Learning Climate as a Predictor of Nurse Clinical Competence: A Cross-Sectional Regression Analysis
Abstract
Background: Clinical competence is essential for safe, high-quality nursing care. Workplace learning conditions (learning climate) may be a key organizational lever to strengthen competence among practicing nurses.
Aim: To examine whether learning climate predicts nurses’ clinical competence in an Indonesian tertiary referral hospital.
Methods: This associative cross-sectional study was conducted at Prof. Dr. Margono Soekarjo Hospital, Central Java, Indonesia (August–December 2025). A total of 125 registered nurses from IRNA 1 and the Emergency Department participated via total sampling. Learning climate was measured using the Clinical Learning Environment and Supervision (CLES) scale, while clinical competence was assessed using a 28-item questionnaire based on Indonesia’s Regulation No. 40/2017. Linear regression tested the predictive effect of learning climate on clinical competence (p < .05).
Results: Participants’ mean age was 36.90 years (SD = 8.24) with mean work experience of 12.24 years (SD = 8.75). Mean learning climate and clinical competence scores were 113.52 (SD = 12.53) and 121.02 (SD = 10.05), respectively. Learning climate significantly predicted clinical competence (B = 0.615, p < .001), explaining substantial variance (R² = 596). Age and work experience were not significant predictors.
Conclusion: A more supportive learning climate is associated with higher nurse clinical competence. Strengthening supervision, feedback, and learning opportunities may accelerate competence development and improve care quality.
References
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Murray, R. (2018). An overview of experiential learning in nursing education. Advances in Social Sciences Research Journal, 5(1), 1–6. https://doi.org/10.14738/assrj.51.4102
Pakpahan, J. E. S., & Damanik, D. H. (2023). Hubungan peran perawat dengan tingkat kecemasan pada pasien pre operasi di RSU Sundari Medan. Jurnal Kebidanan, Keperawatan Dan Kesehatan (J-BIKES), 3(2), 1–8. https://doi.org/10.51849/j-bikes.v3i2.314
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Salifu, D., Heymans, Y., & Christmals, C. (2022). Teaching and learning of clinical competence in Ghana: Experiences of students and post-registration nurses. Healthcare, 10(3), 538. https://doi.org/10.3390/healthcare10030538
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Suliman, M., Aljezawi, M., Tawalbeh, L., Ta’an, W., Abdalrhim, A., ALBashtawy, M., & Alkhawaldeh, A. (2022). Assessing professional competencies among undergraduate nurses: An exploratory study. Nursing Education Perspectives, 44(3), E10–E14. https://doi.org/10.1097/01.nep.0000000000001074
Sutriyanti, Y., & Mulyadi, M. (2019). Analisis faktor-faktor yang mempengaruhi penerapan berpikir kritis perawat dalam melaksanakan asuhan keperawatan di rumah sakit. Jurnal Keperawatan Raflesia, 1(1), 21–32. https://doi.org/10.33088/jkr.v1i1.394
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Visiers-Jiménez, L., Suikkala, A., Salminen, L., Leino-Kilpi, H., Löyttyniemi, E., Henriques, M., & Kajander-Unkuri, S. (2021). Clinical learning environment and graduating nursing students’ competence: A multi-country cross-sectional study. Nursing & Health Sciences, 23(2), 398–410. https://doi.org/10.1111/nhs.12819
Widiyanto, R., Astuti, E. S., & Pramono, R. (2021). Literatur review: Pengaruh gaya kepemimpinan terhadap kinerja perawat. Journal of Health Research, 4(2), 147–153. https://doi.org/10.36419/avicenna.v4i2.539
William, D., Tua, M., & Mardhiyah, A. (2022). Pengaruh tingkat pendidikan dan pengalaman kerja terhadap kinerja karyawan bagian keperawatan rumah sakit umum daerah Padang Sidimpuan. Jurnal Akuntansi, Manajemen Dan Ilmu Ekonomi, 2(3), 8.
Zhang, J., Shields, L., Ma, B., Yin, Y., Wang, J., Zhang, R., & Hui, X. (2022). The clinical learning environment, supervision and future intention to work as a nurse in nursing students: A cross-sectional and descriptive study. BMC Medical Education, 22, Article 609. https://doi.org/10.1186/s12909-022-03609-y
Abuadas, M. (2022). A multisite assessment of Saudi bachelor nursing students’ perceptions of clinical competence and learning environments: A multivariate conceptual model testing. Healthcare, 10(12), 2554. https://doi.org/10.3390/healthcare10122554
Andika, R., Maulani, & Widiawati, S. (2020). Hubungan perilaku caring perawat dengan tingkat kecemasan pasien pre operasi. Jurnal Kesehatan Samodra Ilmu, 11(1), 57–66.
Argyris, C., & Schön, D. A. (1978). Organizational learning: A theory of action perspective. Addison-Wesley.
