[A comparison of the most used instruments to assess the quality of clinical learning environments of nursing students].

Unlabelled: . A comparison of the most used instruments to assess the quality of clinical learning environments of nursing students.

Introduction: A clinical learning environment (CLE) promotes the development of professional competences, of critical and diagnostic reasoning in future nurses, thus the continuous assessment of its quality is pivotal.

Aim: To describe and compare the most used instruments to measure the nursing students' perception of the quality of CLEs.

Methods: Six validated questionnaires were identified and compared: CLE (Clinical Learning Environment), CLEDI (Clinical Learning Environment Diagnostic Inventory), SECEE (Student Evaluation of Clinical Education Environment), CLEI (Clinical Learning Environment Inventory), CLES (Clinical Learning Environment and Supervision), CLES+T (Clinical Learning Environment and Supervision plus Teacher nurse). The following elements were described: conceptual framework, psychometric properties, dimensions explored, the more relevant constructs able to guarantee a high quality CLE: relations between students and ward staff; level of involvement of nurse coordinators; inclusion of the student in the ward team, ward climate, involvement of clinical teacher and feedback to the students.

Results: The only instrument that explores all the relevant constructs is the CLES+T. The involvement of clinical nurse teacher and nurse coordinator are the less explored dimensions. The questionnaires CLEI, CLES and CLES+T, validated in Italian and used in several learning environments share the following weaknesses: do not assess the feedback offered to the students, the students' satisfaction for the tutoring strategies and the role of different professionals in the students' learning.

Discussion: The analysis of strengths and weaknesses is the basis to start from to devise and validate a new questionnaire.