Assessing the clinical learning environment among respiratory therapy students in Saudi Arabia: a cross-sectional study

BACKGROUND: The clinical learning environment plays a critical role in shaping healthcare students' professional competence, confidence, and readiness for clinical practice. Evaluating students' perceptions of their clinical training environment can provide valuable insights for improving educational quality and clinical supervision. This study aimed to evaluate the clinical learning environment from the perspective of respiratory therapy (RT) students in Saudi Arabia. METHODS: A nationwide cross-sectional study was conducted between August 4 and December 22, 2025. Data were collected using an online survey based on the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) instrument. One-way ANOVA and independent-sample t-tests were used to examine differences in perceptions across demographic and academic characteristics. Multiple linear regression analysis was performed to identify significant predictors of students' perceptions of the CLE. RESULTS: A total of 1,000 RT students participated in the study (60.4% male; mean age 24 ± 2 years). Overall, students reported moderate perceptions of the CLE, with an overall mean score of 3.44 ± 0.98. Across domains, the highest agreement observed in leadership style and supervision items, while the lowest was observed in pedagogical atmosphere items. Age was negatively associated with CLE scores (β = -0.050, 95% CI: -0.075 to - 0.025, p < 0.001). Married students reported higher CLE scores compared with single students (β = 0.213, 95% CI: 0.067 to 0.359, p = 0.004). Regarding academic level, second-year students showed lower CLE scores compared with internship students, with the strongest effect observed in second-year students (β = -0.900, 95% CI: -1.152 to - 0.649, p < 0.001). CONCLUSION: RT students in Saudi Arabia report moderate CLE perceptions. Academic level, university sector, and clinical training site are significant factors associated with CLE scores, indicating variation in CLE experiences across educational and clinical contexts.