CLINICAL LEARNING EXPERIENCES AND THEIR INFLUENCE ON NURSING STUDENTS' COMPETENCY DEVELOPMENT AND PROFESSIONAL READINESS
Keywords:
Related Learning Experiences, Clinical Learning Environment, CLES+T, Casey-Fink, Clinical Competency, Professional Readiness, Nursing Education, PhilippinesAbstract
The transition from structured academic classrooms to high-acuity healthcare environments is a critical phase in nursing education. In the Philippines, this transition is facilitated through intensive Related Learning Experiences (RLE), where students develop clinical competencies and professional identity under supervision. Despite extensive training hours, graduate nurses face significant reality shock and anxiety during clinical placements, raising questions about how the clinical learning environment translates into clinical competence and transition readiness.
This study evaluated the structural relationships among nursing students' clinical learning experiences, their self-reported competency development, and their professional practice readiness. Specifically, the study examined whether clinical competency development mediates the relationship between the perceived quality of the clinical learning environment and student transition readiness.
A descriptive-correlational and causal-comparative research design incorporating structural equation mediation analysis was employed. A sample of 334 third- and fourth-year Bachelor of Science in Nursing (BSN) students was recruited through stratified random sampling from higher education institutions in Manila and Western Visayas, Philippines. Data were gathered using the validated Clinical Learning Environment, Supervision, and Nurse Teacher (CLES+T) scale, an adapted Clinical Competence Questionnaire, and the Casey-Fink Readiness for Practice Survey. Parametric analyses, including independent-samples t-tests, Pearson correlations, multiple linear regression, and Sobel tests, were used for data analysis.
The respondents perceived their clinical learning environments as highly supportive (), with the leadership style of ward managers scoring highest () and the role of the nurse teacher scoring lowest (). Competency development was rated high (), led by ethico-legal practice () and lagging in evidence-based research application (). Professional readiness was moderate to high (), with support and stress management identified as a critical developmental area (). The clinical learning environment significantly predicted competency development () and professional readiness (). Crucially, competency development partially mediated the relationship between the clinical learning environment and professional readiness (Sobel ), accounting for a substantial portion of the total effect. Fourth-year students demonstrated significantly higher competency () and professional readiness ( compared to third-year students. No significant differences in perceptions of the learning environment were found between those deployed in public and private hospitals ().
While positive clinical learning environments directly foster professional readiness, their impact is significantly amplified when they are structured to systematically develop core clinical competencies. The findings suggest that bridging the academic-practice gap in nursing requires an educational paradigm that optimizes the clinical instructor's role, enhances psychological safety during clinical placements, and aligns classroom instruction with high-acuity clinical realities.
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