of Cape Coast). Boo A, Dzomeku VM, Diji AK, Bonsu AB, Apiribu F. Incivility in the workplace: A study of nursing and midwifery staff in Northern Ghana. medRxiv. 2022 Dec 14:2022-12. Tollstern Landin T, Melin T, Mark Kimaka V, Hallberg D, Kidayi P, Machange R, Mattsson J, Björling G. Sexual harassment in Clinical Practice—A cross-sectional study among nurses and nursing students in sub-Saharan Africa. SAGE Open Nursing. 2020 Oct;6:2377960820963764. Jack K, Levett-Jones T, Ylonen A, Ion R, Pich J, Fulton R, Hamshire C. “Feel the fear and do it anyway”… nursing students’ experiences of confronting poor practice. Nurse Education in Practice. 2021 Oct 1;56:103196. Woo MW, Li W. Nursing students' views and satisfaction of their clinical learning environment in Singapore. Nursing Open. 2020 Nov;7(6):1909-19. Kalyani MN, Jamshidi N, Molazem Z, Torabizadeh C, Sharif F. How do nursing students experience the clinical learning environment and respond to their experiences? A qualitative study. BMJ open. 2019;9(7). Gemuhay HM, Kalolo A, Mirisho R, Chipwaza B, Nyangena E. Factors affecting performance in clinical practice among preservice diploma nursing students in Northern Tanzania. Nursing Research and Practice. 2019 Mar 3;2019. Kamphinda S, Chilemba EB. Clinical supervision and support: Perspectives of undergraduate nursing students on their clinical learning environment in Malawi. Curationis. 2019 Jan 1;42(1):1-0. Chekerwa P. Nursing students’ perceptions of the barriers to applying theory to practice in clinical placement settings. Zhang J, Shields L, Ma B, Yin Y, Wang J, Zhang R, Hui X. The clinical learning environment, supervision and future intention to work as a nurse in nursing students: a cross-sectional and descriptive study. BMC Medical Education. 2022 Dec;22(1):1-9. Ibrahim AF, Abdelaziz TM, Akel DT. The relationship between undergraduate nursing students’ satisfaction with the clinical learning environment and their competency self-efficacy. Journal of Nursing Education and Practice. 2019;9(11):92. Amini A, Bayat R, Amini K. Barriers to clinical education from the perspective of nursing students in Iran: an integrative review. Archiv Pharm Pract. 2020;1:73. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4201477","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":286240553,"identity":"628d5963-94d7-42ac-baef-76eb1f868803","order_by":0,"name":"Ebenezer Quayson","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIiWNgGAWjYDADfgjFDMQ8RGqRbCBZi8EBYrXws+cYfub5Y5NnfPzsMQmGCuvEBv61B/C7p+eNsTRvW1qx2Zm8NAmGM+mJDRLvEvC750aOgTRvw+HEbQdyzCQY2w4DtZwxwKvF/kaO8W+eP4cTN/e/AWr5R4QWA4kcM2ketsOJGyRAtgCta+Dvwa9F4syzMsu5bWmJM268MbZIOJZu3CbBg18Lf3vy5htv/tgk9vfnGN74UGMt289PwGEMDAkMTDwINgMDm0QCAR1AZYw/UC0+QEjLKBgFo2AUjDAAAEznRlQtMrUWAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0009-0007-6025-5960","institution":"All Nations University","correspondingAuthor":true,"prefix":"","firstName":"Ebenezer","middleName":"","lastName":"Quayson","suffix":""},{"id":286240554,"identity":"965d4a6b-4657-4ade-9a2b-cc2af53b923e","order_by":1,"name":"Hannah Okyere-Boateng","email":"","orcid":"","institution":"All Nations University","correspondingAuthor":false,"prefix":"","firstName":"Hannah","middleName":"","lastName":"Okyere-Boateng","suffix":""},{"id":286240555,"identity":"4e3ce6ca-f36e-4a80-99e5-d8e9b52a8cdd","order_by":2,"name":"Emmanuella Boafo","email":"","orcid":"","institution":"All Nations University","correspondingAuthor":false,"prefix":"","firstName":"Emmanuella","middleName":"","lastName":"Boafo","suffix":""},{"id":286240556,"identity":"6f1156f3-9b89-4006-8dcd-561385a5e869","order_by":3,"name":"Comfort Akua Acquah","email":"","orcid":"","institution":"All Nations University","correspondingAuthor":false,"prefix":"","firstName":"Comfort","middleName":"Akua","lastName":"Acquah","suffix":""},{"id":286240557,"identity":"03a36e57-9999-4cbd-89d7-126f4a69bef6","order_by":4,"name":"Patience Kyei","email":"","orcid":"","institution":"All Nations University","correspondingAuthor":false,"prefix":"","firstName":"Patience","middleName":"","lastName":"Kyei","suffix":""}],"badges":[],"createdAt":"2024-04-01 15:11:09","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4201477/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4201477/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":54043741,"identity":"33aeba53-f1bd-46fa-9823-0254507d8486","added_by":"auto","created_at":"2024-04-03 18:31:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":15340,"visible":true,"origin":"","legend":"\u003cp\u003eBox and whisker for participants’ age\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-4201477/v1/fb8414524701d8a0586d5a2d.png"},{"id":54044181,"identity":"9615eb2a-3faa-479b-838f-be7fc98a990f","added_by":"auto","created_at":"2024-04-03 18:39:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":544175,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4201477/v1/68a8bb8c-3727-42c3-a920-8afa8bbde5cf.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eChallenges Experienced by Nursing Students in the Clinical Learning Environment: A Cross-sectional Study in Hospitals within Koforidua, Eastern Region of Ghana\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eNursing students have a significant role to play in healthcare services as a part of their training that prepares them for their professional practice. However, their clinical practice experiences may vary depending on factors such as age, experience, and personality traits. Unfortunately, bullying behavior is not uncommon in the nursing profession regardless of the geographical location [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. According to research conducted on healthcare workers, bullying is more prevalent in the nursing profession compared to other occupations [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. A study conducted in Europe among nurses discovered that bullying behavior is prevalent and is linked to burnout. In recent years, workplace bullying, and its effects have emerged as key research topics [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt has been observed that many Sub-Saharan African countries, Ghana included, tend to teach children to not question authority [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. British nurses, who established a senior-junior relationship, trained the first nurse trainees in colonial Ghana, and these norms have become a part of nursing curricula [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Juniors were expected to obey before complaining and had limited independence and work responsibilities [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. During clinical placements, student nurses in Ghana are expected to demonstrate submissiveness to more experienced nurses [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. When nursing students in Ghana complain about being bullied or having negative experiences during their clinical practicum, they are often labeled as rude or insincere. Instead of addressing the issue, they are expected to adapt to bullying behavior, particularly from senior nurses. The new generation of nurses in Ghana has diverse reactions to this issue. Some believe that bullying is wrong and should not be tolerated under any circumstances, while others advise students to embrace such behaviors as a normal part of their clinical experience, which will eventually end once they become fully qualified nurses [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA recent study in Ghana found that nursing students frequently experience negative clinical encounters, including bullying from patients' relatives [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A study conducted in Ghana found that over half of nursing students, 52.2%, had experienced verbal abuse in a clinical setting [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The study found that 12% of nursing students had experienced sexual harassment by medical doctors, which was one of their most negative clinical experiences [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. During their clinical attachment, several nursing students reported being limited to monitoring vital signs only, regardless of their level [12 All of these negative experiences that nursing students have can cause some students to leave the nursing profession and pursue other careers.