An integrative review of supportive clinical learning environment strategies for undergraduate students in health sciences
Orton, Annelie Magrietha
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The clinical learning environment is essential for the development of healthcare students’ clinical training, clinical competence and professional identity. A supportive clinical learning environment is needed to provide the opportunity for students to integrate their theoretical knowledge with the clinical practice. The aim of the study was to critically synthesise the best available evidence describing strategies for a supportive clinical learning environment for undergraduate students in health sciences. An integrative review was chosen as research method, as studies with various methodologies can be incorporated in an integrative review. The researcher followed the five stages as stated by Whittemore and Knafl (2005:548552), namely problem identification, literature search, data evaluation, data analysis and presentation. The PICO-format (Population, Intervention, Comparative intervention and Outcome) was used to compile the review question, which again led the integrative review. EBSCOHost served as a platform to search for electronic data in 13 databases. Google Scholar was also used as a database to allow for the identification of relevant grey literature. The electronic database search strategy identified 500 potential studies, and after the filtering process, 11 studies were identified for critical evaluation. A critical evaluation was conducted in the form of a round table consensus by the researcher, the supervisor, the co-supervisor and a senior reviewer with experience in conducting integrative reviews. During the critical evaluation, 10 studies were selected for analysis. The selected studies were heterogenous and so a meta-analysis was not feasible. The results of the thematic analysis culminated in a conceptual framework of a supportive clinical learning environment. Three concluding statements, as stated below, summarise the findings of the study: 1) A variety/network of student supporters, who have been carefully selected, may be allocated specific clinical responsibilities while supporting the undergraduate student in the clinical learning environment. 2) The relationship between the student, the student supporter and the clinical staff is crucial to create a sense of belonging, self-efficacy and selfdirectedness. The relationship depends on the roster and ratio of students per student supporter, as well as appropriate learning opportunities. 3) Higher education institutions and healthcare providers (such as healthcare facilities) should support students through formal collaboration/partnerships, with student supporters employed by the institutions, and these institutions should support the student supporters in various ways. A few recommendations made by the researcher include: 1) Higher education institutions and healthcare providers should attempt to forge beneficial relationships in order to support the students. 2) Higher education institutions should support student supporters in the clinical learning environment with adequate and timely information regarding student placement, the students’ level of competence and the students’ outcomes, and also with training and support regarding student problems. 3) Healthcare providers should assist the higher education institutions by providing placement, opportunities for students to learn, and by supporting the students in clinical learning. 4) Student supporters should have certain qualities that enhance clinical teaching and student supporters should be willing to spend time with students. The comprehensive synthesis of the best available evidence has led to new insights regarding creating and maintaining supportive clinical learning environment strategies for undergraduate students in health sciences. These strategies may be implemented in innovative ways to provide the students with the best clinical learning opportunities.