Objective: A primary goal in clinical learning is to apply nursing knowledge and skills learned in the classroom to clinical. While benefits to learning in clinical are evident, this experience is not without challenges, which often relate to coordination of the learning experience. The AM/PM model, an innovative clinical learning model, was developed in response to scheduling challenges that impacted learning.Methods: A Bachelor of Science in Nursing program at a state university in the western region of the United States was using a 12-hour biweekly shift schedule for clinical rotations. This schedule negatively impacted learning. Thus, a 6-hour weekly (AM/PM) clinical learning model was developed and implemented to address barriers in clinical learning, using Lewin’s Theory of Change as the theoretical framework and as a guide to achieving the desired change. Standardized examination performance was used as a measure of success to evaluate summative learning.Results: Clinical learning was improved as a result of implementing the AM/PM model. Nursing students had more opportunity to develop critical thinking, clinical judgment, and communication skills. Learning outcomes measured by standardized exam scores increased for the AM/PM groups.Discussion and conclusions: The AM/PM model, in comparison to other traditional clinical models, was successful in providing experiences to support critical thinking, clinical judgment, and improved learning outcomes. Using Lewin’s Theory of Change as a theoretical framework to guide implementation of the AM/PM model supported all key stakeholders in adapting to the change, ultimately supporting nursing student learning.
Multiple researchers have found that 12-hour shifts contribute to fatigue, an insufficient recovery process, decreased job satisfaction, and reduced well-being in working nurses. Unsatisfactory work performance, including increased rates of error, impaired cognition, reduced quality of care and decreased patient safety, increased nurse and patient injuries, and other health problems resulted from 12-hour shifts for practicing nurses (Clendon & Gibbons, 2015;Rhéaume, &
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