\u003c/p\u003e \u003cp\u003eThe nurse-patient ratio is likely to increase further in Ghana due to the growing brain drain of nurses. To address this issue, nursing students\u0026rsquo; experiences must be thoroughly evaluated to find a remedy. However, there is little research on this phenomenon in various regions of Ghana, particularly in the Eastern Region. Therefore, the researchers aim to analyze the obstacles faced by nursing students during their clinical attachments in hospitals located in Koforidua, Ghana's Eastern Region.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Design\u003c/h2\u003e\n \u003cp\u003eThe research utilized a descriptive cross-sectional survey as part of a quantitative study design..\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eStudy Area\u003c/h2\u003e\n \u003cp\u003eThe study took place in two hospitals located in Koforidua, a town in Ghana\u0026apos;s Eastern Region. The hospitals were St. Joseph Hospital and Koforidua Regional Hospital. These two hospitals were chosen because they were where nursing students were placed for their clinical practicum in Koforidua. St. Joseph Hospital is located in Koforidua-Effiduase, closer to Effiduase prison. It is a secondary healthcare facility that offers services such as medical and surgical care, outpatient department care, theatre-related care, maternity care, and specialized clinics for diabetes, HIV, and other conditions. Koforidua Regional Hospital is located closer to the city campus of All Nations University. It is also a secondary healthcare facility that provides similar services to St. Joseph Hospital.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003eResearch Population\u003c/h2\u003e\n \u003cp\u003eThe study aimed to examine nursing students who had completed their clinical experience in specific healthcare facilities. This included all students who underwent their clinical practicum in the mentioned areas, regardless of whether they were pursuing a degree, diploma, or certificate.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003eSample Size and Sampling Technique\u003c/h2\u003e\n \u003cp\u003eIt was estimated that a total of 80 nursing students attended clinical practicum at St. Joseph Hospital, while about 95 attended clinical practicum at Koforidua Regional Hospital. Thus, the estimated target population was 175. After calculating the sample size, it was determined to be 122 nursing students. The convenience sampling method was used to select 122 nursing students who met the inclusion criteria.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eData Collection Instrument\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThe researchers used an anonymous self-administered questionnaire to collect data within a week. They chose to use the Clinical Learning Environment Inventory (CLEI) questionnaire to assess nursing students\u0026apos; perceptions of the hospital as a learning environment. The CLEI questionnaire has 42 items, with each of the 6 scales comprising 7 items. These scales include Personalization, Student Involvement, Task Orientation, Innovation, Satisfaction, and Individualization. The survey responses are provided on a 4-point Likert scale of agreement.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003eData Collection Procedure\u003c/h2\u003e\n \u003cp\u003eThe participants were fully informed about the purpose of the study before administering the questionnaires. Consent was obtained from them by allowing them to sign a consent form. To ensure confidentiality, participants were not required to provide any personal information. The administering of the questionnaires was done in two ways. First, an instant collection of answered questionnaires was done. Second, if the participants were unable to respond at the time, they were given the questionnaires to complete at a later time.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\n \u003ch2\u003eData Processing and Analysis\u003c/h2\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\n \u003cp\u003eThe information obtained from the participants was analyzed using IBM Statistical Package for Social Sciences (SPSS) version 25 software. The data was inputted into IBM SPSS Statistics 25 and summarized using descriptive statistics such as frequency tables and charts, logistic regression, and linear regression.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003eEthical Considerations\u003c/h2\u003e\n \u003cp\u003eAn introductory letter was requested from the Head of the Nursing Department at All Nations University (ANU). The letter was then sent to the administrators of St. Joseph Hospital and Koforidua Regional Hospital, as well as the preceptors and heads of various units. Clearance to conduct the study in these healthcare facilities was obtained from the administrators of the hospitals.\u003c/p\u003e\n \u003cp\u003eBefore handing out the questionnaire, a comprehensive verbal explanation was given to the respondents about the purpose of the study. Verbal and written consent were obtained by allowing them to sign a consent form for the study. For confidentiality, respondents were not required to write their names on the questionnaire.\u003c/p\u003e\n \u003cp\u003eThey were informed that they had the right to withdraw from participating in the study, even after they had already consented to do so, without it affecting them in any way. Data elicited from respondents were treated as private by securing the software with a password and the hard copy under lock and key.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"RESULTS AND DISCUSSION","content":"\u003cp\u003eThe following Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e provides data on the demographic features of 130 participants. It is worth noting that the nursing profession is female-dominated, as 74.6% of the participants were females and only 25.4% were males. Out of the 130 undergrad nursing students sampled, 26.2% were in level 100, 30% were in level 200, 20% were in level 300, and the least was level 400 (23.1%). This is partly because those who were not available to participate in the study may be engaged in their project work. It is documented that Ghana is a Christian-dominated nation, so it was not surprising to notice that 82.3% of the participants were Christians while the remaining were Muslims. The majority (87.75%) of the undergraduate students were not married, with only 12.3% being married.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on participants\u0026rsquo; demographic features\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eDemographic features\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eFrequency\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePercentage\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25.4%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e74.6%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLevel of education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLevel 100\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26.2%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLevel 200\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30.8%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLevel 300\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLevel 400\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23.1%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eReligion\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChristian\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e107\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e82.3%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMuslim\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17.7%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarital status\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSingle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e114\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e87.7%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.3%\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e and Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e show data related to the age of the participants. The minimum age was 18 years, which is expected for an undergraduate program. However, it is worth noting that the oldest participant among the sampled undergraduate nursing students was 35 years old. The age distribution of the participants was positively skewed, with a mean age of 23.75 and a standard deviation of 3.9. This suggests that the number of participants who were over 30 years old was relatively low.