Exploring Learning Engagement in Rural and Urban Nursing Placements: A Five-Year Mixed-Methods Study.

Professional experience placements are a requirement for undergraduate nursing students enabling real world skill development. Barriers to meaningful and positive placements have previously been reported, however there is limited research on how the location of placement impacts the student experience and outcomes. This study investigates the placement experiences of undergraduate nursing students at the University of Tasmania (UTAS) over a five-year period, with a focus on urban versus rural settings and year-level differences. Findings reveal that over one-third of students reported constructive placement experiences, with rural placements yielding slightly more positive outcomes than urban ones. First-year students were more likely to report constructive experiences compared to their senior counterparts, suggesting that longer placement durations may contribute to increased dissatisfaction. Quality of placement-defined by supervision and skill development-emerged as the most influential factor in shaping student experiences. While most students praised the quality of supervision, third-year students expressed both the highest praise and criticism. Opportunities for clinical and interpersonal skill development were central to students' perceptions of placement quality, with rural placements slightly outperforming urban in skill development. However, some students, particularly in later years, felt that certain venues lacked adequate opportunities for skill acquisition. The study underscores the importance of high-quality supervision and appropriate clinical settings in enhancing placement experiences and suggests that constructive placements are more conducive to learning. These insights can inform strategies to improve the educational value of nursing placements across diverse settings.