A Gamble Pays Off: Students’ Perceived Benefits of a Primary Care Clinical Immersion Experience

Purpose: Traditionally, bachelor of science in nursing (BSN) curricula provide clinical experiences within the community setting, but not specifically in primary care. At a midwestern university, a 150-hour, two-year, longitudinal primary care clinical experience was added to the curriculum. Funding from the health resources and services administration nurse education, practice, quality, and retention registered nurses in primary care grant supported this rotation. The purpose of this presentation is to discuss BSN students’ reflections regarding the benefits of a primary care clinical immersion experience.

Description: Students were placed in rural, primary care settings and paired with registered nurse (RN) preceptors to perform all aspects of care including telehealth, health education, case management, chronic disease management, care of acute illness, and health promotion. Focus group data was obtained from students each semester. To promote unbiased student responses, participation in the focus groups was voluntary and anonymous, a person unrelated to the clinical experience conducted the focus groups, and no rewards were offered for focus group involvement. Standardized questions regarding the primary care clinical experience were asked. This presentation will focus on the students’ perceived benefits of the primary care experience.

Evaluation/outcome: Several themes emerged regarding the students’ perception of the clinical experience benefits. Students felt there is a big disconnect between primary care and acute care. They identified gaps that frequently occur in healthcare and the potential consequences such as hospitalizations and adverse patient outcomes. Additionally, experience in the primary care setting facilitated student understanding of preventative measures and health promotion education, and its impact on decreasing hospital stays and improving patient outcomes. Relationship building between patients and the healthcare team was another perceived benefit. Students enjoyed observing the invested, caring, long-term relationships between patients and the primary care team, which contrast the brief episodic care provided in the acute setting. Students also gained an appreciation of the RN’s knowledge base and scope of practice in the primary care setting. Furthermore, they reported surprise with the amount of critical thinking that primary care, especially telehealth, requires and felt the experience greatly improved their critical-thinking abilities. Students also enjoyed learning new skill sets and were exposed to many unique primary care experiences. Because of the immersion experience, many students have indicated they would consider pursuing a career in ambulatory care post-graduation. In addition to the recognized benefits of the clinical experience, students also provided valuable, constructive feedback which was utilized to revise and improve the primary care clinical immersion.