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on age of the participant\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eDescriptive Statistics\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAge\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eValid\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMissing\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMean\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23.75\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStd. Deviation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.90\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMinimum\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMaximum\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2 presents data on factors that personalize the experiences of respondents in the clinical learning environment. Alarmingly, nearly half (39.9%) of the respondents reported no opportunities for students to express their opinions in the wards. Additionally, 33.9% of the nursing students expressed dissatisfaction with what is done in the wards. Only 13.5% of the respondents agreed that the identified personalized factors had no negative impact on their clinical learning environment. Meanwhile, a combined 24.7% of nursing students reported that the identified personalized factors were having a detrimental effect on their clinical learning environment.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on respondents\u0026rsquo;\u0026rsquo; personalize factors that influence their experiences in the clinical learning environment\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStatement\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eFrequency (percentage)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePersonalization\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eClinical students are satisfied with what is done in the ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12 (9.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e74 (56.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e40 (30.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4 (3.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents seem to do the same type of tasks in every shift\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e31 (24.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e67 (50.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32 (25.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThere are opportunities for students to express their opinions in this ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12(9.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e67 (50.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e45 (35.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6 (4.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor helps the student who is having trouble with the work\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19 (15.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e94 (71.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e17 (13%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGetting a certain amount of work done is important for the ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18 (13.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e86 (66.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26 (20%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eWorkload allocation in the ward is carefully planned\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16 (12.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e87 (66.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21 (16.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6 (4.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThere is little opportunity for a student to pursue his or her particular interest in the ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15 (11.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e87 (66.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26 (20%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 (1.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e910\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e123 (13.5%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e562 (61.8%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e207 (22.7%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e18 (2%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\"\u003eSA\u0026thinsp;=\u0026thinsp;strongly agree, A\u0026thinsp;=\u0026thinsp;agree, D\u0026thinsp;=\u0026thinsp;disagree, SD\u0026thinsp;=\u0026thinsp;strongly disagree\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e presents data on the factors that influence the clinical learning environment experiences of nursing students in terms of student involvement. The data suggests that almost half (47.6%) of the respondents stated that their clinical placement was boring. Similarly, slightly more than half (50.4%) of nursing students disagreed that clinical teachers talked to them individually. Overall, 29.1% of nursing students reported that their involvement in clinical practices was insufficient to facilitate their learning.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on factors influencing nursing students\u0026rsquo; clinical learning environment experiences with student involvement\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStatement\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eFrequency (percentage)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eStudent involvement\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePreceptors consider the feelings of students\u0026rsquo; nurses\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18 (14%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e70 (53.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e38 (29.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4 (3.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThere are few opportunities for student to pursue their interest in the ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e28 (21.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e75 (57.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24 (18.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 (2.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents in the ward pay attention to what others are saying\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e19 (15%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e90 (68.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21 (16.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe clinical teacher talks individually with students\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11 (8.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52 (40.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e58 (43.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9 (6.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe clinical placement is not boring\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10 (7.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58 (44.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e44 (33.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18 (13.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNew and different ways of teaching to the students are seldom used in the ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11 (8.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e93 (71.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25 (19.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 (0.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe clinical teacher helps the student who is having trouble with work\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e20 (15.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e91 (70%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18 (13.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1 (0.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e910\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e117 (12.9%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e529 (58.1%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e228 (25.1%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e36 (4%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\"\u003eSA\u0026thinsp;=\u0026thinsp;strongly agree, A\u0026thinsp;=\u0026thinsp;agree, D\u0026thinsp;=\u0026thinsp;disagree, SD\u0026thinsp;=\u0026thinsp;strongly disagree\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe data presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e highlights the various factors that affect the satisfaction levels of nursing respondents with their clinical learning environment. The majority of the respondents, which amounts to 57.7%, disagreed with the notion that their preceptor showed interest in addressing their concerns. They also reported that the preceptor was not friendly and considerate towards them. In total, the responses indicate that almost half (48.3%) of the participants were not satisfied with their clinical learning environment.