Implementation and evaluation of an integrated mentorship–preceptorship model in undergraduate clinical nursing education

Abstract

Background

High-quality clinical education is critical for preparing competent nursing graduates. Traditional preceptorship alone may not sufficiently address learners’ needs, while mentorship provides additional psychosocial and professional support. This study implemented and evaluated an integrated Mentorship–Preceptorship Model to enhance clinical readiness and student satisfaction among undergraduate nursing students.

Methods

A quasi-experimental one-group pre–post study was conducted with undergraduate nursing students during their clinical rotation. The model combined structured mentorship (guidance, role modeling, reflective support) with preceptorship (direct clinical supervision and skills coaching). Clinical readiness was measured before and after the intervention using a validated clinical competency assessment tool. Student satisfaction with clinical education was assessed through a standardized satisfaction questionnaire. Descriptive and inferential statistics were used to analyze outcomes.

Results

Implementation of the integrated model improved students’ clinical readiness scores compared with baseline. Participants reported higher confidence in performing clinical procedures, greater clarity in role expectations, and improved integration of theory into practice. Satisfaction scores increased across domains including instructor support, feedback quality, and overall learning experience. Students described the combined approach as more supportive and effective than previous clinical learning experiences.

Conclusion

The integrated Mentorship–Preceptorship Model enhanced clinical preparation and satisfaction among undergraduate nursing students. This structured and supportive educational approach may strengthen clinical learning outcomes and represents a feasible strategy for improving the quality of undergraduate nursing education.

Clinical trial number

Not applicable.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12912-026-05089-7.

Introduction

Clinical education constitutes the core of nursing training, shaping students’ competence, confidence, and readiness for future professional practice. The quality of clinical teaching delivered to nursing students directly influences their satisfaction with the educational experience and subsequently affects the quality of healthcare services they will provide as future practitioners [1]. Given the growing need for competent clinical nursing graduates, and the increasing dependence on clinical nurses to support educational functions refers to the role of clinical nurses in facilitating undergraduate nursing students’ clinical education within hospital-based learning environments [2].

The clinical learning environment (CLE) plays a fundamental role in nursing students’ professional development, influencing readiness for practice, professional identity formation, and career trajectories. Through authentic clinical experiences, students integrate theoretical knowledge with practical skills and develop essential competencies. However, the inherent unpredictability and variability of clinical settings may increase stress and affect learning outcomes. Therefore, a supportive and high-quality CLE is crucial for fostering competence and confidence among future nursing professionals [3].

Clinical learning environments play a crucial role in shaping students’ educational outcomes. Through engagement in real patient care, students acquire essential competencies, interpersonal communication skills, and problem-solving abilities. Preceptorship facilitates individualized learning, strengthens the integration of theory and practice, and enhances the development of clinical reasoning. Positive outcomes associated with preceptorship have been consistently reported across diverse settings [4].

Several studies have underscored the effectiveness of approaches that involve clinical staff such as clinical teaching associates or preceptors in supporting students’ learning and enhancing their clinical skills. These methods have been reported to improve students’ overall satisfaction, promote skill acquisition, and strengthen clinical competence. In alignment with this evidence, the present study investigates students’ satisfaction with clinical education delivered by clinical instructor assistants (preceptors) [5].

Given the scientific nature of nursing education, the proper preparation of clinical instructor assistants has become increasingly important in many educational systems. Nursing education typically relies on two major components theoretical and clinical instruction and the gap between these domains has remained a persistent concern Clinical instructors are portrayed as needing to be good educators, as well as excellent clinicians. However, they often lack formal education and professional development opportunities related to the role and must draw on their individual personal and professional experiences to guide their teaching to meet the demands of both the clinical and academic contexts in which they simultaneously work [6].In recent years, similar to trends in other countries, Iranian nursing programs have faced shortages of academic faculty members, resulting in increased reliance on hospital-based staff nurses to provide clinical instruction. However, variations in nurses’ preparedness and the existing gap between theoretical expectations and clinical practice pose significant challenges to the effective delivery of clinical education. Since clinical education typically follows theoretical instruction and takes place in environments vastly different from the academic setting, clinical instructor assistants must possess not only sufficient knowledge of theoretical concepts but also the competencies and readiness required for effective clinical teaching [7].

