Nursing students' lived experience of a clinical placement in prison healthcare: A systematic review

A systematic review of the literature to explore nursing students' lived experience of a clinical placement in a healthcare setting in a prison, to identify how and if their needs were met to enable an optimal learning environment BACKGROUND: There is an increasing demand for clinical placements to support undergraduate/prelicense nurse education, especially within primary and community healthcare settings. A clinical placement in a prison has the potential to provide multiple learning opportunities for nursing students due to the unique requirements of prisoners. However, there remains a need to understand nursing students' experiences of a clinical placement in a prison.

The updated PRISMA guidelines for reporting systematic reviews guided the development of this study. Inclusion and exclusion criteria informed the search strategy of recognised MeSH terms and Boolean operators, which were applied to search CINAHL complete, APA Psycinfo, MEDLINE, Google Scholar and Grey Open. Manual searching of the reference lists of all identified studies was completed. Standardised critical appraisal instruments were applied to each included study. Data extraction and analysis was completed by adhering to the thematic analysis process described by Thomas and Harden.

The electronic database and reference list search identified 81 studies published between January 2000 and December 2021 in the English language, which was reduced to the inclusion of five studies. Following screening, studies were completed in USA (n = 2), Australia (n = 1), Canada (n = 1) and UK (n = 1). A total of 228 nursing students had completed a clinical placement in prison. Four themes were identified: 1) pre-placement anxiety; 2) a sense of safety; 3) impact on negative stereotypes; and 4) an opportunity for learning CONCLUSION: The voluntary and opt-in nature of clinical placements in prison may have created some bias in the results. However, standardised preparation and orientation of nursing students prior to commencing a clinical placement in prison is essential. Nursing students require structured support to understand their anxieties, the rules and regulations of security and how to interact with prisoners prior to entering a prison. Clinical placements within prison provide nursing students with an opportunity to challenge negative attitudes towards diverse and marginalised populations, develop clinical practice, knowledge and become socialised into the profession. However, the experience, knowledge and willingness of Registered Nurses to support nursing students is essential, to enable and empower their learning within this non-traditional clinical placement. Tweetable abstract On completion of a placement in prison healthcare nursing students identified pre-placement anxiety, a sense of safety, impact on negative stereotypes and an opportunity for learning, however, the need for preparation, orientation and realistic understanding of safety remains.