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab5\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on factors affecting nursing respondents\u0026rsquo;\u0026rsquo; satisfaction with the clinical learning environment\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStatement\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eFrequency (percentage)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAfter the shift, the students have a sense of satisfaction\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8 (6.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e86 (66.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e34 (26.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 (1.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents put effort into what they do\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e32 (25%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e85 (66.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11 (8.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIt is the preceptor who decides the students\u0026rsquo; activities in the ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21 (16.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e61 (48.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41 (32.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 (2.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents have a say in how the shift is spent\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7 (5.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35 (27.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e67 (52.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18 (14.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor is interested in the students\u0026rsquo; problems\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9 (6.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33 (25.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e75 (57.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13 (10%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor often gets sidetracked instead of sticking to the point.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9 (6.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33 (25.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e75 (57.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13 (10%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor is friendly and considerate towards students\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9 (6.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33 (25.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e75 (57.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13 (10%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e910\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e95 (10.4%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e366 (40.2%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e378 (41.5%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e62 (6.8%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\"\u003eSA\u0026thinsp;=\u0026thinsp;strongly agree, A\u0026thinsp;=\u0026thinsp;agree, D\u0026thinsp;=\u0026thinsp;disagree, SD\u0026thinsp;=\u0026thinsp;strongly disagree\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe following data is presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e and it indicates the experiences of respondents in the clinical learning environment concerning task orientation factors. The findings suggest that slightly more than one-quarter (35.4%) of the respondents expressed dissatisfaction with the preceptors' activities for the students, as they found the activities uninteresting. Furthermore, over 30% of nursing students disagreed with the notion that clinical teachers considered their feelings while assigning tasks. In summary, more than 20% of the responses indicated that task orientation factors had a negative impact on their clinical learning experience in the clinical learning environment.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab6\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on respondents\u0026rsquo; clinical learning environment experiences with task orientation factors\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStatement\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eFrequency (percentage)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTask Orientation\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor goes out of his/her way to help students\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16 (12.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e74 (58.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e34 (26.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3 (2.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents look forward to coming to clinical placement\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31 (24.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e78 (60.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17 (13.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2 (1.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor often thinks of interesting activities for the students\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12 (9.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e64 (50.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e45 (35.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6 (4.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor thinks up innovative activities for students\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6 (4.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e77 (59.2%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e37 (28.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10 (7.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eWard assignments are clear so students know what to do\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15 (11.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e86 (66.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e27 (20.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1 (0.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents \u0026lsquo;clock watch\u0026rsquo; in this ward ( can\u0026rsquo;t wait till the end of the shift)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26 (20%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e59 (45.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41 (31.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4 (3.1%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe clinical teacher considers students' feelings\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9 (6.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e75 (57.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e40 (30.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6 (4.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e910\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e115 (12.6%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e513 (56.4%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e241 (26.5%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e32 (3.5%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\"\u003eSA\u0026thinsp;=\u0026thinsp;strongly agree, A\u0026thinsp;=\u0026thinsp;agree, D\u0026thinsp;=\u0026thinsp;disagree, SD\u0026thinsp;=\u0026thinsp;strongly disagree\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e presents data on factors that affect respondents\u0026rsquo; clinical learning experience with teaching\u0026nbsp;innovation in the clinical learning environment. The data indicate that the majority (69.5%) of the nursing students disagreed that students were allowed to work\u0026nbsp;at their own pace. Moreover, half (50%) of the respondents disagreed that all staff in the ward did the same work in the same way. Again, almost half (49.4%) of the respondents disagreed that the same ward staff member worked with the students for most of their placement. Overall, over 40% of the responses suggested that the factors of teaching innovation negatively affected their clinical experience in the clinical learning environment.