Abstract Nursing is considered a profession with reliable knowledge and practical skills. Nursing education is a combination of two complementary parts: a theoretical part and clinical practice.Clinical practice provides up to half of the educational experience for students undertaking registration nurse education programs. Clinical learning objectives are affected by a large number of factors, including individual attitudes, experience and characteristics, psychomotor skills, problem-solving ability and knowledge of the student, physical structure of the environment, educational content, and methodology. All these factors occur within a complex and dynamic learning environment known as the clinical environment. Recently, a great deal of attention has been given to the clinical learning environment to emphasize the importance of multi-dimensional placement for students’ learning.The aims of this study are: to investigate the Clinical learning environment, supervision, and nurse teacher (CLES+T) scale in 10 countries all around the world; to describe the process of translation, cultural adaptation and to validatethe CLES+T questionnaire in Persian language. Methods: in general The Clinical Learning Environment and Supervision, Nurse Teacher (CLES+T) Evaluation Scale was used in this study. CLES+T consist of 34 items defined in 5 dimensions that were identified in the psychometric testing: pedagogical atmosphere (9 items) supervisory relationship (8 items), premises of nursing in the ward (4 items), leadership style of the ward (4 items) and the role of nurse teachers (9 items). Each CLES+T items evaluates on five-Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Results: The review study includes 7 cross-sectional studies, five studies were carried out in Europe and two studies were in Asia, it was carried out by systematic review and meta-analysis (PRISMA).The other objective consists of a cross sectional study carried out in 2018-2019in four universities in Iran, descriptive statistics such as demographic and characteristics of data showed by excel, The reliability of the instrument was estimated with Cronbach’s alpha coefficient that examine the internal consistency of the Persian version of the instrument and each sub-dimension.The construct validity of CLES+T scale was assessed by Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA).In overallthe actions, which were used in this confirmation of validity and reliability, were: (1) The evaluations of results of pilot study.(2) The use of an expert panel.(3) Test-retest with a small sample.(4) Content validity, face validity, concurrent validity, construct validity and internal consistency reliability were measured and confirmed.There are no significant differences in the mean value related to different topographical territories and different educational system.The result of this study indicate that the Persian version of the CLES+T instrument showed acceptable psychometric properties for evaluating student nurses clinical placement the adapted CLES+T scale when used among nursing student in Iran, was understandable, useful, and had high internal consistency and reliability so the CLES+T can be considered to be promising tool for the evaluation the learning environment for nursing student. Discussion:TheCLES+Tis a valuabletool to evaluatepractical part of nursing studies and to identifykey factors in clinical learning environmentof student nurses in differentcountries from distinct geographical areas. The most important factors of the Iranian version of CLES+T are the role of nurse teacher and the pedagogical aspects.
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