The Shortage of Clinical Sites; Meeting the Demand

Participation of nursing students within the clinical environment has been historically instrumental in developing therapeutic relationships, learning how to adapt to unexpected situations, fostering professional socialization and translating theory to practice. In today’s evolving educational arena there is a call to shift the pedagogy to a simulated experiential learning method in response to the national shortages of clinical sites. This presents nursing faculty with the challenge to prepare nursing students to deliver safe patient high quality care where the worlds of laboratory and clinical learning merge.  

In response to the current demands to prepare a new nursing workforce, the nursing community has investigated and researched the use of simulated experiences. The National Council of State Boards of Nursing (NCSBN) published an award-winning and groundbreaking study that found that up to half of traditional clinical hours in pre-licensure nursing programs can safely be replaced by high-quality patient scenarios for students in the form of nursing simulations (http://nursingeducation.lww.com). For over a decade this pedagogy has also been studied and supported by the national League for Nursing (NLN) (Larue, Pepin &Allard, 2015).

Using simulators, students can practice complex assessment skills, and hone their ability to set priorities, make decisions, and take appropriate action when things go wrong. Simulated experiences offer a controlled-learning environment and provide students with immediate feedback, allowing for self-correction and remediation if needed. Students learn from their own mistakes, which is a powerful way to learn, in a safe environment. When well-designed simulated experiences are followed by debriefing on what went well and what could be done better, students learn to manage common clinical issues before they care for real patients (http://nursingeducation.lww.com; http://ortoday.com; Larue, Pepin &Allard, 2015).

According to Lippincott Nursing Education, 2017 there are 7 reasons to appreciate utilization of the simulated learning experience: 1) they provide clinical opportunities, 2) they provide vulnerable patient situations for practice, 3) they make room for failure (identification and correction of mistakes), 4) provide for objective reflection of performance, 5) provide practice of uncommon but important events (heart attack or stroke), 6) bring awareness to improve safety and reduce risk of harm, 7) they work according to a study published NCSBN(https://www.ncsbn.org/JNR_Simulation_Supplement.pdf

Although there is evidence to support the use of simulation as a shared nursing student learning experience there still remains a need to maintain a maximized engagement of authentic clinical face-to-face participation to address competencies of professional socialization, adapting, developing the nurse-patient relationships and providing safe high quality care beyond the classroom.

~ E. Roderigues MSN, RN