A substantial body of literature supports the significance of clinical training as a major component of nursing education, aiming to build students’ confidence, competence, autonomy, and self-efficacy. More than ten foundational models of clinical instruction have been described in the literature, with preceptorship identified as one of the most effective [8]. Bandura’s social learning theory was selected as the guiding framework due to its relevance in explaining observational learning and role modeling in clinical education, which are central to both mentorship and preceptorship processes [9].

The literature continues to report persistent gaps in essential competencies among nursing graduates, largely attributed to systemic challenges within nursing education. These include insufficient strategic leadership to guide educational transformation, curricula that are inadequately responsive to evolving healthcare needs, shortages of qualified nursing faculty, and limited teaching and learning resources, all of which constrain the training capacity of educational institutions. At a global level, nursing education remains affected by chronic underinvestment, inflexible and static curricula, inadequate interprofessional education, and weak coordination and support among key stakeholders. Collectively, these structural and organizational deficiencies hinder the preparation of a competent nursing workforce capable of meeting contemporary healthcare demands [10].

To address these challenges, many nursing education systems worldwide have adopted structured preceptorship models, relying on experienced and motivated clinical nurses who receive formal preparation for their instructional roles. Evidence indicates that the competencies gained through structured preparation programs significantly enhance the quality of clinical teaching and ultimately improve the clinical readiness of nursing students. International literature further demonstrates widespread emphasis on the systematic preparation of clinical instructors, including well-defined criteria for selection, comprehensive training programs, and clear role expectations. Although these programs vary across educational systems, their shared goal is to ensure the clinical competence and instructional preparedness of those who directly guide nursing students [11].

Despite the growing reliance on preceptors in clinical nursing education, evidence also indicates that many preceptors feel inadequately prepared for their roles, particularly regarding instructional responsibilities and student evaluation [12]. Therefore, structured preparation, continuous support, and collaboration between preceptors and academic faculty members are essential for effective clinical instruction [13]. Lack of institutional support remains one of the most significant barriers to successful preceptorship programs. Factors such as self-confidence, interest in teaching, prior clinical experience, and participation in preparation programs have been identified as key predictors of preceptors’ commitment and effectiveness [4, 14].

In Iran, the researcher’s prior experience implementing structured clinical mentorship in the nursing management course provided the foundation for extending this approach to other clinical areas. Despite the increasing use of hospital-based nurses as clinical instructors in the country, few studies have evaluated their readiness for this role or the outcomes of structured preparation programs. Therefore, there is a clear need for rigorous assessment of clinical instructor assistants’ preparedness and the impact of mentorship-based training on their instructional competence. By examining the impact of mentorship-based training on preceptors’ readiness, the present study aims to contribute evidence that may guide educational planning, program design, and policy development in nursing education. The findings may support improved selection, preparation, and ongoing support of preceptors, ultimately enhancing the quality of clinical education and ensuring safer, more effective patient care.

Methods

Study design

This study used a single-group quasi-experimental pretest–posttest design to evaluate changes in clinical preceptors’ readiness for clinical teaching following implementation of an integrated mentorship–preceptorship model. Nursing students’ satisfaction with clinical education was assessed separately following completion of their clinical placements.

Setting, participants, and sampling

The study was conducted in the clinical wards of Firoozgar, Shafa, and Hasheminejad teaching hospitals, all affiliated with Iran University of Medical Sciences. These hospitals serve as major clinical training sites for undergraduate nursing students.

The study included two distinct participant groups: 30 clinical preceptors and 94 undergraduate nursing students. Eligible preceptors were officially or informally appointed clinical instructors or experienced staff nurses who were directly involved in supervising nursing students. Eligible students were enrolled in the Bachelor of Nursing program and were undertaking medical–surgical nursing or nursing management clinical courses under the supervision of the participating preceptors. Participants with incomplete assessments or incomplete participation in the intervention were excluded from the final analysis.

