Validity and Reliability of the Korean Version Scale of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale (CLES+T)

Sun-Hee Kim; So Yeon Yoo; Yae Young Kim

doi:10.4040/jkan.2018.48.1.70

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Kim, Yoo, and Kim: Validity and Reliability of the Korean Version Scale of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale (CLES+T)

Original Article

J Korean Acad Nurs 2018;48(1):70-84.

Published online: 15 January 2018

DOI: https://doi.org/10.4040/jkan.2018.48.1.70

Validity and Reliability of the Korean Version Scale of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale (CLES+T)

Sun-Hee Kim¹, So Yeon Yoo², Yae Young Kim^2,

¹Department of Nursing, Daegu Catholic University, Daegu

²Department 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

Received 26 September 2017 Revised 7 February 2018 Accepted 8 February 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.

Keywords: Environment, Learning, Nursing students, Preceptorship, Validity and reliability

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Figure 1.

Differences in score between test-retest.

Table 1.

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.

Table 2.

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.

Table 3.

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.

Table 4.

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.

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