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab7\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on factors that affect respondents\u0026rsquo; clinical learning experience concerning teaching innovation in the clinical learning environment.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStatement\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eFrequency (percentage)\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eA\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eD\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTeaching Innovation\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTeaching approaches allow students to proceed at their own pace.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10 (7.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e92 (70.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e26 (20%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2 (1.5%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents are generally allowed to work at their own pace\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5 (3.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e34 (26.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e78 (60.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11 (8.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe preceptor talks rather than listens to the students\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16 (12.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e61 (48%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e47 (37%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3 (2.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAll staff in the ward are expected to do the same work in the same way\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16 (12.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e49 (37.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e55 (42.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10 (7.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTeaching approaches allow students to proceed at their own pace\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18 (13.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e74 (56.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35 (26.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3 (2.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eThe same ward staff member works with the student for most of this placement\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9 (6.9%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e57 (43.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e58 (44.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6 (4.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eIt is the clinical instructor who decides the students\u0026rsquo; activities in the ward\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e130\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23 (17.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e75 (57.7%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29 (22.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3 (2.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e910\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e97 (10.7%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e442 (48.6%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e328 (36%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u003cstrong\u003e38 (4.2%)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"6\"\u003eSA\u0026thinsp;=\u0026thinsp;strongly agree, A\u0026thinsp;=\u0026thinsp;agree, D\u0026thinsp;=\u0026thinsp;disagree, SD\u0026thinsp;=\u0026thinsp;strongly disagree\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe following data is presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e7\u003c/span\u003e, which examines the relationship between clinical involvement and satisfaction with clinical experiences among the respondents. The data indicate a direct proportional (0.484) relationship between the two, which means that students are more likely to be satisfied when they are involved in clinical practices in the learning environment. The data suggests that a unit increase in students' involvement in clinical practice in the clinical learning environment results in a 0.509 increase in their satisfaction level, accounting for a 23.4% change. This change was significant (p\u0026thinsp;\u0026lt;\u0026thinsp;.001) and observed at t\u0026thinsp;=\u0026thinsp;6.258 (95% CI: 0.340\u0026ndash;0.670).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab8\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on the relationship between respondents\u0026rsquo; clinical involvement and their satisfaction with clinical experiences\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eModel\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eUnstandardized\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStandard Error\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStandardized\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e95% CI\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUpper\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eH₀\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e(Intercept)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.406\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.032\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e75.273\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.343\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.469\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eH₁\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e(Intercept)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.293\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.180\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7.178\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.936\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.649\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eStudents\u0026rsquo; involvement\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.509\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.081\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.484\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6.258\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.340\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.670\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.484\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.234\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe data presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e8\u003c/span\u003e shows a relationship between the age of respondents and personal factors that affect their clinical experiences. The data suggests that as students get older, they are more likely to be negatively affected by these personal factors. The relationship is direct and proportional, with a value of 0.124. This means that even a small increase in age (1.5%) can cause a slight increase in dissatisfaction with clinical experiences (0.01), but this increase is not statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;.161). The t-value for this relationship is 1.409, with a 95% confidence interval between \u0026minus;\u0026thinsp;0.004 and 0.025.