Predictors of nursing students’ satisfaction with the clinical learning environment in Kosovo: A multivariate analysis using the Clinical Learning Environment, Supervision and Nurse Teacher framework

Abstract

Background A supportive clinical learning environment is essential in nursing education; however, evidence regarding predictors of student satisfaction in Southeast European higher education contexts remains limited. Objective To identify demographic and item-level CLES+T predictors of nursing students’ overall satisfaction with the clinical learning environment in Kosovo. Methods A cross-sectional study was conducted between April and May 2025 among 300 undergraduate nursing students. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) scale, while overall student satisfaction was assessed using a separate single-item measure. Data were analyzed using descriptive statistics, non-parametric tests, and multiple linear regression analyses. The primary demographic model included sex, year of study, and economic status, while a second model included all 34 CLES+T items simultaneously. Results The demographic model was statistically significant, F(4, 295) = 35.894, p < 0.001, explaining 32.7% of the variance in satisfaction (R2 = 0.327; adjusted R2 = 0.318). Compared with first-year students, second- and third-year students reported significantly lower satisfaction, while sex and Economic Status were not significant predictors. The CLES+T item-level model was statistically significant, F(34, 265) = 18.319, p < 0.001, explaining 70.2% of the variance (R2 = 0.702; adjusted R2 = 0.663). The strongest positive predictors were positive joint meetings with the mentor and nurse teacher (β = 0.415), feeling comfortable going to the ward at the start of the shift (β = 0.335), and sufficient meaningful learning situations (β = 0.249). Because several item-level predictors showed elevated multicollinearity, individual coefficients, particularly negative coefficients, should be interpreted cautiously. Conclusion Nursing students’ satisfaction was associated with both academic year and specific relational, supervisory, and pedagogical characteristics of the clinical learning environment. Supportive mentorship, meaningful learning opportunities, and effective integration of theory and practice remain important components of positive clinical learning experiences.