JKAN Journal of Korean Academy of Nursing J Korean Acad Nurs 2005-3673 2093-758X Korean Society of Nursing Science 10.4040/jkan.2018.48.1.70 jkan-48-70 Original Article Validity and Reliability of the Korean Version Scale of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale (CLES+T) KimSun-Hee1 YooSo Yeon2 KimYae Young2 Department of Nursing, Daegu Catholic University, Daegu Department of Nursing, Kyungil University, Gyeongsan, Korea Address reprint requests to : Kim, Yae Young Department of Nursing, Kyungil University, 50 Gamasil-gil, Hayang-eup, Gyeongsan 38428, Korea Tel: +82-53-600-5662 Fax: +82-53-600-5679 E-mail: yykim@kiu.kr 012018 15012018 481 7084 260920170702201808022018 Copyright © 2018 Korean Society of Nursing Science 2018 This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium. Abstract Purpose

This study was conducted to evaluate the validity and reliability of the Korean version of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES+T) that measures the clinical learning environment and the conditions associated with supervision and nurse teachers.

 Methods

The English CLES+T was translated into Korean with forward and back translation. Survey data were collected from 434 nursing students who had more than four days of clinical practice in Korean hospitals. Internal consistency reliability and construct validity using confirmatory and exploratory factor analysis were conducted. SPSS 20.0 and AMOS 22.0 programs were used for data analysis.

 Results

The exploratory factor analysis revealed seven factors for the thirty three-item scale. Confirmatory factor analysis supported good convergent and discriminant validities. The Cronbach's alpha for the overall scale was .94 and for the seven subscales ranged from .78 to .94.

 Conclusion

The findings suggest that the 33-items Korean CLES+T is an appropriate instrument to measure Korean nursing students'clinical learning environment with good validity and reliability.

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Differences in score between test-retest.

Parameter Estimates, Convergent, and Discriminant Validity of Korean CLES+T (N=217)

Factors Item no B or variance β SE Critical ratio p CR AVE
F1 0.53 .09 5.82 .014 .82 .66
1 1.00 .74 .015
2 0.99 .70 .10 9.72 .039
3 0.80 .62 .10 8.44 .011
4 0.75 .63 .09 8.30 .004
5 0.96 .67 .11 8.60 .021
6 0.73 .53 .11 6.96 .006
F2 0.58 .09 6.82 .005 .87 .82
7 1.00 .82 .026
8 0.99 .81 .08 12.63 .014
9 1.01 .81 .08 12.11 .026
F3 0.41 .07 6.09 .006 .87 .79
10 1.00 .76 .015
11 0.88 .66 .09 9.47 .019
12 1.18 .78 .11 10.48 .010
13 1.11 .81 .10 10.91 .018
F4 0.27 .06 4.30 .006 .83 .70
14 1.00 .59 .004
15 1.19 .73 .15 7.82 .012
16 1.06 .71 .15 7.19 .018
17 1.07 .70 .15 7.29 .009
F5 0.43 .07 6.28 .012 .94 .91
18 1.00 .74 .025
19 1.21 .75 .11 11.33 .004
20 1.20 .79 .10 11.88 .006
21 1.27 .83 .10 12.60 .009
22 1.26 .87 .10 13.20 .020
23 1.16 .80 .10 12.09 .016
24 1.23 .84 .10 12.66 .007
25 1.16 .83 .09 12.59 .005
F6 0.48 .06 7.59 .006 .92 .89
26 1.00 .86 .021
27 0.99 .86 .06 15.42 .013
28 1.09 .83 .08 14.62 .008
F7 0.45 .09 4.84 .006 .86 .78
30 1.00 .62 .007
31 0.96 .67 .11 8.35 .002
32 1.19 .78 .13 9.09 .006
33 1.34 .87 .14 9.84 .012
34 1.14 .80 .12 9.21 .003

CLES+T=Clinical learning environment, supervision and nurse teacher evaluation scale; SE=Standard error; CR=Construct reliability; AVE=Average variance extracted; F1=Pedagogical atmosphere; F2=Learning environment; F3=Leadership style of the ward manager; F4=Nursing care on the ward; F5=Supervisory relationship; F6=Nurse teacher’s the integration of theory and practice; F7=Nurse teacher’s relationship and cooperation.

