Högskolan i Skövde

Background: The importance of the clinical learning environment in nurse education has gained increasing attention over the last decades. However, there is a lack of research on the learning environment, its significance and meaning in specialist nurse education. Objective: The objectives of the study were to investigate specialised nursing students' experiences of supervision during clinical practice and to compare students who were satisfied with the supervision with those who were dissatisfied with respect to a)organisation of supervision and number of preceptors, as well as time allocated by preceptors for b)supervision, c)reflection, d)discussion of intended learning outcomes, and e)assessments of students' performance by preceptors. Design: This study used a cross-sectional design. Sample and settings: A convenience sample of specialised nursing students was derived from five Swedish universities in the years 2016 and 2017. Methods: Data were collected using a questionnaire. Statistical analyses and a qualitative conventional content analysis were performed. Results: While almost all specialised nursing students reported that there had been time for discussion on their performance assessment, almost half of the students reported not getting time for supervision, or time for reflections and discussions on intended learning outcomes with the preceptor. Students reporting having time allocated for supervision by preceptors were found to be more satisfied with supervision. It was described as important that the preceptor(s)acknowledged the students previous work experiences. Even though being a registered nurse, reflections and feedback were described as valuable for the students learning. Several preceptors were described as positive allowing a broader picture and different views regarding working as a specialist nurse. Conclusions: This study indicates that supervision, in terms of discussions and reflections, of specialised nursing students is significant for learning experiences and satisfaction during clinical placement. © 2019 Elsevier Ltd