A systematic review of placement-related attrition in nurse education.

Background: Attrition in nurse education is a worldwide issue. Clinical placements form a major part of nurse education and have an important role in students' perceptions of nursing. Student nurses cite unsatisfactory placement experiences as a reason for leaving nursing education.

Objective: To conduct a systematic review to establish nursing students' placement-related reasons for leaving their programme.

Data Sources: Major health literature databases were searched, including studies from 1995 to 2011.

Review Methods: This review considered quantitative and qualitative research investigating student nurse attrition, with an emphasis on placement-related issues. After a systematic selection process, included studies were quality assessed by three researchers.

Results: Eighteen studies were included in the review. The studies investigated personal reasons for leaving, demographic and other factors, and students' attributes. As for all student attrition, there was no single reason (related to placements) why students chose to leave, however, being a young or a male student were major factors, along with being exposed to unpleasant placement experiences, the attitudes of placement staff, and lack of support. Perceptions of the nursing profession and practice assessments were also factors in placement-related attrition.

Conclusions: There is a need for more high quality reporting in the area of attrition in student nursing, whether this is due to placement issues or other reasons. Prior work experience in healthcare settings is important in enabling students to complete their programmes and recruitment and retention strategies should consider this. When students are recruited with limited or no healthcare experience, targeting retention strategies and support on these students may be useful.