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab9\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on the relationship between respondents\u0026rsquo; age and the personal factors influencing their clinical experiences\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eModel\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eUnstandardized\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStandard Error\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eStandardized\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003et\u003c/p\u003e\n\u003c/th\u003e\n\u003cth rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e95% CI\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eLower\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eUpper\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eH₀\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e(Intercept)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.135\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.029\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e73.936\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.078\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.192\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eH₁\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e(Intercept)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.887\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.178\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e10.589\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.535\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.240\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.010\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.007\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.124\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.409\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.161\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.004\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.025\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.124\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.015\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e9\u003c/span\u003e presents data on how personal factors affect the clinical experiences of nursing students based on their age and gender. The data indicates that male nursing students are about 3 times more likely to be dissatisfied with their clinical environment compared to female nursing students (OR\u0026thinsp;=\u0026thinsp;3.27 [95% CI: 1.67\u0026ndash;4.88], p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Married nursing students are also more likely to be dissatisfied with their clinical environment than unmarried nursing students (OR=-0.89 [95% CI: -2.57-0.80], p\u0026thinsp;=\u0026thinsp;0.30). Additionally, Muslim nursing students are more likely to be dissatisfied with their clinical environment compared to Christian nursing students (OR=-0.68 [95% CI: -2.27-0.41], p\u0026thinsp;=\u0026thinsp;0.17).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab10\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eData on the relationship between respondents\u0026rsquo; age and the personal factors affecting their clinical experiences\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eDemographic features\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCI 95%\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGender\u003c/p\u003e\n\u003cp\u003e*male\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.67\u0026ndash;4.88\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarital status\u003c/p\u003e\n\u003cp\u003e*Single\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-2.57-0.80\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eReligion\u003c/p\u003e\n\u003cp\u003e*Christian\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.68\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e-2.27-0.41\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n\u003ch2\u003eChallenges Faced by Nursing Students During Their Clinical Experiences\u003c/h2\u003e\n\u003cp\u003ePersonalization emphasizes the opportunity for students to interact with preceptors and raises concerns about their well-being [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. The personal aspect of certain factors makes them critical to nursing students' desire to gain valuable clinical experience in the clinical learning environment. As a result, personalization aspects can have a significant impact on nursing students, potentially leading them to leave the nursing profession if negatively impacted. The findings of this study offer stakeholders with the basis to be proactive in ensuring students' welfare and interactions with preceptors are suitable. This is because nearly half of the nursing students reported dissatisfaction with what was done on the wards. The reason for this could be due to a lack of opportunities to perform duties on the wards. Data revealed that around one-quarter of nursing students reported that their tasks on the ward were nearly identical. Student nurses are usually tasked with performing routine duties such as ward dusting, serving bedpans, and bed making during each shift. Apart from these responsibilities, nursing students are rarely allowed to perform additional nursing tasks apart from running errands, during which they often miss observing procedures performed by staff nurses on the ward [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. In this situation, many students are unable to achieve the objectives for which they were sent to the clinical learning environment. For instance, the study revealed that some nursing students felt frustrated because they were not allowed to pursue their specific interests (performing duties based on their goals) in the ward. Moreover, almost half of the nursing students were not allowed to express their ideas on the ward but were instead expected to observe and obey without any input or concerns about the practices being followed.\u003c/p\u003e\n\u003cp\u003eWhen student nurses questioned the practices being followed by clinical nurses, they were often labeled as confrontational or rude, which created an intimidating environment for them. This intimidation stopped student nurses from bridging the gap between theoretical knowledge taught in the classroom and practical knowledge gained in the ward. Although most students did not face any issues in their clinical learning environment, almost a quarter of student nurses who faced problems due to personal concerns required treatment.\u003c/p\u003e\n\u003cp\u003eIf these student nurses leave nursing school due to these difficulties, it will have a devastating long-term impact on the nursing profession and public health. It will result in fewer nursing students graduating for employment, and with the continuous brain drain, it will only widen the nurse/patient ratio in Ghana, significantly harming public health and hindering the achievement of the Sustainable Development Goals.\u003c/p\u003e\n\u003cp\u003eLastly, student involvement in ward activities is critical for their active participation and attentiveness [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\n\u003cp\u003eInvolving student nurses in clinical practice provides experiential learning to bridge the theory-practice gap in nursing [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. It has been observed that nursing students who have little or no involvement in clinical practices face difficulties in understanding the relationship between theory and practice. Such students are likely to find the clinical learning environment uninteresting and may lack motivation to study there. Even when they attend the clinical learning setting, it is usually because they fear losing attendance marks rather than a desire to learn. The lack of motivation to attend the clinical learning environment, coupled with preceptors' disregard for their students' feelings and learning needs, can cause these student nurses to spend time in the clinical learning environment without paying attention to the clinical nurses' practice. It is concerning to note that over a quarter of nursing students feel a lack of involvement in clinical practice while in the clinical learning environment, as revealed in the data collected by Gemuhay, Kalolo, Mirisho, Chipwaza, and Nyangena [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e] and According to Kamphinda and Chilemba's [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e] study, student nurses were not able to engage actively in clinical practice due to inadequate resources in healthcare facilities. This lack of resources meant that student nurses did not have access to the necessary tools and equipment required for clinical learning experiences. Satisfaction with the clinical learning environment is measured by the extent to which students enjoy it. [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. Nursing students' dissatisfaction with the clinical learning environment can be attributed to their inability to meet their clinical placement objectives, a poor relationship with their preceptors, and insufficient learning resources in the clinical setting [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. It has been observed that nursing students' dissatisfaction with the clinical learning environment is often caused by poor relationships with their preceptors. Some preceptors tend