Rita C. Ramos,

University of the Philippines Open University, Philippines.

Title: Clinical Learning Environment, Learner’s Motivational and Learning Outcomes: the Philippine Nursing Education Experience


Rita Ramos is an Assistant Professor of the Faculty of Management and Development Studies in the UP Open University. She finished her Bachelor of Science in Nursing from San Juan De Dios College. She obtained her Master of Arts in Nursing from the University of the Philippines Manila. Her research interests include Item Response Theory; Classical Test Theory; tool validation; motivation in distance education; achievement goals in education; self-regulation; clinical learning environment; dignified dying; and aggression. She is taking her PhD in Educational Psychology, major in Quantitative Methods in De La Salle University Manila, currently on dissertation writing.



In nursing, we are interested with learning outcomes of student nurses because they impact on how they would perform as professional nurses. Cognitive, Psychomotor, Affective are the expected aspect to which they are honed for as a student nurse. The Clinical Learning Environment (CLE) has been shown to be most influential in shaping and directing the development of student nurses (Saarikoski & Kilpi, 2002; Tiwari et al, 2005 ;). CLE encompasses the clinical setting and placement of students studying to become professional nurses, and includes all practitioners that students are exposed to and work with, and the supervision that they receive from ward managers and classroom teachers. Additionally, learner’s characteristics reflect individual differences among student nurses in terms of motivational variables. Intrinsically motivated individuals’ engagement in learning is coupled with pleasure and enjoyment as this can bring challenge and arouse curiosity (Pintrich 1999).Several researchers done in higher education showed that a learning climate which involves respect for students, freedom to learn, and teacher enthusiasm encourages a deeper approach to learning.

CLE has been extensively used in most parts of the world. Ferguson's CLE study (2000) concluded that the diversity and complexity of clinical areas and the implications for student learning must be acknowledged. One of the most anxious times for a learner was entering a new clinical situation that they desire to ‘fit in’. And Ferguson's study discovered the importance of the “mentors” role at this time as she/he played an important role in assisting the student to ‘fit in’. And the uniqueness of nursing education in the Philippines is that the teacher in the university is mostly doing the clinical supervision in the hospital wards and other settings. This was evident in the unpublished study of Ramos & Valera (2012) where three factors, namely 1) Supervision in the hospital, 2) Academic Supervision, and 3) Nursing Care in the Ward is being done by the “clinical instructor” who is usually the teacher from the academe. Clinical learning is achieved when the student receives effective hospital and academic supervision, and sees the “teacher” as mentor and model in providing quality and safe nursing care. These enhance the student’s “intrinsic” or innate motivation.

Clinical Learning Environment mirrors external factors namely academic supervision, supervision in the hospital and nursing care in the ward. The individual factors will be taken into account which represents the individual differences of nursing students in terms of motivational level in this study. Having both Clinical Learning Environment (external) and learner’s characteristics (internal) will provide us a model of good clinical learning outcomes. Thus, this study will test a model showing the effects of Clinical Learning Environment, Learner’s Characteristics and Clinical learning outcomes using Structural Equation Modelling (SEM).

Methods Research design This study will use exploratory cross- sectional design (Johnson 2001). This will test the model where Clinical learning Environment, Learner’s Motivational Factor as it affects clinical learning outcomes.