A national study of nursing homes as learning environments according to undergraduate nursing student’s perspective

BACKGROUND: Nursing students report care of the older people as an undesirable career pathway. Positive clinical placement experiences influence students' attitudes and career intentions with respect to nursing home (NH) setting. The clinical environment's quality depends on meaningful learning opportunities, the relationship with the preceptors, and the pedagogical atmosphere as influenced by the staff-student interactions. AIM: The aim of this study was to explore nursing students' perceptions on their clinical learning experience and competence learned in the NH setting as compared to other clinical areas. METHODS: A secondary analysis was performed of an Italian national cross-sectional study involving 9,607 nursing students attending 95 different three-year bachelor laureate nursing programmes in 27 universities. A questionnaire exploring individual and nursing programme variables was devised. Moreover, students self-reported the perceived quality of the clinical learning experience using the Clinical Learning Quality Evaluation Index tool and the degree of competence learned using a four-point Likert-type scale. RESULTS: Students in the NH setting scored the overall quality of the learning environment significantly higher (p = 0.046) compared to those experiencing other clinical settings, and they scored higher learning occasions (p = 0.002) and self-directed learning opportunities (p = 0.018). No difference emerged in the perceived mean degree of competences learned at the end of the clinical rotation (p = 0.271). CONCLUSION: Nursing students perceive the NH setting to be a good quality learning environment with valuable learning opportunities and self-directed learning opportunities compared to other settings. The nursing home setting provides opportunities to acquire clinical competences comparable to the ones in other clinical settings such as hospital units. IMPLICATIONS FOR PRACTICE: Nursing home settings should be considered by all nursing programmes as a learning environment particularly worthy for students at different levels of their education.