Local people's perceptions of international clinical placements in low- and middle-income countries: A literature review.

Background: Student nurses in high-income countries are increasingly taking opportunities to undertake international clinical placements in low- and middle-income countries as part of their pre-registration studies. Objectives: This review aimed to identify and evaluate existing research explores what local people in low- and middle-income countries think of international clinical placements taking place in their localities. This includes a range of local stakeholders, such as clinicians (including midwives, nurses, physicians, pharmacists, and academics), healthcare students (from any discipline), patients, carers, and community members. Considering the limited research focused specifically on local individuals exposed to nursing students, we sought to review the wider research exploring the perceptions of local people in low- and middle-income countries who have been exposed to any type of travelling pre-registration healthcare students. The aim of this review was to assess the size and scope of available research literature, establish research priorities, and provide generalizable findings relevant to all international clinical placements, including those undertaken by nursing students. Design: Electronic databases were used to search for published results of previous research, including PubMed, Embase, Web of Science, CINAHL, Medline Ovid, and the Cochrane Library. Thirteen peer-reviewed articles were included after the screening process. The results of the original studies were analysed using a thematic synthesis. Results: Themes identified included learning (with subthemes of travelling students learning from local people, local people learning from travelling students, and optimising learning), prestige, travelling student behaviour, and resource use (with subthemes of enhancing resources, draining resources and improvements via partnership working). Whilst challenges and drawbacks of international clinical placements were identified, on balance, local people across all the studies were positive about receiving travelling students and keen for this to continue. Conclusion: This work has found that the current body of research exploring perceptions of international clinical placements was heavily focused on local clinicians who have been exposed to travelling medical students. Some of the themes identified may be generalisable to all stakeholders of all types of international clinical placements. These include the central concern regarding reciprocity and the desire that international placements should be beneficial for all involved, rather than solely the travelling student. However, further research is required to understand how other types of placements, such as nursing placements, are viewed by other local people (e.g., patients).