An integrative literature review of pre-registration nursing students' attitudes and perceptions towards primary healthcare

Abstract

Background: There is a renewed focus on the role of primary healthcare within the health system due to an ageing population, increasing cost of acute healthcare services, and an emphasis on developing healthier communities. Associated with this focus is the need for an increase in primary healthcare workforce capacity. Despite this, primary healthcare is rarely prioritised within the pre-registration nursing curricula. By understanding the perspectives and experiences of student nurses regarding clinical placement in primary healthcare, educators and industry will be better informed to support the student nurse within this setting. Aim: The aim of this integrative literature review was to identify the established knowledge regarding the attitudes, perceptions and experiences of student nurses attending clinical placement within primary healthcare. Methods: A search of electronic databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Pubmed, Proquest, Informit, Scopus, Clinical Key and Google Scholar was undertaken. The review included papers over a 10 year period; January 2007 to December 2017. Quality evaluation was undertaken using a Mixed Methods Appraisal Tool and the selected papers were then analysed thematically. Findings: Analysis identified two interrelated themes. The first theme primary healthcare clinical experience is comprised of three sub themes; learning on placement, context of care, and support on placement. This theme discusses students understanding of primary healthcare practice and learning. The second theme attitudes towards primary healthcare also comprises three sub themes including focus on acute care, usefulness of placement, and autonomy in practice. This theme highlights the varied perspectives and attitudes pre-registration student nurses hold towards nursing within primary healthcare and their clinical placement experience. Conclusion: Student nurses are reported to have both positive and negative attitudes towards primary healthcare nursing. Despite this, clinical placement within primary healthcare is generally well received by the student nurse. To support student nurses in their learning within primary healthcare, it is essential to offer both theoretical content and clinical experiences which address preconceptions and attitudes towards the setting.