Combatting the Nursing Shortage by Requiring Prior Healthcare Experience as a Condition of Admission to Nursing School: a Systematic Review

Abstract

Novice nursing students confront a variety of challenges as they begin their clinical rotations and encounter patients for the first time. These students often experience anxiety related to a lack of appropriate clinical knowledge, feelings of incompetence due to clinical inexperience, and underdeveloped communication skills. While anxiety may motivate a student to learn, it can also hinder the learning process. It has been suggested that students who enter nursing school with prior healthcare experience may have decreased levels of anxiety upon beginning their clinical coursework. The purpose of this systematic review was to determine the advantages and disadvantages of requiring healthcare experience as a condition of admission to nursing school. Research, from the last 15 years, focusing on nursing students was reviewed. Eligible studies for this review met the following criteria: student enrollment in a nursing program, data collected before or after the student’s first clinical rotation, and inclusion of healthcare experience as a variable. Databases searched included PubMed and CINAHL. Search terms included nursing student, employment, nursing assistants, socialization, confidence, and anxiety. Results suggest that requiring healthcare experience prior to admission to nursing school has a variety of advantages and disadvantages. Students express increased confidence levels when interacting with interdisciplinary teams and performing skills and decreased feelings of anxiety on the unit. However, prior healthcare experience can also lead to role confusion and questioning of unit placement. Though previous experience among nursing students is beneficial, requirement for admission should be carefully considered. Nursing schools should allow only certain programs and/or healthcare facilities to gain experience for admission to ensure consistency amongst peers. Upon admission, a brief course on caregiver responsibilities should be considered to address the disadvantage of caregiver role confusion related to previous healthcare experience.