Aufar, F. N., Purwandari, R., & Kurniawan, D. E. (2021). Lingkungan belajar klinik di rumah sakit: Asesmen pada mahasiswa profesi ners. Jurnal Ilmu Keperawatan, 9(1). https://doi.org/10.21776/ub.jik.2021.009.01.6
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley.
Chen, Q., Liu, D., Zhou, C., & Tang, S. (2020). Relationship between critical thinking disposition and research competence among clinical nurses: A cross-sectional study. Journal of Clinical Nursing, 29(7–8), 1332–1340. https://doi.org/10.1111/jocn.15201
Cheng, J., Wu, Y., Huang, L., Wu, Y., & Guan, Y. (2025). Integrating Kolb’s experiential learning theory into nursing education: A four-stage intervention with case analysis, mind maps, reflective journals, and peer simulations for advanced health assessment. Frontiers in Medicine, 12, 1–9. https://doi.org/10.3389/fmed.2025.1616392
Figueiredo, L. D. F., Silva, N. C., & Prado, M. L. D. (2022). Primary care nurses’ learning styles in the light of David Kolb. Revista Brasileira de Enfermagem, 75(6), 1–7. https://doi.org/10.1590/0034-7167-2021-0986
Fuladovandi, M., Hasanvand, S., Ghazi, S., Abdi, M., & Sarlak, E. (2025). Enhancing clinical competence of nursing students through the integration of microlearning and spaced learning: An action research study. Medical Journal of the Islamic Republic of Iran. https://doi.org/10.47176/mjiri.39.42
Hasan, S. M. (2012). Hubungan antara persepsi mahasiswa terhadap lingkungan belajar klinik dengan pencapaian kompetensi praktik klinik keperawatan di Akademi Keperawatan Lawuk [Master’s thesis]. Universitas Gadjah Mada.
Hastuti, A. (2023). Faktor-faktor pelaksanaan kompetensi klinis perawat dan pelayanan keperawatan: A scoping review. Jurnal Keperawatan, 15(2).
Hoffman, C., & Willemse, J. (2024). Factors influencing nursing students’ learning in a clinical skills laboratory. Health SA Gesondheid, 29, Article 2631. https://doi.org/10.4102/hsag.v29i0.2631
Jiwanti, S., Purnamawati, D., & Widastuti, E. (2022). Faktor yang berhubungan dengan profesionalisme perawat di instalasi rawat inap rumah sakit. Jurnal Keperawatan, 14(S3), 625–632.
Kementerian Kesehatan Republik Indonesia. (2017). Peraturan Menteri Kesehatan Republik Indonesia Nomor 40 Tahun 2017 tentang Pengembangan Jenjang Karir Profesional Perawat Klinis. https://peraturan.go.id/id/permenkes-no-40-tahun-2017
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice-Hall.
Lam, C., Schubert, C., & Herron, E. (2020). Evidence-based practice competence in nursing students preparing to transition to practice. Worldviews on Evidence-Based Nursing, 17(6), 418–426. https://doi.org/10.1111/wvn.12479
Laoh, V. C. E., Kairupan, B. H. R., & Nelwan, J. E. (2022). Pengaruh kecerdasan emosional, iklim organisasi, dan kepuasan kerja terhadap kinerja perawat di Rumah Sakit Umum Hermana Lembean. Health Care: Jurnal Kesehatan, 11(2), 366–373. https://doi.org/10.36763/healthcare.v11i2.268
Ma, H., Niu, A., Li, S., & Luo, Y. (2022). Development and evaluation of competency-based curriculum for continuing professional development among military nurses: A mixed methods study. BMC Medical Education, 22, Article 846. https://doi.org/10.1186/s12909-022-03846-1
Mohamed, R., Alharbi, M., Aloufi, R., Abraham, N., Taref, N., Bauomy, E., & Almowafy, A. (2024). Perceived clinical competence and its related factors among registered nurses employed at selected outpatient clinics in Egypt. PLOS ONE, 19(12), e0314206. https://doi.org/10.1371/journal.pone.0314206
Murray, R. (2018). An overview of experiential learning in nursing education. Advances in Social Sciences Research Journal, 5(1), 1–6. https://doi.org/10.14738/assrj.51.4102
Pakpahan, J. E. S., & Damanik, D. H. (2023). Hubungan peran perawat dengan tingkat kecemasan pada pasien pre operasi di RSU Sundari Medan. Jurnal Kebidanan, Keperawatan Dan Kesehatan (J-BIKES), 3(2), 1–8. https://doi.org/10.51849/j-bikes.v3i2.314
Park, H., Lee, Y., Moser, D., & Lee, J. (2024). Relationship of high-fidelity simulation experience, clinical reasoning, and clinical competence of new nurses: A cross-sectional study. International Nursing Review, 72(1). https://doi.org/10.1111/inr.12973
Prasetyo, Y. D. (2024). Pengaruh kompetensi keselamatan pasien terhadap aktivitas keselamatan pasien dan penilaian kinerja perawat. Journal of Telenursing, 6(2), 1–10. https://doi.org/10.31539/joting.v6i2.12633
Pratiwi, E. P. L., Umar, E., & Mulyanasari, F. (2024). Hubungan usia, jenis kelamin, pendidikan, dan los dengan persepsi pasien terhadap perilaku caring perawat dalam pelayanan keperawatan di ruang rawat inap RSUD Dr. Adjidarmo. Jawara: Jurnal Ilmiah Keperawatan, 5(2), 22–33.