to dismiss the students' complaints, including their difficulties in the clinical learning setting. As a result, preceptors fail to recognize bullying of students by other clinical nurses or healthcare workers, which prevents them from finding solutions to improve nursing students' satisfaction with the clinical learning environment, leading to a less effective learning experience. One key issue that could help nursing students feel more comfortable in the clinical learning environment is to consider their schedules and arrange their shifts accordingly. Some students may have to take care of themselves or their family members. If their work schedules conflict with their clinical shifts, such students may become dissatisfied with the clinical shift and choose to prioritize more lucrative work instead. Kalyani, Jamshidi, Molazem et al. [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e] identified that interactions with staff in clinical settings can be a significant stressor for students. According to Kalyani and colleagues [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e], five factors contribute to student stress in a clinical setting: academic challenges, connections with clinical personnel and nursing lecturers, clinical experiences, finances, and patient death. As a result, healthcare workers, particularly ward nurses, play a vital role in the practical instruction of nursing students in hospitals. Even though these staff members do not actively guide students, their actions may indirectly impact the nursing students' learning outcomes. They have the authority to allow students to practice nursing skills and care for their patients. Additionally, they provide equipment and give pupils detailed instructions for completing healthcare operations.\u003c/p\u003e\n\u003cp\u003eClarity and organization of ward activities refer to task orientation in the clinical learning environment. [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. Nursing students may feel confused and find it difficult to learn when nursing duties are not carried out in a logical sequence. This confusion may lead to student nurses becoming uncertain about how to perform a task when assigned to it. It can be even more confusing when nursing students are only allowed to observe and not permitted to discuss their concerns. This is because the practice being observed may be performed differently by different clinical nurses, and there may be a direct conflict between the practice being seen and the theory being taught. To bridge the gap between theory and practice in nursing, student nurses must observe all clinical nurses performing nursing tasks in an ordered and logical manner. This would enable nursing students to understand the necessary stages related to a particular activity, allowing them to accomplish the task in a structured and coherent manner. The process of bridging the theory-practice gap becomes more consolidated when student nurses are allowed to express their concerns about observed or performed tasks, and those concerns are addressed using evidence-based content. However, some nursing students have reported that they found the tasks in the ward disorganized. According to Cherkewa's [\u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e] study, poor relationships between nursing students and their preceptors can prevent students from raising concerns about practices that do not align with theoretical knowledge. The level of teaching innovation by preceptors can be determined by their ability to plan creative and productive clinical experiences, teaching methods, learning activities, and patient assignments [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. Preceptors have the potential to effectively introduce new duties to student nurses by using suitable teaching strategies. This can significantly increase productivity and students would be more engaged in attending clinical learning sessions. The clinical learning environment would then become an efficient location for learning and meeting the objectives of the clinical placement. This, in turn, would help bridge the theory-patient gap in nursing and address the nursing student attrition rate. Ultimately, this would help bridge the nurse/patient ratio and enhance public health in support of SDG goal 3.\u003c/p\u003e\n\u003cp\u003eHowever, the findings of a recent study revealed that many nursing students believed that educational innovations had a negative impact on their clinical experience in the clinical learning setting. It was discovered that while clinical teachers and staff nurses both mentor student nurses in the clinical learning environment, neither clinical teacher nor staff nurse was eager to teach student nurses. In the study of Kamphinda and Chilemba [\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e], all participants reported that clinical preceptors were too occupied to give individual attention to each student. Having too many students in a single ward can make it challenging for the instructor to monitor all the nursing students' activities. When students perform interventional procedures, such as administering injections, changing dressings, or collecting blood samples, which may pose a risk to patients, they must do so under the guidance and instruction of the instructor. However, if the instructor is too busy, then the students may be deprived of the opportunity to perform these treatments on patients. Clinical preceptors play a crucial role in Clinical Learning Environment (CLE) by appropriately distributing assignments and training nursing students on how to conduct procedures safely and effectively [\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n\u003ch2\u003eRelationship between Nursing Students\u0026rsquo; Clinical Involvement and their Satisfaction with Clinical Experiences\u003c/h2\u003e\n\u003cp\u003eThe statistics demonstrate a positive correlation between students' satisfaction and their participation in clinical learning activities. It is predicted that a 23.4% increase in students' involvement in clinical practice would result in a significant improvement in their satisfaction with the clinical learning environment. These findings offer hope to nursing educators, clinicians, and other stakeholders, as they suggest that eliminating factors that impede students' participation in clinical practices may be a direct way to enhance their satisfaction in the clinical learning environment. Some strategies include ensuring that clinical and student nurses have sufficient equipment for practicing. When equipment is scarce, it can negatively impact both clinical and student nurses' participation in clinical practices. For example, Kamphinda and Chilemba's [\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e] study observed similar outcomes, where a lack of clinical involvement by student nurses was largely attributed to insufficient equipment in the clinical learnin. Gemuhay, Kalolo, Mirisho, and other researchers [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e] discovered that the hospital where student nurses were training did not have sufficient infrastructure to support their learning. Consequently, student nurses were unable to engage in significant clinical learning activities. The hospital's inability to address these difficulties and enhance the clinical learning environment may lead to an increase in nursing student dropout rates [\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\n\u003ch2\u003eAssociation between Nursing Students\u0026rsquo; Demographic Features and Their Factors Affecting Clinical Experiences\u003c/h2\u003e\n\u003cp\u003eThere is a slight positive relationship between the age of nursing students and their dissatisfaction with clinical experiences due to personal factors. However, this association is not significant as it only accounts for a 1.5% difference. In other words, a unit increase in the age of students is expected to result in a slight increase in their dissatisfaction with clinical experience variables. Additionally, male, Muslim, and married nursing students have expressed their discontent with the clinical learning environment. As per Kalyani et al. [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e], individuals who are older, male, married, or Muslim are less likely to tolerate bullying behavior, which could explain the study's results. Many nursing studies have addressed the issue of bullying culture. Kalyani et