Do therapeutic recreation mental health clinical placements provide educational experiences to pre-registration student nurses? A mixed methods systematic review

Journal article


Leplaw, Abigail, Fernandez, Ritin, Lewer, Kelly, Patterson, Christopher and Moxham, Lorna. (2025). Do therapeutic recreation mental health clinical placements provide educational experiences to pre-registration student nurses? A mixed methods systematic review. International Journal of Mental Health Nursing. 34(1), p. Article e13473. https://doi.org/10.1111/inm.13473
AuthorsLeplaw, Abigail, Fernandez, Ritin, Lewer, Kelly, Patterson, Christopher and Moxham, Lorna
Abstract

Clinical placements are a critical component in any pre-registration student nurse's skill development and play an influential role in career specialisation upon registration. However, students are reporting to feel anxious and under prepared attending clinical placements, especially within mental health settings. Such a concern was highlighted in the Australian Government's Productivity Commission into Mental Health (2020). With recommendations for clinical placements to occur in therapeutic recreation environments, allowing increased interactions between students and individuals with a lived experience. Hence, this mixed methods systematic review aims to explore the experiences of pre-registration student nurses completing their mental health clinical placement within a therapeutic recreation environment. Six databases were searched for the review; CINHAL, Medline, PsycINFO, Web of Science, Scopus and the ProQuest Dissertation and Theses database, yielding 10 214 articles. Data were imported to COVIDENCE for management and screening processes. Risk of bias was undertaken by two authors utilising the Joanna Briggs Institute's Critical Appraisal Checklist for qualitative and quasi-experimental studies and McGill's Mixed Methods Appraisal Tool 2018 Version for mixed methods studies. Data were extracted manually for the 13 included articles which met the review inclusion criteria. Following a thematic analysis of the extracted data, three themes emerged: an optimal learning environment, impact on stigmatising beliefs and influence on future career. Findings identified that therapeutic recreation environments pose numerous education benefits for pre-registration student nurses. It is apparent through an immersive mental health clinical placement; student nurses are able to increase their mental health understanding through the lens of those with lived experiences. Such environments challenge stigmatising beliefs held by students prior to clinical placements and can lead to an increased desire to pursue a career within the mental health speciality. This review offers an insight into the many benefits for pre-registration student nurses who complete their mental health clinical placements in therapeutic recreation environments, including reduced stigmatising beliefs, increased mental health knowledge and improved clinical confidence.

Trial Registration: PROSPERO: CRD42023476280

Keywordsclinical placement; mental health; pre-registration student nurse; systematic review; therapeutic recreation
Year2025
JournalInternational Journal of Mental Health Nursing
Journal citation34 (1), p. Article e13473
PublisherJohn Wiley & Sons Australia, Ltd
ISSN1445-8330
Digital Object Identifier (DOI)https://doi.org/10.1111/inm.13473
PubMed ID39533459
Scopus EID2-s2.0-85208953205
Page range1-17
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online12 Nov 2024
Publication process dates
Accepted25 Oct 2024
Deposited04 Jun 2025
Additional information

© 2024 John Wiley & Sons Australia, Ltd.

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