Clinical learning environment and supervision plus nurse teacher (CLES+T) scale: testing the psychometric characteristics of the Italian version

G Ital Med Lav Ergon. 2012 Apr-Jun;34(2 Suppl B):B72-80.


Background: A clinical learning environment is an "interactive network of forces within the clinical setting that influence the students' learning outcomes". International research indicates the Clinical Learning Environment and Supervision plus Nurse Teacher scale (CLES+T) as the gold standard to assess a good clinical learning environment.

Aim: This study aims to evaluate the psychometric proprieties of CLES+T Italian version.

Methods: 875 students attending the Bachelor in Nursing in 3 Universities in Italy participated in the study. Cronbach's alpha, item to total correlations, skewness and kurtosis were calculated; factor analysis was performed using Principal Axis Factoring and an oblique rotation method.

Results: Results showed a Cronbach's alpha of 0.95 of the scale and ranging from 0.80 to 0.96 among factors; all items verified item to total correlation and answers' variability criteria. Factor analysis showed a 7-factors model as explaining more than 67% of the variance, the higher variance was explained by the "pedagogical atmosphere" factor (37.61%). The nurse teacher factor in the Italian model is split into 3 sub-factors: theory-practice integration, cooperation with ward staff and relationship with mentor and student.

Conclusion: These results enable an international debate concerning the theoretical structure of CLES+T and provide a reliable and valid tool for the comparison of supervisory models in guiding nursing students' clinical learning.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Algorithms
  • Education, Nursing, Baccalaureate / standards*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Italy
  • Learning*
  • Male
  • Middle Aged
  • Nursing Education Research / organization & administration
  • Nursing, Supervisory / standards*
  • Psychometrics*
  • Reproducibility of Results
  • Sampling Studies
  • Students, Nursing / psychology*
  • Surveys and Questionnaires / standards*