National survey of clinical placement settings across Canada for nursing and other healthcare professions--who's using what?

BACKGROUND: The types of pre-licensure clinical placements being used and by what health professions are becoming an important and pressing issue as concerns about clinical placement shortages and competition for placements increase.

OBJECTIVE: This study was designed to address a gap in the literature by quantifying the range and specific types of pre-licensure clinical placements being used by nursing and other health professions.

METHOD: This was a Canadian national online cross-sectional survey designed to create an inventory of the types of hospital, community, long-term care, and innovative settings being used for pre-licensure clinical placements by schools of nursing, licensed practical nursing, registered psychiatric nursing, midwifery, occupational therapy, physiotherapy, and medicine.

RESULTS: The response rate was 70% (113/162). There was no difference in nursing vs. other professions in the general types of placements used-hospitals (97%), community (93%), and long-term care (93%), or travel out of the academic community for placements (85%) which was primarily intra-provincial and rural. Medical and surgical inpatient units were the specific types of placements most commonly used by all respondents (93%). The significant differences included more nursing schools using inpatient maternal/child (p<0.001), mental health (p=0.006), and pediatric (p=0.006), and community public health (p<0.001), and more other healthcare professions using hospital outpatient orthopedic (p=0.002) and research placements (p=0.001). The innovative placements reported by respondents were all community-based and quite diverse (e.g., summer camps, businesses, etc.).

CONCLUSIONS: This inventory of pre-licensure clinical placements fills a gap in the literature and revealed a broad and diverse range of settings being used by nursing and other healthcare professions, especially in the community. The diversity raises questions as to whether the organization of clinical education in the past is the best way to meet the needs of tomorrow's healthcare providers, yet it also offers new possibilities for re-contextualizing pre-licensure clinical education.