Contents lists available at ScienceDirect Nurse Education Today journal homepage: www.elsevier.com/locate/nedt Perceptions of community care and placement preferences in first-year nursing students: A multicentre, cross-sectional study Margriet van Iersel a,⁎ , Corine H.M. Latour a , Rien de Vos b , Paul A. Kirschner c,e , Wilma J.M. Scholte op Reimer a,d a ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands b Centre of Evidence Based Education, Academic Medical Centre, Amsterdam, The Netherlands c Open University of the Netherlands, Heerlen, The Netherlands d Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands e University of Oulu, Oulu, Finland ARTICLE INFO Keywords: Bachelor of Nursing Career preferences Community care Nursing education Perceptions Placements Nursing students ABSTRACT Background: Despite increasing shortages of highly educated community nurses, far too few nursing students choose community care. This means that a strong societal problem is emerging that desperately needs resolution. Objectives: To acquire a solid understanding of the causes for the low popularity of community care by exploring first-year baccalaureate nursing students' perceptions of community care, their placement preferences, and the assumptions underlying these preferences. Design: A quantitative cross-sectional design. Settings: Six universities of applied sciences in the Netherlands. Participants: Nursing students in the first semester of their 4-year programme (n = 1058). Methods: Data were collected in September–December 2014. The students completed the ‘Scale on Community Care Perceptions’ (SCOPE), consisting of demographic data and three subscales measuring the affective com- ponent of community care perception, perceptions of a placement and a profession in community care, and students' current placement preferences. Descriptive statistics were used. Results: For a practice placement, 71.2% of first-year students prefer the general hospital and 5.4% community care, whereas 23.4% opt for another healthcare area. Students consider opportunities for advancement and enjoyable relationships with patients as most important for choosing a placement. Community care is perceived as a ‘low-status-field’ with many elderly patients, where students expect to find little variety in caregiving and few opportunities for advancement. Students' perceptions of the field are at odds with things they believe to be important for their placement. Conclusion: Due to misconceptions, students perceive community care as offering them few challenges. Strategies to positively influence students' perceptions of community nursing are urgently required to halt the dissonance between students' preference for the hospital and society's need for highly educated community nurses. 1. Introduction The international shift in healthcare from intramural to extramural is associated with aging populations and an increase in chronic diseases and multimorbidity; both global phenomena (Afshar et al., 2015; WHO, 2008). For the nursing profession, people with chronic conditions living outside of a facility and receiving healthcare at home are fast becoming a large and important population (Altman et al., 2015). To reflect the current shift in healthcare delivery, one such challenge is to ensure that nursing students receive appropriate theoretical programme-content and placement experiences. Therefore, both general profiles for bac- calaureate nursing education (AACN, 2008; NMC, 2010) and those in the Netherlands (Lambregts et al., 2014) increasingly contain elements of community care. However, many Western countries are experiencing a problematic shortage of community nurses (Bloemendaal et al., 2015; Larsen et al., http://dx.doi.org/10.1016/j.nedt.2017.09.016 Received 19 January 2017; Received in revised form 5 July 2017; Accepted 26 September 2017 ⁎ Corresponding author at: ACHIEVE - Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 BD Amsterdam, The Netherlands. E-mail addresses: m.van.iersel@hva.nl, http://twitter.com/@m_iersel (M. van Iersel), c.h.m.latour@hva.nl (C.H.M. Latour), r.vos@amc.uva.nl (R. de Vos), Paul.Kirschner@ou.nl (P.A. Kirschner), w.j.m.scholte.op.reimer@hva.nl (W.J.M. Scholte op Reimer). Nurse Education Today 60 (2018) 92–97 0260-6917/ © 2017 Elsevier Ltd. All rights reserved. MARK