Clinical Educator Combinations and Their Impact on Second-Degree Nursing Students' Learning: A Mixed-Methods Study

This study aimed to examine how the number and combination of clinical educators influence second-degree Bachelor of Science in Nursing students' learning outcomes and clinical placement experiences.

A sequential explanatory mixed-methods design was used to integrate quantitative survey data with qualitative focus group interviews.

Between March and December 2021, 48 s-degree Bachelor of Science in Nursing students who responded to the survey after having had teaching experience with more than one clinical educator completed 93 post-placement surveys. The survey assessed the students' self-reported core competencies and satisfaction with placement courses in relation to the number and type of clinical educators encountered. In the second phase, 13 students volunteered through online registration to participate in two focus groups conducted between January and May 2022. Quantitative data were analysed using descriptive statistics and analysis of variance followed by multivariable linear regression to examine factors associated with the overall core competency score and course satisfaction. Qualitative data were analysed thematically, and the findings were integrated during interpretation.

Students supervised by both clinical instructors and preceptors reported significantly higher communication competency than those supervised by a single educator type. Course satisfaction and the combination of educator roles were key predictors of overall competency. Thematic analysis revealed three core themes: clinical educator profiles enhanced the participants' learning experiences, clinical educators' attributes influenced the participants' clinical learning, and student-to-educator ratio should be tailored to the subject and teaching load. Students described how exposure to various teaching styles deepened their clinical reasoning, improved adaptability, and fostered reflective learning.

The number and combination of clinical educators significantly influence the students' learning experiences and perceived competency by providing varied feedback, broader clinical insights, and stronger professional support.

These findings underscore the importance of educator diversity in shaping an effective clinical education for second-degree nursing students.