Correlation Matrix among Factors of Korean CLES+T and among Clinical Learning Environment, Clinical Practice Stress, and Korean CLES+T (N=217)

Total CLES+T (p) F1 (p) F2 (p) F3 (p) F4 (p) F5 (p) F6 (p) F7 (p) CLE (p)
F1 .73 (<.001) .48 (.009) .46 (.012) .43 (.007) .55 (.006) .53 (.006) .47 (.005) −
F2 .67 (<.001) .41 (<.001) .51 (.016) .60 (.013) .47 (.003) .38 (.015) .33 (.016) −
F3 .67 (<.001) .40 (<.001) .46 (<.001) 　 .70 (.012) .48 (.023) .41 (.012) .32 (.012) −
F4 .70 (<.001) .40 (<.001) .52 (<.001) .54 (<.001) 　 .54 (.009) .46 (.003) .33 (.007) −
F5 .82 (<.001) .51 (<.001) .46 (<.001) .44 (<.001) .50 (<.001) 　 .42 (.003) .41 (.005) −
F6 .63 (<.001) .38 (<.001) .34 (<.001) .35 (<.001) .39 (<.001) .37 (<.001) .71 (.002) −
F7 .66 (<.001) .35 (<.001) .32 (<.001) .32 (<.001) .35 (<.001) .38 (<.001) .57 (<.001) −
CLE .69 (<.001) .51 (<.001) .54 (<.001) .49 (<.001) .49 (<.001) .62 (<.001) .29 (<.001) .36 (<.001) −
CPS −.14 (.004) −.18 (<.001) −.10 (.035) −.05 (.287) −.03 (.503) −.08 (.120) −.10 (.042) −.13 (.008) -. .08 (.082)

The upper part of the diagonal is the correlation coefficient with the error removed.

The lower part of the diagonal is Pearson’s correlation coefficient.

CLES+T=Clinical learning environment, supervision and nurse teacher evaluation scale; F1=Pedagogical atmosphere; F2=Learning environment;

F3=Leadership style of the ward manager; F4=Nursing care on the ward; F5=Supervisory relationship; F6=Nurse teacher’s the integration of theory and practice; F7=Nurse teacher’s relationship and cooperation; CLE=Clinical learning environment; CPS=Clinical practice stress.

Item Analysis and Internal Reliability of Korean CLES+T (N=434)

