Substitution of Clinical Experience With Simulation in Prelicensure Nursing Programs: A National Survey in the United States

Breymier, Tonya; Rutherford-Hemming, Tonya; Horsley, Trisha Leann; Atz, Teresa; Smith, Lisa; Badowski, Donna; Connor, Kelley

doi:10.1016/j.ecns.2015.09.004

Cited by 44 publications

(20 citation statements)

References 7 publications

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“…Most of the studies evaluated specific curricula components being taught over short placement equivalent periods, with the exception of Hayden et al () where a “whole of programme” simulation replacement was evaluated over a two‐year period. Only one study reported an explicit ratio of substitution where one hour of the simulation was equated to two hours of clinical placement (Curl et al, ), and the national survey of academics in the USA (Breymier et al, ) found that the most frequently utilised ratio was 1:1 hr. While there is currently no evidence to support either approach, it would seem reasonable to propose that simulation (which can be both controlled and time compressed) would attract more than parity in terms of clinical practice hours.…”

Section: Discussionmentioning

confidence: 99%

“…Full-text articles were read initially by one author who tabulated the study characteristics. Because the focus of the review was on substitution of clinical practice with simulation, simulation studies (n=4) (Breymier et al, 2015;Pai, 2016;Roh, Lim, & Issenberg, 2014;Veltri, Rowe, Bell, Arwood, & Kindler, 2014) which did not address direct substitution were excluded ( Figure 1).…”

Section: Selection Processmentioning

confidence: 99%

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Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education: A systematic review

Bogossian

Cant

Ballard

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To extract, examine and report the highest available levels of evidence from healthcare disciplines in the use of simulation‐based education as substitution for clinical placement in prelicensure programmes. Background Simulation is widely employed across prelicensure health professional education to create safe, realistic clinical learning experiences for students. Whether simulation can be employed to substitute for actual clinical placement, and if so, in what proportion, replacement ratio and duration, is unclear. Methods A systematic review and quality appraisal of primary studies related to prelicensure students in all health disciplines, guided by the PRISMA checklist. Results Ten primary studies were included, representing 2,370 students from three health disciplines in four countries. Nine studies were experimental and quasi‐experimental and methodological quality was assessed as moderate to high with good to very good inter‐rater agreement. Direct substitution of simulation for clinical practice ranged from 5% to 50%. With one exception, replacement ratios were 1:1 and duration of replacement ranged from 21 hr–2 years. Levels of evaluation included measures of reaction, knowledge and behaviour transfer; no negative outcomes were reported. We appraised practicalities for design of substitution, design limitations and knowledge transfer to accreditation standards for prelicensure programmes. Conclusions This review synthesised highest levels and quality of available evidence for substitution of simulation for clinical placement in health professional education. Included studies were heterogenous in simulation interventions (proportion, ratio and duration) and in the evaluation of outcomes. Future studies should incorporate standardised simulation curricula, widen the health professions represented and strengthen experimental designs. Relevance to clinical practice Current evidence for clinical educational preparation does not appear to be translated into programme accreditation standards governing clinical practice experience for prelicensure programmes in relevant jurisdictions. Overall, a stronger evidence base is necessary to inform future curricula and policy development, to strengthen clinical practice in health.

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Section: Discussionmentioning

confidence: 99%

Section: Selection Processmentioning

confidence: 99%

Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education: A systematic review

Bogossian

Cant

Ballard

et al. 2019

Journal of Clinical Nursing

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“…A national survey of 432 academics in US nursing schools reported that three-quarters of the schools were substituting SBE for clinical hours (Breymier et al, 2015). In the UK, the Nursing and Midwifery Council (2010) ruled that up to 300 hours (13%) of the required 2300 hours of clinical practice can be replaced with simulation-based practice (p. 9).…”

Section: Introductionmentioning

confidence: 99%

Do Simulation Studies Measure up? A Simulation Study Quality Review

Cant

Levett‐Jones

James

2018

Clinical Simulation in Nursing

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“…Education with simulation gives the learner access to a wide variety of clinical scenarios, the opportunity to practise and allows timely feedback on clinical capability (Laschinger et al, 2008). This perceived value of learning by simulation has led to its acceptance as valid learning strategy gaining acceptance by accrediting bodies and professional organizations (Breymier et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Manikin Simulation in Mental Health Nursing Education: An Integrative Review

Kunst

Mitchell

Johnston

2016

Clinical Simulation in Nursing

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Mental health is a significant issue worldwide, and the contemporary nursing graduate needs to be skilled in all aspects of patient care, including proficiency in physical and psychosocial health care, and competency in assessing and managing mental health challenges. Developing clinical ability in mental health care can be difficult without adequate exposure to mental health care situations. While simulation has gained increasing popularity in nurse education in recent years, there has been limited investigation of the effect of manikin simulation in the development of knowledge and confidence in mental health care in undergraduate nurse education. To investigate this further, a review of the published literature from 2000 to 2016 was undertaken, which found nine articles that met criteria for inclusion in this review. Simulation was found to increase learner confidence, satisfaction with learning, and self-efficacy in knowledge and communication in mental health care scenarios through the opportunity to rehearse complex care situations. While there are limitations in the available research, simulation holds potential to enhance undergraduate nurse education in mental health care.

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Substitution of Clinical Experience With Simulation in Prelicensure Nursing Programs: A National Survey in the United States

Cited by 44 publications

References 7 publications

Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education: A systematic review

Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education: A systematic review

Do Simulation Studies Measure up? A Simulation Study Quality Review

Manikin Simulation in Mental Health Nursing Education: An Integrative Review

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