Because of the limited number of eligible clinical preceptors, total population sampling was used. All eligible preceptors involved in clinical teaching at the participating hospitals were invited to participate. Nursing students supervised by the participating preceptors during the study period were also invited to complete the student satisfaction assessment. Participation was voluntary, and no academic or employment-related consequences were associated with participation or non-participation.

Data collection tools

Data were collected using structured questionnaires designed for two groups: preceptors and nursing students. The preceptors’ questionnaire comprised three sections: (1) demographic and professional characteristics, (2) 16 items assessing readiness for clinical teaching rated on a five-point Likert scale (1 = strongly disagree, 5 = strongly agree), and (3) student satisfaction assessed using a 10-item scale adapted from the Faculty Development Office. The clinical preceptor readiness questionnaire was adapted from the Clinical Preceptor Assessment Tool based on the University of Texas at Arlington framework. The instrument was modified to ensure contextual relevance to the Iranian clinical education setting while maintaining its original conceptual domains. The minimum and maximum scores were 16 and 80. The student satisfaction questionnaire was developed by the Faculty Education Development Office to evaluate students’ perceptions of clinical education quality during their clinical placements. The selected instruments were chosen due to their prior validation in nursing education research and their alignment with the constructs of clinical readiness and educational satisfaction. The preceptor readiness questionnaire used in this study was adapted from the Clinical Preceptor Assessment Tool (CPAT), originally developed by Schira et al. at the University of Texas at Arlington College of Nursing. This instrument has been widely used in nursing education research to assess clinical preceptor readiness.

The adapted version consisted of 16 items designed to evaluate key domains of preceptor readiness, including preparedness for clinical teaching, communication and feedback skills, support for student learning, mentorship and preceptorship roles, and professional competence. All items were rated on a 5-point Likert scale ranging from strongly disagree (1) to strongly agree (5), with higher scores indicating greater readiness.

Content validity of the adapted instrument was confirmed by a panel of nursing education experts. Reliability was assessed using Cronbach’s alpha, which demonstrated acceptable internal consistency.

Validity and reliability

For the student satisfaction questionnaire, content validity was reviewed by a panel of experts, and internal consistency was confirmed using Cronbach’s alpha.Content validity of the questionnaires was confirmed by ten faculty members, with final approval by two clinical education experts. Reliability was assessed using test–retest (r = 0.85) and Cronbach’s alpha (α = 0.93) for preceptors’ readiness, and Cronbach’s alpha (α = 0.92) for the clinical readiness instrument as reported by Jafar Jalal et al. The student satisfaction questionnaire was evaluated using Cronbach’s alpha on a five-point Likert scale.

Intervention procedure

Following ethical approval (IR.IUMS.REC.1398.780) and institutional permissions, preceptors were invited to participate voluntarily. Two webinars were conducted, and a comprehensive educational package on clinical teaching was provided, including guidelines, ethical codes, and practical teaching strategies. Mentorship support was maintained through WhatsApp groups and on-site supervision during students’ clinical placements. Preceptors guided one to two students each, with formative and summative assessments conducted under the supervision of clinical mentors. The intervention consisted of structured mentorship support, preceptorship training workshops, and continuous clinical guidance delivered over a defined six-month period.

The domains of the clinical readiness questionnaire were aligned with key components of the integrated mentorship–preceptorship model, including clinical teaching competence, communication skills, role clarity, and supervisory support.

Data analysis

Data were analyzed using descriptive statistics (means, standard deviations, frequency distributions) and inferential statistics (Chi-square test and Spearman’s correlation) to examine associations between variables, using SPSS software. Statistical analyses were performed using standard parametric and non-parametric tests appropriate for pre–post quasi-experimental designs. In addition to p-values, effect sizes (Cohen’s d) and 95% confidence intervals were calculated to provide a more comprehensive interpretation of the intervention effects.

