Status of knowledge on student-learning environments in nursing homes: A mixed-method systematic review.

AIM AND OBJECTIVE: To give an overview of empirical studies investigating nursing homes as a learning environment during nursing students' clinical practice.

BACKGROUND: A supportive clinical learning environment is crucial to students' learning and for their development into reflective and capable practitioners. Nursing students' experience with clinical practice can be decisive in future workplace choices. A competent workforce is needed for the future care of older people. Opportunities for maximum learning among nursing students during clinical practice studies in nursing homes should therefore be explored.

DESIGN: Mixed-method systematic review using PRISMA guidelines, on learning environments in nursing homes, published in English between 2005-2015.

METHODS: Search of CINAHL with Full Text, Academic Search Premier, MEDLINE and SocINDEX with Full Text, in combination with journal hand searches. Three hundred and thirty-six titles were identified. Twenty studies met the review inclusion criteria. Assessment of methodological quality was based on the Mixed Methods Appraisal Tool. Data were extracted and synthesised using a data analysis method for integrative reviews.

RESULTS: Twenty articles were included. The majority of the studies showed moderately high methodological quality. Four main themes emerged from data synthesis: "Student characteristic and earlier experience"; "Nursing home ward environment"; "Quality of mentoring relationship and learning methods"; and "Students' achieved nursing competencies."

CONCLUSION: Nursing home learning environments may be optimised by a well-prepared academic-clinical partnership, supervision by encouraging mentors and high-quality nursing care of older people. Positive learning experiences may increase students' professional development through achievement of basic nursing skills and competencies and motivate them to choose the nursing home as their future workplace.

RELEVANCE TO CLINICAL PRACTICE: An optimal learning environment can be ensured by thorough preplacement preparations in academia and in nursing home wards, continuous supervision and facilitation of team learning.