Flexible rostering in nursing student clinical placements: A qualitative study of student and staff perceptions of the impact on learning and student experience

Aim: To explore whether a flexible rostering system for nursing students during their clinical placements enhanced their experience and contributed to a positive learning environment. Background: In England, attrition from nursing programmes is an enduring issue, often related to student experience of clinical placements. Students juggle caring responsibilities, academic assessment and additional part-time jobs to mitigate financial hardship, while they are undertaking the clinical placement aspect of their courses. Flexible or self-rostering is a system that has been implemented with qualified practitioners in several NHS organisations and may present a solution to the need for flexibility in clinical placements for students. Design: This was a qualitative pre-and post-intervention study. Method: A flexible rostering system was co-produced with nursing and midwifery students and subsequently implemented in four in-patient areas in an inner-city NHS healthcare organisation between November 2019 and February 2020. Qualitative interview data were collected from participating students and NHS staff from participating clinical areas, before and after implementation between October 2019 and February 2020. Results: Three focus groups and one interview were undertaken pre-intervention, involving 13 students. Seven students and seven staff participated in a focus group or interviews post implementation. Findings indicated that the flexible rostering system gave students control over their work-life balance and enabled them to feel empowered in their clinical areas, less anxious and more focused on their development. Clinical staff reported unexpected benefits in terms of student attitude and attendance, allowing them to focus on teaching rather than dealing with concerns or changing the rota. Some staff felt there were challenges with implementation, which both students and staff agreed could be addressed by developing rostering guidelines. Conclusion: The findings indicate that wider implementation of the flexible rostering system should be recommended to capitalise on the personal and contextual benefits.