al. [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e] observed this behavior in all individuals, including physicians, head nurses, and ward nurses. Nursing students reported being subjected to odd jobs and serving the nurses, which prevented them from performing their duties as intern nurse practitioners and participating in real clinical educational processes [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. At CLE, medical students had access to dressing rooms, restrooms, and the library while nursing students were left without access to these basic amenities [\u003cspan class=\"CitationRef\"\u003e14\u003c/span\u003e]. Another study emphasized a similar disparity when the head nurse requested that nursing students provide medical students seats whenever possible [\u003cspan class=\"CitationRef\"\u003e15\u003c/span\u003e]. This was utterly irrational and had the potential to create unfavorable opinions about the nursing profession. Nursing students may have believed that their profession was unworthy of respect and that their true purpose was solely to aid physicians or others. This was a significant challenge for nursing students who aspired to be clinical nurses. The higher risk that could emerge from such unfavorable actions in clinical education was the increasing rate of nursing students (particularly men, Muslims, and married nursing students) who wished to leave the nursing career. This might be explained as they sought a more polite learning environment. Smith, Gillespie, Brown, and Grubb also discovered that 'inadequate,' 'not respected,' and even 'be bullied' were commonly used comments. Learning situations became increasingly complex, and student nurses were no longer self-sufficient in their environment, where they should be the focal point. One of the difficulties that nursing students have throughout the CLE may be due to an unsuccessful interaction between clinical nurses, other stakeholders, and nursing students. According to Amini, Bayat, and Amini [\u003cspan class=\"CitationRef\"\u003e20\u003c/span\u003e], non-cooperation by nursing personnel is a significant barrier to clinical education.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eMale nursing students, Muslim nursing students, married nursing students, and relatively older nursing students were found to be more susceptible to dropping out of nursing school due to their inability to tolerate bullying and disrespect in the clinical environment. This, in turn, led to dissatisfaction with their clinical experience.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthical approval to conduct the study was provided by the Review Board of All Nations University.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no financial support for the study, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful for the support from friends, colleagues, and all nursing students who participated in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization, Quayson E.; Methodology, Review \u0026amp; Editing, and Manuscript, all the team members were active.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of Conflicting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no potential conflicts of interest concerning the study, authorship, and/or publication of this article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLeidl DM, Ritchie L, Moslemi N. Blended learning in undergraduate nursing education\u0026ndash;A scoping review. Nurse Education Today. 2020 Mar 1;86:104318.\u003c/li\u003e\n\u003cli\u003eKaratuna I, J\u0026ouml;nsson S, Muhonen T. Workplace bullying in the nursing profession: A cross-cultural scoping review. International journal of nursing studies. 2020 Nov 1;111:103628.\u003c/li\u003e\n\u003cli\u003eGupta P, Gupta U, Wadhwa S. Known and unknown aspects of workplace bullying: A systematic review of recent literature and future research agenda. Human Resource Development Review. 2020 Sep;19(3):263-308.\u003c/li\u003e\n\u003cli\u003eScharpf F, Kirika A, Masath FB, Mkinga G, Ssenyonga J, Nyarko-Tetteh E, Nkuba M, Karikari AK, Hecker T. Reducing physical and emotional violence by teachers using the intervention Interaction Competencies with Children\u0026ndash;for Teachers (ICC-T): study protocol of a multi-country cluster randomized controlled trial in Ghana, Tanzania, and Uganda. BMC Public Health. 2021 Dec;21:1-5.\u003c/li\u003e\n\u003cli\u003eAmoo SA, Menlah A, Garti I, Appiah EO. Bullying in the clinical setting: Lived experiences of nursing students in the Central Region of Ghana. PloS one. 2021 Sep 23;16(9):e0257620.\u003c/li\u003e\n\u003cli\u003eAustin EE, Do V, Nullwala R, Pulido DF, Hibbert PD, Braithwaite J, Arnolda G, Wiles LK, Theodorou T, Tran Y, Lystad RP. A systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims, or impaired performance. BMJ open. 2021 Aug 1;11(8):e050377.\u003c/li\u003e\n\u003cli\u003eClarke J, van der Riet P, Bowen L. Nurses and undergraduate student nurses\u0026apos; experiences in collaborative clinical placement programs in acute hospitals: An integrative literature review. 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The relationship between undergraduate nursing students\u0026rsquo; satisfaction with the clinical learning environment and their competency self-efficacy. Journal of Nursing Education and Practice. 2019;9(11):92.\u003c/li\u003e\n\u003cli\u003eAmini A, Bayat R, Amini K. Barriers to clinical education from the perspective of nursing students in Iran: an integrative review. Archiv Pharm Pract. 2020;1:73.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"All Nations University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"clinical learning environment, clinical learning experience, nursing students","lastPublishedDoi":"10.21203/rs.3.rs-4201477/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4201477/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eNursing students have a crucial role to play in healthcare services while they are in training. It is an essential step in their professional practice preparation. Unfortunately, nursing students often experience obstacles such as bullying behavior which makes some of them drop out of nursing education, regardless of their geographic location. With the increasing brain drain of nurses in Ghana, the nurse-patient ratio is likely to rise further if the phenomenon is not given attention. Therefore, it is crucial to thoroughly evaluate nursing students' bad experiences in the clinical learning environment for a remedy. Hence, the researchers aim to analyze the obstacles faced by nursing students during their clinical attachments in hospitals located in Koforidua, Ghana's Eastern Region.\u003c/p\u003e \u003cp\u003eA cross-sectional survey was conducted using a convenient sampling technique to select 130 nursing students from specific clinical learning environments. The study found that male nursing students (OR\u0026thinsp;=\u0026thinsp;3.27 [95% CI: 1.67\u0026ndash;4.88], p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), nursing students who are married (OR=-0.89 [95% CI: -2.57-0.80], p\u0026thinsp;=\u0026thinsp;0.30), and Muslim nursing students (OR=-0.68 [95% CI: -2.27-0.41], p\u0026thinsp;=\u0026thinsp;0.17) were more likely to be dissatisfied with their clinical learning environment compared to female, unmarried, and Christian nursing students, respectively.\u003c/p\u003e \u003cp\u003eMale nursing students, Muslim nursing students, married nursing students, and nursing students who were relatively old were more likely to drop out of nursing school due to their intolerance of bullying and disrespect in the clinical environment, which led to dissatisfaction with their clinical experience.\u003c/p\u003e","manuscriptTitle":"Challenges Experienced by Nursing Students in the Clinical Learning Environment: A Cross-sectional Study in Hospitals within Koforidua, Eastern Region of Ghana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-03 18:31:14","doi":"10.21203/rs.3.rs-4201477/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"38685edc-a797-4c84-bf52-1d141b292210","owner":[],"postedDate":"April 3rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":30127656,"name":"Nursing"}],"tags":[],"updatedAt":"2024-04-03T18:31:14+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-03 18:31:14","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4201477","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4201477","identity":"rs-4201477","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}