Nursing Clinical Experiences Reboot: Incorporating Simulation

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Brief Abstract

With the onset of COVID-19, nursing programs witnessed student clinical opportunities disappear as institutions worked to maintain client and staff safety. 

To meet clinical experience requirements, nursing leaders flexed their creative muscles to offer these experiences with out-of-the-box thinking.

Discover how one university met this challenge.


I’m an ID III who loves to learn and loves to share! As an 'educational architect, ' I work alongside our partners in overseeing online/hybrid new course development or revisions. This includes aligning measurable learning objectives, course content, learning activities, and assessments. I may either lead the course development/revision or act as a consultant if another ID is leading. Given that my role creates student experiences, I take my work very seriously. My spare time has me studying Middle Eastern dance, listening to audio plays, and taking care of my three 'furry overlords' (cats). I am located in the Chicagoland area. Feel free to connect with me via LinkedIn!

Extended Abstract

Session Theme:

COVID impacted health sciences programs’ clinical experience offerings. With healthcare institutions removing these opportunities, program leaders explored alternative options that allowed for simulated experiences. Based upon the recommendations and approval of its state board of nursing and the National Council of State Boards of Nursing, one educational institution met the challenge by supplanting in person clinical experiences with simulations.

In 2020 across the United States, 80,000+ students were turned away from nursing education due to inadequate numbers of faculty, very limited clinical sites, funding issues, cost of preceptors and classroom space (Wolters Kluwer and National League for Nursing, 2021).  Due to the shortage of clinical sites, many educational institutions were forced to consider other options for clinical experience. 

Another confounding factor is the location of the educational institution in a rural area with limited community health clinical settings, which necessitated finding alternatives for clinical experiences.  Using simulation alternatives allowed clinical experiences to occur during COVID while keeping the nursing staff, the clients, and the students safe.

Research supports that clinical simulation develops clinical reasoning and clinical judgement.  One author even suggested that one hour of simulation was equal to two hours of actual clinical time (Jefferies, 2015; Haerling & Prion, 2021).  Simulation is considered to be much more effective for student learning than actual clinical hours in a clinical setting.  Prior to COVID, up to 50% of the clinical hours required for a course could be completed using simulation per professional nursing organization guidelines.

With research backing, program faculty were confident in investigating simulation alternatives. During COVID community agencies did not allow students to have contact with their staff or their clients. This was a common occurrence across most states and therefore 100% of the clinical hours were able to be completed using simulations per professional nursing organizations. 

As writers of this abstract were developing simulation alternatives to community health clinical experiences, one advantage that emerged was the fact that all students would have opportunities for the same clinical experiences.  In addition, the number and variety of community health clinical experiences available to students increased by using simulations rather than if the students had rotated through a number of in person clinical opportunities.

Another advantage of using simulation is having the capability of crafting common experiences for all students where the real-life opportunities may not be realistic within an actual clinical setting. Simulation has been successfully used with scenarios of developing cultural competence (Weideman, Y. L., et. al., 2016) and care of people of various gender identity and sexual orientation (Luctkar-Flude, M., et. al., 2020). This is an example of where a common clinical experience was available to students through simulation. In a real-life clinical situation, not all students would have this opportunity.

COVID required out of the box thinking by health sciences programs to meet students’ clinical requirements. OLC’s community at large would benefit from learning how programs adapted during the pandemic and the impact of long-term revisions moving forward. For any institution that offers simulation experiences, regardless of the content, this session would provide process blueprints and questions to ponder.

Participant Interaction:

Throughout the session participants will be polled and respond to reflective questions, comparing their experiences in adjusting the clinical experience during COVID. Poll responses will also allow presenters to identify common themes and challenges across the participants, allowing for real time discussion.

While discussion occurs, a resource will be developed in real time based upon the identified challenges proposed by participants.

Session Goals:

Session participants will be able to:

  • Describe the strategies used to adjust simulation requirements for nursing students’ clinical experiences during COVID.

  • Compare the intent of simulation experiences pre COVID and beyond.

  • Assess their institution’s program clinical requirements and simulation possibilities for health sciences students.


Haerling (Adamson), K & Prion, S. (2021).  Questions regarding substitution of simulation for clinical.  Clinical Simulations in Nursing, 50, 79-80.  file:///D:/OLC%20Abstract/Questions%20REgarding%20Substitution%20of%20Simulation%20for%20Clinical.pdf

Jefferies, P. R. (2015).  Signs of Maturity . . . Simulations Are Growing and Getting More Attention [Editorial].  Nursing Education Perspectives 36(6).  file:///D:/OLC%20Abstract/Signs%20of%20Maturity.%20.%20.%20Simulations%20are%20Growing%20and%20Getting%20More%20Attention.pdf

Luctkar-Flude, M., Tyerman, J., Zeigler, E., Carroll, B., Shortall, C., Chumbley, L., & Tregunno, D.  (2020). Developing a sexual orientation and gender identity nursing education toolkit. Journal of Continuing Education in Nursing. 51(9). 412 – 419. doi:10.3928/00220124-20200812-06

Weideman, Y. L., Young, L., Lockhart, J. S., Grund, F. J., Fridline, M. M., & Panas, M. (2016).  Strengthening cultural competence in prenatal care with a virtual community: Building capacity through collaboration. Journal of Professional Nursing, 32(5S), S48 – S53. 03.004.

Wolters Kluwer and National League of Nursing. (2021).  Forecast for the Future: Technology Trends in Nursing Education. ///D:/OLC%20Abstract/report-dean-survey%20technology.pdf