Ethical considerations

This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethical approval was obtained from the Ethics Committee of Iran University of Medical Sciences (IR.IUMS.REC.1398.780). Official permissions were obtained from the Faculty of Nursing and Midwifery and the nursing offices of the participating teaching hospitals before data collection.

All clinical preceptors and undergraduate nursing students were informed about the study objectives, procedures, voluntary nature of participation, confidentiality of their information, and their right to withdraw from the study at any stage without academic or professional consequences. Written informed consent was obtained electronically from all participants before enrollment. Questionnaires were completed anonymously, access to the collected data was restricted to the research team, and the findings were reported in aggregate form.

Results

Demographic and professional characteristics of clinical preceptors

A total of 30 clinical preceptors participated in this study. Most were female (93.3%) and married (70%), with a mean age of 40.67 ± 4.61 years. Regarding work experience, 46.7% had 5–10 years, and 53.3% had 10–15 years of clinical experience. The majority of participants held a staff nurse position (36.7%), followed by senior nurse (26.7%), head nurse (20%), and supervisor (16.7%) (Table 1).

Table 1.

Demographic and Professional Characteristics of Clinical Preceptors (n = 30(

	Characteristic	Frequency (n = 30)	Percentage (%)
Gender	Male	2	6.7
	Female	28	93.3
Age	30–40 years	12	40.0
	> 40 years	18	60.0
Experience	5–10 years work experience	14	46.7
	10–15 years work experience	16	53.3
Professional Position	Staff Nurse	11	36.7
	Senior Nurse	8	26.7
	Head Nurse	6	20.0
	Supervisor	5	16.7

Educational needs and participation in preceptor-related courses

Clinical preceptors reported varied participation in preceptor-related educational courses. The majority attended patient communication courses (63.3%), followed by effective organizational communication (46.7%) and ethics and ethical codes training (46.7%). Courses with the lowest participation included clinical teaching in the ward and special units training (20% each).

clinical preceptors had participated in a range of preceptor-related educational courses prior to the intervention. The most frequently reported training topic was patient communication, attended by 19 preceptors (63.3%). This was followed by effective organizational communication and ethics and ethical codes, each reported by 14 participants (46.7%). Training related to the patient education process was reported by 13 preceptors (43.3%), while legal aspects and documentation and advanced cardiopulmonary resuscitation (CPR) were each attended by 12 participants (40.0%). Courses focusing on clinical evaluation were reported by 10 preceptors (33.3%). Less frequently attended topics included care plan development (23.3%) and clinical teaching in the ward as well as special units training, each reported by 6 participants (20.0%). Overall, the findings indicate variability in preceptors’ prior educational exposure, with higher participation in communication-related topics and comparatively lower participation in structured clinical teaching and specialized clinical training (Table 2).

Table 2.

Educational needs and participation in preceptor-related courses (n = 30)

Educational Need	Frequency	Percentage (%)
Critical Thinking	3	10.0
Clinical Preceptor Duties	12	40.0
Clinical Teaching Methods	6	20.0
Clinical Evaluation and Student Scoring	3	10.0
Teaching Students Through Practice	1	3.3
Assessing Students’ Educational Needs	3	10.0
Retraining Preceptors and Practical Nursing Content	2	6.7
Training Topic	Frequency	Percentage (%)
Clinical Teaching in the Ward	6	20.0
Patient Communication	19	63.3
Effective Organizational Communication	14	46.7
Legal Aspects and Documentation	12	40.0
Clinical Evaluation	10	33.3
Ethics and Ethical Codes	14	46.7
Care Plan Development	7	23.3
Patient Education Process	13	43.3
Special Units Training	6	20.0
Advanced Cardiopulmonary Resuscitation	12	40.0

Preceptors’ readiness for clinical teaching

The mean preceptor readiness score before the intervention was 52.80 ± 16.82. After the blended preceptorship intervention, the mean score increased to 60.36 ± 14.34, indicating a statistically significant improvement in readiness for clinical teaching (p < 0.05, Table 3).

Table 3.

