Nursing Students’ Clinical Placement Experiences Across Healthcare Settings: A Ten-Year Repeated Cross-Sectional Study

Background: Clinical placements are central to nursing education, yet students’ experiences depend on the quality of the clinical learning environment. Although student evaluations are widely used to monitor placement quality, evidence on long-term trends and comparisons across healthcare settings remains limited.

Aim: This study examined how nursing students’ clinical placement experiences evolved over 10 years and compared these experiences across healthcare settings.

Methods: A repeated cross-sectional survey was conducted among bachelor’s degree nursing students at HOGENT University of Applied Sciences and Arts. Between the 2015/16 and 2024/25 academic years, students completed placement evaluations using the Dutch Clinical Learning Environment and Supervision scale. In total, 5,080 completed evaluations from placements in hospitals, home healthcare, psychiatric care, nursing homes, and preventive health and welfare services were analyzed. Scores were transformed to a 0–100 scale, and nonparametric tests were used to assess trends and differences across settings.

Results: Students rated their placements positively (median overall score: 79.7), with scores improving over time. The total score increased from 75.8 in 2015/16 to 82.8 in 2024/25, with the largest improvements observed in the learning environment and nursing care dimensions. Preventive health and welfare services and psychiatric care received the highest median scores; however, preventive health and welfare services accounted for only 1.2% of evaluations. Nursing homes received the lowest overall scores and the lowest ratings for supervision and the learning environment, although leadership ratings were comparatively high.

Conclusion: Students’ evaluations improved over time but varied across settings. Strengthening learning opportunities, supervision, and leadership accessibility, particularly in nursing homes and home healthcare, remains essential to enhancing clinical learning and may support future workforce development.

Keywords: Clinical learning environment, clinical placement, nursing students, student experiences