Comparing Student Nurse Experiences With Developing Psychiatric Mental Health Nursing Competencies in Hospital and Nursing Homes: A Mixed Methods Study

Problem: Nurse educators today face many barriers to attracting and retaining an adequate workforce of nurses to serve two significantly underserved and growing populations: elders and persons with mental illnesses. Purpose: The primary purpose of this study was to compare and contrast how baccalaureate student nurses’ level of engagement and the perceived quality of the learning environments in inpatient mental health units and nursing homes were related to students’ (a) perceived levels of PMH nursing care competency, and (b) attitudes towards working with the elderly and/or mentally ill. Research Design: This study was a mixed methods case study design guided by Bronfenbrenners’ (2006) bioecological theory of human development. Sample and setting: The sample included 37 junior level nursing students and 3 senior level nursing students from one baccalaureate nursing program at a medium-sized university in the Midwest who attended mental health clinical education at a nursing home for veterans or on inpatient acute mental health hospital units during 2018-2020. Methods: Linear regression, repeated measures ANOVA, and independent samples t-tests were used to analyze the quantitative data collected from 37 students. A case study approach and thematic analysis was used to develop two in-depth cases using qualitative interview data from 11 nursing students in the sample pool. Finally, the quantitative and qualitative data were integrated by analyzing and interpreting points where the data were in agreement and where they diverged. Findings: There were no statistically significant differences between the groups in perceived attainment of PMH nursing competency. There was a significant statistical difference between groups in student engagement (p = .047) and satisfaction (p = .018), with students attending mental health clinical in a nursing home being less engaged in and satisfied with clinical education than their peers assigned to mental health units in hospitals. Conclusion: Baccalaureate nursing students can attain PMH nursing competencies as well in a nursing home as on inpatient mental health units, but are less satisfied and engaged. Stigma, personal characteristics of students, culture, and time factors affect student engagement in and satisfaction with mental health clinical