Preceptors’ readiness for clinical teaching before and after the intervention (n = 30)

Time Point	Mean Score	SD
Pre-Intervention	52.80	16.82
Post-Intervention	60.36	14.34

Nursing students’ demographic characteristics

A total of 94 nursing students participated in the study. Most were female (58.5%) and single (90%). The mean age was 23.34 ± 1.03 years. 66% reported interest in nursing as a profession. Other demographic characteristics, including residence, family size, and parental education, are summarized in (Table 4).

Table 4.

Nursing students’ demographic characteristics (n = 94)

Characteristic	Frequency (n)	Percentage (%)
Female	55	58.5
Male	39	41.5
Single	85	90.0
Married	9	10.0
Interested in Nursing	62	66.0
Not Interested in Nursing	32	34.0

Nursing students’ satisfaction with clinical education

The mean satisfaction score among nursing students was 82.36 ± 21.88, ranging from 22 to 110. Student satisfaction was positively correlated with age and interest in the nursing profession (p < 0.05). Students who lived locally reported higher satisfaction compared to non-local students (p = 0.002). The findings indicate that preceptor support and effective clinical teaching significantly influence students’ satisfaction with their clinical education (Table 5).

Table 5.

Nursing students’ satisfaction with clinical education (n = 94)

Variable	Mean Score	SD
Overall Satisfaction	82.36	21.88

Discussion

This study evaluated an integrated mentorship–preceptorship model by examining changes in clinical preceptors’ readiness for teaching and nursing students’ satisfaction with clinical education. The principal finding was an increase in the mean preceptor readiness score from 52.80 ± 16.82 before the intervention to 60.36 ± 14.34 after the intervention. This represents an absolute increase of 7.56 points. The findings suggest that structured preparation combined with continuing mentorship may strengthen preceptors’ perceived readiness to undertake clinical teaching responsibilities. However, because the study used a single-group design, the observed improvement should not be interpreted as definitive evidence of causality.

The improvement in readiness may be explained by the combination of formal educational preparation and continuing mentorship. Clinical expertise alone does not necessarily prepare nurses to teach students, communicate learning objectives, provide constructive feedback, assess clinical performance, or balance educational responsibilities with patient care. The preparatory webinars and educational materials may have improved participants’ understanding of their instructional responsibilities, while continuing virtual and on-site mentorship may have reduced role ambiguity and provided opportunities to address teaching challenges during actual clinical placements.

These findings are consistent with previous studies indicating that structured preceptor-development programs can improve teaching confidence, clinical teaching behavior, and preparedness for student supervision [12, 15, 18]. Previous research has also shown that inadequate preparation may limit preceptors’ ability to provide consistent instruction and assessment, particularly when their educational role is added to an existing clinical workload [13, 14]. The present findings therefore support the view that preceptor preparation should extend beyond a single introductory session and should include continuing guidance and opportunities for consultation.

Bandura’s social learning theory provides a useful framework for interpreting the observed improvement. Within the integrated model, experienced mentors served as professional role models from whom preceptors could observe teaching behaviors, communication approaches, feedback practices, and strategies for student assessment. Preceptors then had opportunities to apply these behaviors during direct supervision of nursing students. Observation, guided practice, feedback, and successful teaching experiences may have strengthened their perceived self-efficacy and readiness for clinical teaching.

The findings are also relevant to the persistent theory–practice gap in nursing education. Clinical nurses are often expected to support student learning because of their clinical expertise; however, inconsistent preparation can result in variation in teaching practices and expectations. A structured mentorship–preceptorship model may help clarify educational roles and create a more consistent link between academic learning objectives and clinical activities. This interpretation is consistent with literature emphasizing the importance of prepared clinical educators in facilitating integration of theoretical knowledge with clinical nursing practice [7, 19].

Nursing students reported a mean satisfaction score of 82.36 ± 21.88 following their clinical placements. This result reflects students’ perceptions of the clinical education provided during the study period. Supportive preceptors may contribute to positive student experiences by clarifying expectations, providing timely feedback, facilitating learning opportunities, and creating an environment in which students feel able to ask questions. Previous studies have associated structured preceptorship with favorable learning experiences, increased self-efficacy, and improved perceptions of clinical education [5, 16].

