The limitations for this study may be related to the relatively small
sample size, and somemodifications of the demographical and descriptive
questions that the researcher has applied to the HPPSACS instrument,
in order to accommodate the students' educational and clinical
placement context. The original HPPSACS tool contained some demographical
questions that are applied specifically to the American culture
and nursing educational systems, such as the dominant ethnicities in the
US (i.e. African American, Hispanic and Native American, and (associate
degree, accelerated and tradition programme). These demographical
characteristics had to be omitted/condensed respectively from the current
tool. It is acknowledged that such modifications may have affected
theway in which the students have responded compared to the original
HPPSACS instrument. However, such descriptive questions were not
included in the factor analysis, and all other items in the HPPSACS instrument
remain identical to the original tool.