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Updated: Jun 12, 2026

Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
[Assessing quality in clinical educational setting: Italian validation of the clinical learning environment and
M Tomietto1, L Saiani, M Saarikoski
1Università degli Studi di Udine, Italy. m.tomietto@uniud.it
Abstract:
The clinical learning in the wards is one of the most important moment in nursing education: Instruments assessing the quality of the clinical settings as perceived by students may inform and support the best didactic and tutorial choices. In the last 10 years, three clinical learning environment assessment tools for Bachelor Nursing students has been validated. The aim of this study was to validate in the Italian context the Clinical Learning Environment and Supervision scale (CLES) developed in Finland and considered the gold standard within the instruments available. CLES's face and content validity has been evaluated with forward and backward translation and involving a selected group of experts in the field. 117 Bachelor Nursing Students from Udine and Verona University have been enrolled in the study. 28 out of 117 students have filed the instrument twice in order to measure test-retest reliability. The internal consistency has been evaluated with Cronbach alpha. Kurtosis and skewness was measured in order to verify the answers variability distribution. The CLES Cronbach' alpha was 0.96 and the test-retest reliability was r = -0.89. The validity and reliability of the scale has been confirmed. Further research is needed to define a cut-off in order to recognize positive clinical learning environments. The CLES practical use could support in the process of the teaching hospital accreditation and in the evaluation of the effectiveness of the tutorial strategies activated in the wards.
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