Pu, Y., Xie, H., Fu, L., Zhang, X., Long, T., Su, X., & Feng, X. (2025). Self-efficacy as a mediator in the relationship between clinical learning environment and core nursing competence of intern nursing students: A multicentre cross-sectional study. BMJ Open, 15(5), e094858. https://doi.org/10.1136/bmjopen-2024-094858
Putra, K., Hany, A., Vatmasari, R., Rahmawati, I., Hidayah, R., Agse, K., & Zuhri, S. (2025). Clinical learning environment: Improving cultural competence in nursing students. Journal of Education and Health Promotion, 14(1). https://doi.org/10.4103/jehp.jehp_501_24
Salifu, D., Heymans, Y., & Christmals, C. (2022). Facilitating the development of clinical competence in a low-resource setting: Perceptions and challenges of nurse educators. Nurse Media Journal of Nursing, 12(1), 42–60. https://doi.org/10.14710/nmjn.v12i1.43995
Salifu, D., Heymans, Y., & Christmals, C. (2022). Teaching and learning of clinical competence in Ghana: Experiences of students and post-registration nurses. Healthcare, 10(3), 538. https://doi.org/10.3390/healthcare10030538
Senge, P. M. (1990). The fifth discipline: The art and practice of the learning organization. Currency.
Sitwira, J., Ashipala, D., & Katjimune, V. (2025). Nursing students’ experiences of clinical competency evaluation in a pre-registration nurse education programme: A qualitative study. Curationis, 48(1). https://doi.org/10.4102/curationis.v48i1.2699
Suliman, M., Aljezawi, M., Tawalbeh, L., Ta’an, W., Abdalrhim, A., ALBashtawy, M., & Alkhawaldeh, A. (2022). Assessing professional competencies among undergraduate nurses: An exploratory study. Nursing Education Perspectives, 44(3), E10–E14. https://doi.org/10.1097/01.nep.0000000000001074
Sutriyanti, Y., & Mulyadi, M. (2019). Analisis faktor-faktor yang mempengaruhi penerapan berpikir kritis perawat dalam melaksanakan asuhan keperawatan di rumah sakit. Jurnal Keperawatan Raflesia, 1(1), 21–32. https://doi.org/10.33088/jkr.v1i1.394
Tuomikoski, A., Ruotsalainen, H., Mikkonen, K., Miettunen, J., Juvonen, S., Sivonen, P., & Kääriäinen, M. (2019). How mentoring education affects nurse mentors’ competence in mentoring students during clinical practice: A quasi-experimental study. Scandinavian Journal of Caring Sciences, 34(1), 230–238. https://doi.org/10.1111/scs.12728
Visiers-Jiménez, L., Suikkala, A., Salminen, L., Leino-Kilpi, H., Löyttyniemi, E., Henriques, M., & Kajander-Unkuri, S. (2021). Clinical learning environment and graduating nursing students’ competence: A multi-country cross-sectional study. Nursing & Health Sciences, 23(2), 398–410. https://doi.org/10.1111/nhs.12819
Widiyanto, R., Astuti, E. S., & Pramono, R. (2021). Literatur review: Pengaruh gaya kepemimpinan terhadap kinerja perawat. Journal of Health Research, 4(2), 147–153. https://doi.org/10.36419/avicenna.v4i2.539
William, D., Tua, M., & Mardhiyah, A. (2022). Pengaruh tingkat pendidikan dan pengalaman kerja terhadap kinerja karyawan bagian keperawatan rumah sakit umum daerah Padang Sidimpuan. Jurnal Akuntansi, Manajemen Dan Ilmu Ekonomi, 2(3), 8.
Zhang, J., Shields, L., Ma, B., Yin, Y., Wang, J., Zhang, R., & Hui, X. (2022). The clinical learning environment, supervision and future intention to work as a nurse in nursing students: A cross-sectional and descriptive study. BMC Medical Education, 22, Article 609. https://doi.org/10.1186/s12909-022-03609-y
Published
2026-01-30
How to Cite
MAULANA, Muhammad Gilang; MULYONO, Wastu Adi; SUMARWATI, Made.
Learning Climate as a Predictor of Nurse Clinical Competence: A Cross-Sectional Regression Analysis.
Journal of Bionursing, [S.l.], v. 8, n. 1, p. 27-35, jan. 2026.
ISSN 2685-6484.
Available at: <https://jos.unsoed.ac.id/index.php/job/article/view/19496>. Date accessed: 10 feb. 2026.
doi: https://doi.org/10.20884/1.job.2026.8.1.19496.
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