Challenges Facing Administrators – Rethinking Clinical Placements

Deans continue to be most likely to say that getting qualified faculty and finding enough clinical placements for students are their top two challenges. The National Council of State Boards of Nursing (NCSBN) published the results of the largest, most comprehensive research study on the use of simulation in nursing education. The results of this study and subsequent guidelines can help to address the clinical placement dilemma (NCSBN, 2015). How can purposeful integration of simulation in nursing curricula address the clinical challenge head on to effectively target resources?

What we already know…Guidelines have been identified based on evidence to assist boards of nursing and schools of nursing to develop and implement simulation appropriately. Simulation has become the Trojan horse for establishing standards and guidelines that help us to implement good teaching in nursing education. How can we use it to inform us about good quality clinical experiences?

  • What we should know now…Specifically, the NCSBN raises the issue of needing faculty to differentiate clinical experiences from good clinical experiences – thus approaching the use of clinical very thoughtfully. The quality of the experience…is crucial (p.41). The guidelines raise an important consideration: if students in clinical do not have the opportunity for a meaningful hands-on experience, perhaps the use of simulation and theory-based debriefing by educated faculty is a better option.

What we already know:  In 2010, Benner, Sutphen, Leonard, Day discussed the need for transformational learning in nursing education suggesting that the scholarship of teaching and learning includes developing new approaches to curricula…new instructional innovations such as simulation; and evaluation strategies to capture the processes of using knowledge (p. 32). Why are we still talking about this?  Simulation as a teaching methodology to prepare nurses for practice across the continuum of care in today’s complex health care environment provides a rich learning opportunity for students to integrate theory with practice while making real-time clinical decisions in an environment that poses no risk to patients.

  • What we should know now… We have guidelines for the use of teaching with simulation that focus on evidence from the literature on best practice in teaching. Create strategic partnerships with schools and clinical agencies to plan for the best clinical experiences. Capitalize on how clinical can be reimagined or enhanced through the strategic and effective use of simulation in our nursing curricula with clear connections toward achievement of student learning outcomes.

Three ideas to help you strategize, click here,  on the strategic use of simulation and speak to Benner et al’s (2010) ideas in transforming nursing education.

Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses:  A call for radical transformation. San Francisco, CA: Jossey-Bass.

Alexander, M.; Durham, C.; Hooper, J.; Jeffries, P.; Goldman, N.;  Kardong-Edgren, S.; Kesten, K.; Spector, N.; Tagliareni, E.; Radtke, B.; Tillman, C. (2015).  NCSBN simulation guidelines for prelicensure nursing programs. Journal of Nursing Regulation, 6(3).

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