The Role of the Clinical Learning Environment in Shaping Nursing Students’ Clinical Self-Efficacy

Abstract

Introduction. A supportive Clinical Learning Environment (CLE) is essential for developing self-efficacy in clinical practice. This study aimed to examine how specific characteristics of the CLE influence nursing students’ development of clinical self-efficacy.

Methods. A multicenter cross-sectional study was conducted in October 2024 among third-year nursing students at the end of their final clinical placements. Participants completed an online survey including the Nursing Student Self-Efficacy in Clinical Skills Scale (NSSE-CS) and the Clinical Learning Quality Evaluation Index (CLEQI).

Results. Participants were 387 nursing students from five Italian universities. Self-efficacy across all clinical skill domains was significantly correlated with the five CLE dimensions  (r>.20, p<.001). A more supportive CLE was associated with higher placement satisfaction, greater self-efficacy, and successful completion of the placement examination. Students supervised by a nurse guide reported a more supportive CLE (r>.18, p<.001), higher satisfaction (r=.23, p<.001), and greater self-efficacy in Fundamental Care, Assessment, and Low-Complexity Care (r>.10, p<.05).

Discussion. A supportive CLE can foster students’ self-efficacy, satisfaction, and academic success. Supervision by a nurse guide further enhances perceived CLE quality and confidence in core clinical skills. Strengthening mentorship and CLE  may promote students’ professional development and readiness for practice.