Nevertheless, student satisfaction was assessed only after implementation of the model. Therefore, the present study cannot determine whether satisfaction increased compared with baseline or whether the observed satisfaction was directly caused by the intervention. The result should be interpreted as a post-intervention assessment rather than a pretest–posttest outcome. Future controlled studies should assess student satisfaction both before and after implementation and should compare the integrated model with standard clinical education.

Student satisfaction was associated with age, interest in the nursing profession, and place of residence. Greater interest in nursing may be associated with stronger intrinsic motivation and greater engagement in clinical learning. Older students may also differ in confidence, coping ability, or previous clinical experience. Differences according to place of residence may reflect contextual factors such as travel demands, access to support, or adaptation to the clinical environment. These explanations remain tentative because the mechanisms underlying these associations were not directly assessed.

The findings also highlight the importance of collaboration between academic and clinical settings. Effective preceptorship requires clear communication among preceptors, academic faculty members, ward nurses, supervisors, and nursing administrators. Communication training may support interactions with students, patients, and healthcare team members [20], while collaborative clinical environments can promote shared responsibility for student learning [21]. Formal recognition of the preceptor role, adequate time for student supervision, workload adjustment, and continuing access to academic support may strengthen the sustainability of the model.

This study has several strengths. The intervention was implemented within routine clinical education in three teaching hospitals, included both clinical preceptors and undergraduate nursing students, and combined initial educational preparation with continuing mentorship over a six-month period. This structure allowed preceptors to receive support while applying teaching strategies in actual clinical environments.

Several limitations should be considered. First, the absence of a control group limits causal interpretation of the improvement in readiness. Changes may partly reflect repeated testing, maturation, concurrent organizational changes, or other unmeasured influences. Second, the relatively small sample of preceptors and recruitment from hospitals affiliated with one university limit the generalizability of the findings. Third, readiness was assessed through self-report and may have been affected by response or social desirability bias.

Fourth, student satisfaction was measured only after the intervention, preventing assessment of change over time. Fifth, students were supervised by different preceptors and were distributed across three hospitals, but the possible clustering of students within preceptors and clinical settings was not considered in the analysis. Finally, the absence of objective measures of teaching behavior, student clinical competence, or long-term follow-up limits conclusions regarding the educational effectiveness and sustainability of the intervention.

Future studies should use controlled or cluster-randomized designs, larger multisite samples, and longitudinal follow-up. Evaluations should incorporate direct observation of preceptor teaching behavior, assessment of feedback quality, student clinical competence, psychological safety, and other objective educational outcomes. Mixed-methods studies may also clarify which components of mentorship and preceptorship are most beneficial to preceptors and nursing students.

Conclusion

The integrated mentorship–preceptorship model was associated with improved self-reported readiness for clinical teaching among participating preceptors. Nursing students also reported their level of satisfaction with the clinical education provided during the intervention period. However, the study design does not permit conclusions regarding changes in student satisfaction or a definitive causal effect of the intervention.

The findings provide preliminary support for combining structured preceptor preparation with continuing mentorship. More rigorous controlled studies using objective educational outcomes and long-term follow-up are needed to determine the effectiveness, sustainability, and broader applicability of the model.

Interpretation of preceptors’ readiness findings

The significant increase in preceptors’ readiness scores following the intervention suggests that structured educational support, combined with mentorship and ongoing guidance, can meaningfully enhance preceptors’ preparedness for their teaching role. Readiness in this context reflects not only clinical competence but also confidence, educational skills, communication ability, and role clarity. These findings are consistent with prior research indicating that preceptors who receive formal preparation and continuous support demonstrate higher self-efficacy and effectiveness in clinical teaching [15].

The observed improvement may be attributed to several components of the intervention, including educational webinars, access to structured instructional materials, and continuous mentorship support. These elements likely helped reduce role ambiguity and addressed the theory–practice gap commonly reported in clinical nursing education. Previous studies have emphasized that inadequate preparation of preceptors is a major barrier to effective clinical learning, often resulting in stress, reduced motivation, and inconsistent teaching practices [16]. The current findings suggest that a blended mentorship–preceptorship approach can mitigate these challenges by providing both educational structure and emotional support.

