Impact of nurse education prior to and during COVID-19 on nursing students' preparedness for clinical placement: A qualitative study.

Introduction: Nursing students internationally entered challenging clinical placements during COVID-19. Lessons learnt could inform nurse education planning, particularly in preparation to implement future workforce plans.

Aim: This study aimed to explore the impact of COVID-19 on nursing students undertaking clinical placements across the UK, particularly the extent to which nursing education prior to and during COVID-19 had prepared them for placements, and to distil key messages for future nursing education.

Methods: A UK-wide qualitative study was conducted using audio or written placement diaries and post-placement telephone or online interviews with nursing students from all years of study and from adult, children, mental health and learning disability disciplines. Transcripts were analysed thematically using the Framework Approach. A pre-survey collected participants' demographic information, details and expectations of their upcoming clinical placements, and how well prepared they felt. Ethical approval was gained.

Results: Two hundred and sixteen nursing students from across the UK participated in the study. Five key themes were identified: 'stepping up to the challenge and feeling the fear', 'new ways of learning', 'theory versus clinical practice', 'impact on clinical and academic partnerships', and 'concerns around demonstrating proficiency'.

Discussion: Differing levels of preparedness of nursing students for clinical placement were reported. While many felt honoured to be a part of the nursing workforce during COVID-19, the rapidly changing clinical landscape led to unplanned changes to placements, lack of skills practice, uncertain practice supervision and distance learning which impacted on their confidence and perceived levels of competence leading to anxiety around demonstrating proficiency and achieving practice hours. Greater collaboration between universities, clinical placement teams, policy makers and regulators are key lessons post COVID19 to improve the support and preparedness of nursing students.