The impact of pre-registration nurse education on students perceptions of nursing homes as clinical placement settings

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Supervisory Team Director of Studies: Dr Julie Cooke, Senior Lecturer in Nursing Supervisors: Dr Richard Warner, Senior Lecturer in Nursing

Research Group: Health Professions Education and Practice

The PhD Opportunity The population aged over 65 is rapidly growing and is projected to triple by 2050 (United Nations, 2023). Coupled with an increasing number of individuals aged 90 and over in the UK (Office for National Statistics, 2024), this demographic shift is expected to increase the number of older adults with complex health and social care needs by 54%, placing greater demands on expert nursing within the social care sector (Age UK, 2019). In the UK however, this demand is challenged by a significant nursing shortage, with registered nurse (RN) vacancies in nursing homes at a record high (Royal College of Nursing (RCN), 2022) and a 33% reduction (n=17,000) in nurses working in adult social care since 2013 (Skills for Care, 2023). The global literature indicates that nursing students often view nursing homes less favourably than acute hospitals for clinical placements (Carlson & Idvall, 2015; Ryan et al, 2018; Naughton et al, 2019), perceiving care for older adults in these settings as "boring and unchallenging" (Shen & Dongxia Xiao, 2012, p. 221). McCann et al. (2010) suggest that students’ perceptions of caring for older people are heavily influenced by the focus of the adult nursing curriculum. These findings imply that nurse education plays an important role in shaping the views of students towards caring for older people in nursing homes. Nurse educators have a responsibility to challenge negative perceptions to prepare students to meet future healthcare demands. While research exists on the use of nursing homes as clinical placement areas, the need for well-supported placements (Algoso et al., 2016; Keeping-Burke et al., 2020), and educators’ experiences of supporting nursing home placements (Cooke, 2024) there is limited empirical evidence exploring the impact that nurse education (for example: curriculum, faculty experiences and attitudes) has on student perceptions of nursing homes as clinical placements, and the impact this might have on the uptake of newly qualified nurses into nursing older people in social care settings such as nursing homes. This PhD offers a motivated person the opportunity to explore this further using a qualitative or mixed method approach. PhD Opportunity

The impact of pre-registration nurse education on students perceptions of nursing homes as clinical placement settings.

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References • Age UK (2019). Briefing: Health and Care of Older People in England 2019. Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports- and-publications/reports-and-briefings/health-- wellbeing/ageukbriefingstateofhealthandcareofolderpeoplejuly2019. pdf. Last accessed 18/04/2024. • Algoso, M., Peters, K., Ramjan, L., East, L. (2016). Exploring undergraduate nursing students’ perceptions of working in aged care settings: A review of the literature. https://doi.org/10.1016/j.nedt.2015.08.00. • Carlson, E., Idvall, E. (2014). Nursing students’ experiences of the clinical learning environment in nursing homes: A questionnaire study using the CLES + T evaluation scale. https://doi.org/10.1016/j.nedt.2014.01.009. • Cooke J (2024) Academic nurse educators’ experiences and perceptions of supporting adult nursing students in clinical placements in nursing homes: An Interpretative Phenomenological Analysis. Unpublished PhD thesis. Available at: https://radar.brookes.ac.uk/radar/home.do (accessed 19 June 2025). • Keeping-Burke, L., McCloskey, R., Donovan, C., Yetman, L., Goudreaux, A., 2020. Nursing students' experiences with clinical placement in residential aged care facilities: a systematic review of qualitative evidence. JBI evidence Synthesis. https://doi.org/10.11124.JBISRIR-D-19-00122. • Mccann, T. V, Clark, E., Lu, S. (2010). Bachelor of nursing students’ career choices: A three-year longitudinal study. https://doi.org/10.1016/j.nedt.2009.05.014. • Naughton, C., O’Shea, KL., Hayes, N. (2019). Incentivising a career in older adult nursing: The views of student nurses. Int J Older People Nurs. 14:e12256. https://doi-org.oxfordbrookes.idm.oclc.org/10.1111/opn.12256 • Office for National Statistics (2024). Estimates of the very old, including centenarians, England and Wales: 2002 to 2022: Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriage s/ageing/bulletins/estimatesoftheveryoldincludingcentenarians/2002to2022#:~:text =2, Last accessed 27/03/2024. • Royal College of Nursing (RCN), (2022). Staffing for Safe and Effective Care: state of the nation’s labour nursing market 2022, Available at: https://www.rcn.org.uk/search?Keyword=State%20of%20the%20nation%e2%80 %99s%20nursing%20labour%20market&Sort=5&SortOption=5&Scope=Global. Last accessed 28/04/2023. • Ryan, C., Ellem, P., Heaton, L., Mulvogue, J., Cousins, M., De George – Walker, L. (2018). Australian final year nursing students′ and registered nurse supervisors’ perceptions of a gerontology clinical learning experience: A preliminary appraisal. Nurse Educ. Pract. 31, 182–187. https://doi.org/10.1016/j.nepr.2018.06.003. • Shen, J., Dongxia Xiao, L. (2012). Factors affecting nursing students’ intention to work with older people in China. Nurse Education Today, https://doi.org/10.1016/j.nedt.2011.03.016