Furthermore, communication-focused training emerged as a particularly influential factor in preceptor readiness. Effective communication with patients, students, and healthcare team members facilitates clinical teaching, supports patient-centered care, and enhances learning opportunities in complex clinical environments [17]. Improved communication skills may also contribute to better collaboration within clinical teams, which was identified as an important source of support for preceptors in this study.

Collaboration and organizational support in clinical education

An important finding of this study was the role of collaboration and support from ward nurses and supervisors in facilitating preceptors’ educational role. Participants identified colleagues and ward managers as primary sources of support, highlighting the importance of a supportive clinical learning environment. Interprofessional and intraprofessional collaboration has been widely recognized as a key factor in ensuring safe, effective, and high-quality patient care, as well as successful clinical education [18].

However, relatively limited support was perceived from formal educational and nursing administrative offices. This finding underscores the need for stronger institutional engagement in clinical education and clearer integration between academic and clinical systems. Organizational recognition of the preceptor role, workload adjustment, and formal incentives may further enhance preceptors’ motivation and sustained engagement in teaching activities.

Nursing students’ satisfaction with clinical education

The high level of student satisfaction observed in this study indicates that the integrated mentorship–preceptorship model positively influenced students’ clinical learning experiences. Satisfaction was significantly associated with student age, place of residence, and interest in the nursing profession, suggesting that both personal and contextual factors shape students’ perceptions of clinical education.

Students who expressed greater interest in nursing reported higher satisfaction, which aligns with previous research demonstrating that intrinsic motivation enhances engagement, learning outcomes, and professional identity formation [19]. Moreover, older students may possess greater emotional maturity and coping skills, enabling them to benefit more fully from clinical learning opportunities.

The presence of prepared and supported preceptors likely contributed to students’ satisfaction by reducing anxiety, improving feedback quality, and fostering a sense of psychological safety in the clinical environment. Prior studies have shown that supportive preceptorship enhances students’ confidence, critical thinking, and clinical decision-making abilities [5, 20].

Educational and clinical implications

The findings of this study have important implications for nursing education and clinical practice. Integrating mentorship with preceptorship provides a comprehensive framework that supports both educators and learners, promotes consistency in clinical teaching, and strengthens the link between theory and practice. Nursing faculties and healthcare organizations should consider implementing structured preceptor preparation programs that include mentorship, ongoing evaluation, and institutional support.

Additionally, allocating protected time for preceptors, recognizing their educational contributions, and fostering collaborative clinical cultures may enhance the sustainability and effectiveness of such programs. From a broader perspective, improving the quality of clinical education contributes to the development of competent, confident, and professional nurses, ultimately impacting patient safety and quality of care.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

CLE

Clinical Learning Environment

Author contributions

Ezzat Jafarjalal and Maryam Kashani contributed to the conception and design of the study.Data collection was performed by Alice Khachian and Daryadokht Masror.Data analysis and interpretation were conducted by Shima Haghani.The first draft of the manuscript was written by Maryam Kashani.All authors reviewed, commented on, and approved the final version of the manuscript.

Funding

This study was funded by Iran University of Medical Sciences.

Data availability

The datasets generated and analysed during the current study are not publicly available due to institutional and ethical restrictions but are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

This study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Ethical approval was obtained from the Ethics Committee of Iran University of Medical Sciences (IR.IUMS.REC.1398.780). Official permissions were obtained from the Faculty of Nursing and Midwifery and the nursing offices of the participating teaching hospitals before data collection. All clinical preceptors and undergraduate nursing students were informed about the study objectives, procedures, voluntary nature of participation, confidentiality of their information, and their right to withdraw from the study at any stage without academic or professional consequences. Written informed consent was obtained electronically from all participants before enrollment. Questionnaires were completed anonymously, access to the collected data was restricted to the research team, and the findings were reported in aggregate form.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.