Exploring nursing students’ perceptions of the clinical learning environment: a sequential mixed-methods study at two Moroccan institutes

BACKGROUND: Clinical experiential learning is a vital component of nursing education, ensuring that students integrate theoretical knowledge into practice and professional development. Evaluating clinical placements is essential to ensure effective learning. This study aims to evaluate nursing students' perceptions of the clinical learning environment and identify factors associated with students' satisfaction at two public nursing institutes. METHODS: This study used an explanatory sequential mixed-method design in which A cross-sectional research used the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale among 486 students, followed by a qualitative phase using semi-structured interviews with 26 students. Qualitative and quantitative findings were integrated using a joint display. RESULTS: Students were generally dissatisfied with their placements, with a low overall CLES + T score (2.51 ± 0.32). Subscale scores ranged from 2.38 ± 0.63 for the ward manager's leadership style to 2.62 ± 0.56 for the role of clinical nurse teacher. Students reported being more satisfied with their experiences in hospital settings than in primary healthcare centers (p < 0.001). The qualitative results support and provide in-depth explanations for the CLES + T domains. The unsuitable learning environment, the theory-practice gap, combined with supervision shortcomings and the ineffective role of the nurse teacher, represent the most recurrent challenges faced by students during internships. CONCLUSIONS: Students at both institutes rated their clinical placements as below average. Despite various reforms implemented to promote clinical training at the national level, several structural, organizational, and supervisory shortcomings persist at the institutes studied. It is recommended to enhance the role of clinical nurse instructors and strengthen partnerships between institutions and clinical settings.