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• Skills for Care (2023). The state of the adult social care sector and workforce in England. Available at: https://www.skillsforcare.org.uk/Adult-Social-Care- Workforce-Data/Workforce-intelligence/publications/national-information/The- state-of-the-adult-social-care-sector-and-workforce-in-England.aspx. Last accessed 01/02/2024. • United Nations, (2023). The World Social Report, 2023; leaving no one behind in an ageing world. Available at: https://www.un.org/development/desa/dspd/world- social-report/2023-2.html. Last accessed 05/05/2023.

Application Process To begin the application process please go to https://www.worc.ac.uk/research/research-degrees/applying-for-a-phd/.

The Interview All successful applicants will be offered an interview with the proposed Supervisory Team. You will be contacted by a member of the Doctoral School Team to find a suitable date. Interviews can be conducted in person or over Microsoft Teams.

Funding your PhD For information about Doctoral Loans please visit: https://www.worc.ac.uk/study/fees- and-finance/doctoral-loans.aspx

During your PhD you can access the Research Conference Support Scheme to support the costs of presenting your research at an external conference.

Research at the University of Worcester Research is central to the University’s mission to make a difference in everything that we do. We are committed to delivering excellent research which extends the boundaries of human knowledge but which also improves people’s lives by enabling better health outcomes, improving food security, developing environmentally sustainable solutions for crop production and socially sustainable solutions to our ageing population, enhancing public knowledge and understanding of the past and present.

The University hence focuses its research around five high-level challenges facing society, locally, nationally and globally:

• Human Health and Wellbeing • Sustainable Futures • Digital Innovation • Culture, Identity and Social Exclusion • Professional Education

The success of our research is reflected in our continuous improvement in external research assessment processes. In the most recent Research Excellence Framework, REF 2021, the University saw a near 50% increase in the scale of its research and 12% increase in quality, building on its performance in REF 2014 when it was the UK’s most improved university in terms of Research Power, a combination of scale and quality.

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Research Degrees at Worcester Our research students are central to our overall mission for research. They are working at the cutting edge of their disciplines and driving forward the quality of our research whilst enriching our research culture. We are looking to increase our research student numbers as a strategic imperative.

Our commitment to our students is reflected in the results of the Postgraduate Research Experience Survey 2025 in which we ranked 3rd for overall research student satisfaction nationally. Key to our success in his area is the Doctoral School, a focal point for all our research students.

It provides:

• day-to-day support for our students, both administrative and practical, through our dedicated team • a Research Student Study Space with both PCs and laptop docking station • a comprehensive Researcher Development Programme for students and their

supervisors

• a programme of student-led conferences and seminars

Widening Participation As part of its mission statement the University is committed to widening participation for its higher degrees. Although most candidates will have an undergraduate and/or a Master’s degree, the University is happy to accept applications from candidates with relevant professional qualifications and work-related experience.

For further information or an informal discussion on this project, please contact Dr Julie Cooke: email j.cooke@worc.ac.uk

Research areas