What exposure do student nurses have to Primary Health Care and community nursing during the New Zealand undergraduate Bachelor of Nursing programme?

A research project to examine the theoretical and practical exposure student nurses have to Primary Health Care (PHC) and community nursing in their undergraduate programme was undertaken in New Zealand (NZ). Providing quality clinical placements for health care students is acknowledged as a major challenge for tertiary institutions. In order to reflect the current shift in health care delivery from hospital to community settings, one such challenge is to ensure students receive appropriate theoretical programme content and clinical experience in PHC and community settings. The project consisted of a review of relevant international literature, and a questionnaire sent to all NZ tertiary institutions providing a Bachelor of Nursing (BN). Findings included a variable understanding of the concept of PHC, a lack of appropriate PHC placements across the country, competition for student placements in PHC, and professional organisation requirements for student supervision impacting on placement availability. Innovations identified to increase PHC placements comprised the establishment of Dedicated Education Units (DEUs), curriculum revision, and final year PHC placements offered only to students targeting PHC settings on registration. Study recommendations involve establishing a regional rather than a local approach to managing clinical placements, increasing professional governance support and reviewing clinical placement funding.

Clinical practice placements in the community: a survey to determine if they reflect the shift in healthcare delivery from secondary to primary care settings.

With the worldwide strategic shift of health care delivery from secondary to primary care settings, more newly qualified nurses are working in primary care, making exposure to the variety of roles available to nurses essential for future workforce development. The aim of this small research project was to explore whether English universities' programmes are providing clinical practice placement experiences which reflect the breadth and complexity of nursing roles available in primary care. A survey of academic staff highlighted that universities designed curricula based on local placement and mentor availability and while a variety of primary care teams are being used, district nursing teams continue to be used the most, particularly for substantive placements. The need for specified staff to work across university and placement settings was deemed essential for identifying and supporting community based clinical placements. Recommendations from the project include: an increasingly collaborative approach amongst clinical, academic and managerial staff to create a learning culture for all health professional students' practice experience; robust strategic systems to ensure clinical placements are offered by services on the periphery of a national health service; and focussing of resources on students with a desire to pursue a primary care career.