Subscales Item no M SD SE Skewness Kurtosis ITC Difference in ISC (%) α if item deleted Alpha (95% CI) M SD
Pedagogical 1 2.84 0.96 .05 0.00 −0.39 .70 100 .79 .83 16.44 4.32
atmosphere 2 2.51 1.02 .05 0.49 −0.32 .62 100 .80 (.81~.86)
on the ward 3 2.79 0.96 .05 0.08 −0.48 .63 100 .80
4 3.41 0.89 .04 −0.25 −0.01 .58 100 .81
5 3.00 1.04 .05 −0.03 −0.49 .61 100 .81
6 1.90 0.97 .05 0.98 0.32 .50 100 .83
Learning 7 3.38 0.93 .04 −0.30 −0.20 .75 100 .78 .86 10.33 2.43
environment 8 3.45 0.90 .04 −0.46 0.25 .75 100 .78 (.83~.88)
9 3.51 0.92 .04 −0.38 0.03 .69 100 .83
Leadership style 10 3.68 0.82 .04 −0.55 0.47 .66 100 .80 .84 14.62 2.84
of the ward 11 3.81 0.84 .04 −0.60 0.42 .62 100 .82 (.82~.86)
manager 12 3.58 0.92 .04 −0.54 0.42 .70 100 .79
13 3.57 0.85 .04 −0.34 0.26 .73 100 .78
Nursing care on 14 3.25 0.89 .04 −0.11 −0.13 .51 100 .76 .78 14.34 2.58
the ward 15 3.65 0.82 .04 −0.68 0.90 .60 100 .71 (.74~.81)
16 3.71 0.79 .04 −0.76 1.27 .64 100 .69
17 3.73 0.83 .04 −0.38 −0.05 .56 100 .73
Supervisory 18 3.43 0.89 .04 −0.44 0.27 .74 100 .94 .94 25.00 6.49
relationship 19 2.88 1.06 .05 0.11 −0.62 .77 100 .94 (.93~.95)
20 2.81 0.98 .05 0.19 −0.39 .79 100 .94
21 3.16 1.00 .05 −0.19 −0.30 .83 100 .93
22 3.26 0.94 .05 −0.34 0.03 .81 100 .93
23 3.18 0.94 .05 −0.27 −0.12 .80 100 .93
24 3.13 0.95 .05 −0.13 −0.14 .82 100 .93
25 3.17 0.92 .04 −0.19 −0.08 .80 100 .93
Nurse teacher’s 26 3.88 0.77 .04 −0.50 0.45 .75 100 .81 .87 11.54 2.11
integration 27 3.87 0.78 .04 −0.51 0.42 .75 100 .81 (.84~.89)
of theory and 28 3.79 0.83 .04 −0.51 0.24 .74 100 .82
practice
Nurse teacher’s 30 3.30 1.02 .05 −0.38 −0.33 .60 100 .85 .86 16.90 3.88
relationship 31 3.62 0.94 .04 −0.50 0.06 .65 100 .83 (.83~.88)
and 32 3.38 1.01 .05 −0.15 −0.52 .67 100 .82
cooperation 33 3.14 0.99 .05 −0.05 −0.22 .76 100 .80
34 3.46 0.91 .04 −0.43 0.38 .67 100 .82
Total items 1.90~3.88 0.77~1.06 .04~.05 −0.76~0.98 −0.62~1.27 .50~.83 100 .94 .94 109.14 17.74
(.93~.95)

CLES+T=Clinical learning environment, supervision and nurse teacher evaluation scale; M=Mean; SD=Standard deviation; SE=Standard error;

ITC=Item-total correlation; Alpha=Cronbach’s alpha coefficient; Difference in ISC(%)=Percentage of success of item discriminant validity based the differences in item-scale correlations.

Test-Retest Reliability of the CLES+T (N=98)

Subscales Test M (SD) Retest M (SD) Difference Mean (SD) ICC (95% CI) SEM SDC
F1 3.31 (0.54) 3.40 (0.56) 0.02 (0.53) .72 (.60~.80) 0.35 0.97
F2 2.74 (0.72) 3.05 (0.65) 0.10 (0.66) .72 (.61~.81) 0.43 1.20
F3 3.44 (0.81) 3.48 (0.88) 0.07 (0.72) .63 (.50~.74) 0.43 1.20
F4 3.38 (0.78) 3.54 (0.85) 0.07 (0.72) .63 (.50~.74) 0.39 1.09
F5 3.58 (0.65) 3.52 (0.73) 0.05 (0.74) .66 (.53~.76) 0.47 1.32
F6 3.12 (0.81) 3.14 (0.89) 0.14 (0.64) .49 (.32~.62) 0.40 1.11
F7 3.85 (0.70) 4.02 (0.67) 0.07 (0.72) .60 (.45~.71) 0.45 1.26
Total 3.38 (0.78) 3.54 (0.85) 0.07 (0.72) .78 (.69~.85) 0.25 0.70

CLES+T=Clinical learning environment, supervision and nurse teacher evaluation scale; M=Mean; SD=Standard deviation; ICC=Intraclass correlation coefficient; SEM=Standard error of measurement; SDC=Smallest detectable change; F1=Pedagogical atmosphere on the ward; F2=Learning environment; F3=Leadership style of the ward manager; F4=Nursing care on the ward; F5=Supervisory relationship; F6=Nurse teacher’s integration of theory and practice; F7=Nurse teacher’s relationship and cooperation.