Student nurses' perceptions of clinical placements in Australian Prison Health Services: A mixed methods study

Abstract

Increasing demands for clinical placements have forced tertiary institutions to look for alternative placements for third year nursing students. While Prison Health Services provide an opportunity for nursing students to engage in care of offender populations with significant chronic illnesses, there has been little evaluation of such placements. Third year undergraduate nurses (18/46) participated in a mixed methods study to provide evidence-based research on students' perceptions of clinical placements in Prison Health Services. Quantitative and qualitative data were collected via an anonymous survey and individual interview. Whilst the majority of students valued the opportunity to increase their knowledge and clinical skills and felt supported by preceptors, challenges included being psychologically ill-prepared for the physical and emotional aspects of placement, and witnessing poor attitudes and behaviours of staff, which impacted on the quality of their experience. Recommendations include changes to orientation programs and introduction of simulation to help students feel better prepared and supported during placements in prison settings. Refining the selection process for placements in this setting will also help to ensure student suitability for clinical placement in Prison Health Services.

Seeing is believing: The effect of prison-based insight-days on student nurses’ perceptions of undertaking practice placements within a prison healthcare environment

“…Personal safety was students' overriding concern, this finding corresponds with the findings of other studies (Kent-Wilkinson, 2011;van de Mortel et al, 2017). Levels of violence against NHS staff are high; a third have been the subject of violent behaviour within the last year and almost every accident unit nurse reports being the victim of violence (Solheim, 2018).…”

“…Practical assessment documents can impede, rather than enhance, individual's development in placements because students strategically collect competencies and skills rather than focussing on the wider learning opportunities on offer (Hunt et al, 2016). Given that other studies have identified a range of transferable nursing skills are available in prisons (van de Mortel et al, 2017) students' concerns were an unexpected finding of this study. However, the reason may be that students had not seen clinics working and so had not witnessed the skills being practiced which, again, emphasises the impact that seeing first-hand had.…”

“…Studies conducted in Turkey (Topcu and Kazan, 2018), Australia (van de Mortel et al, 2017) and the Unite States of America (Priano, 2017) suggest that universities have a role to play in drawing students' attention to prisoners' health care needs; particularly within custodial prisons as opposed to forensic nursing settings such as secure hospitals. National Health Service (NHS) England's (2019) long term plan supports this international agenda, encouraging universities to diversify the range of placements available, including prison placements which offer unique experiences caring for marginalised groups (Brooker et al, 2018).…”

“…Evidence indicates that students feel more comfortable in prison settings when detailed prison inductions have been delivered at universities (van de Mortel et al, 2017;Bouchard and Brooks, 2017;Diaz et al, 2014). Several studies demonstrate that: enhancing students' understanding of security protocols reduces anxiety (Bouchard and Brooks, 2017); stereotypes are discarded when information about prisoners' legal and ethical rights are included in induction programmes (Brooker et al, 2018); and challenging students' prejudices enhances their responsiveness to prisoners (Gorman et al 2018).…”

Qualitative exploration of the medical learner’s journey into correctional health care at an academic medical center and its implications for medical education

“…However, our study provides an important caveat to the previously reported positive outcomes of other studies in correctional health settings (Applebaum et al 2002;Alemagno et al 2004;Weiskopf 2005;Dhawan et al 2007;Haley et al 2009;Rich et al 2012;Filek et al 2013;Diaz et al 2014;Bouchaud and Swan 2017;Simon et al 2017;van de Mortel et al 2017;Brooker et al 2018;Candamo et al 2018). Our data suggests a more cautionary approach may be required before immersing medical trainees (or their proctors) in correctional healthcare settings.…”