Towards primary health care education reform: A reflexive thematic analysis of nursing supervisors' perceptions, experiences and challenges

Aim To explore Primary Health Care nurses' experiences of supervising nursing students on clinical placements and their perceptions of academic preparation for placement and future employment. BACKGROUND: Primary Health Care nurses are essential workers within sustainable health systems but pre-registration educational preparation and access to clinical experiences can be limited. Previous research correlates positive clinical experiences with workforce intentions. Furthermore, nursing supervisors are pivotal to maximising student experiences and education, yet little is known about their perceptions, challenges, and views about how current curriculum prepares students to commence professional careers in primary care. Understanding their perceptions may inform curriculum, improve placement experiences and develop a sustainable future workforce. DESIGN: A qualitative study using Braun and Clarke's reflexive thematic analysis. PARTICIPANTS: Nursing supervisors who attended the Australian Primary Health Care Nurses Association conference 2025 participated in a focus group session. METHOD: One large focus group with 24 participants, divided across five tables for focused discussion, was conducted over 90 min. Facilitators documented verbatim conversations. Summary group feedback was documented through field notes and audio recordings. Data were transcribed, collated and analysed using Braun and Clarke's six-phase framework. RESULTS: Participants described the rewards and challenges of supervision, including workload pressures, professional behaviour concerns, and limited support and training for supervisors. They perceived curricula left students underprepared, with knowledge gaps in communication, critical reasoning, and scope. They interpreted workforce sustainability as hindered by inequities and stigma; however, stronger education, greater scope, and increased autonomy and flexibility could improve attraction and retention. CONCLUSION: Participants called for systematic reform to reorient nursing education and placements towards Primary Health Care. National collaboration between industry and universities is essential to strengthen curricula, expand autonomy and scope, and promote Primary Health Care as viable career options. Without reform, the Primary Health Care workforce could face future sustainability challenges.