Psychometric properties of Clinical Learning Environment Inventory and its association with Moroccan nursing students’ satisfaction: A PLS-SEM approach

Background: The Clinical Learning Environment (CLE) is integral to pre-registration nursing
curricula. Assessing the student’s perceptions of their CLE is essential to adjust clinical
placement to trainees’ needs. Clinical Learning Environment Inventory (CLEI) appears to be
widely used in measuring CLE, but no previous study has reported a full structural validity and
its association with students’ satisfaction in the Moroccan context.
Objectives: This study investigated the psychometric properties of the CLEI and its subscales
association with Moroccan nursing students’ satisfaction.
Methods: The research design was descriptive, cross-sectional, and conducted from March
and June 2022 using convenience sampling in three nursing institutes of the Fez-Meknes
region of Morocco. The selected sample involved Moroccan nursing students undertaking
clinical practice. First, exploratory factor analysis (EFA) was used to determine the factor
structure of the pilot sample (N = 143). The second sample (N = 206) was then used to confirm
this structure using partial least squares structural equation modeling (PLS-SEM) confirmatory
composite analysis (CCA). Finally, using a bootstrapping method, the significance of the
structural path was evaluated.
Results: The CLEI scale depicted convergent validity (AVE = 0.56 - 0.71), discriminant validity,
estimated by the square roots of AVE and bootstrapped HTMT confidence interval, and
significant reliability (rhoC = 0.83 - 0.92). Using a bootstrapping approach, structural path
significance displayed a substantial association between task orientation and students’
satisfaction ( = 0.29, p <0.001). This ascertains that nurse students need well-planned
guidelines from their facilitators in clinical wards.
Conclusions: The CLEI instrument revealed adequate psychometric properties and
supported its original structure. As a result, the instrument might be used to measure students’
perceptions of their CLE. Task orientation appeared to be the most important factor influencing
the students’ satisfaction in CLE.