A Mixed Methods Study Comparing Nursing Preceptored Clinical Learning Experiences and Nursing Simulation Clinical Learning Experiences of Nursing Students in a Midwest Community College

Among schools of nursing nationwide, the competition for clinical sites, and insufficient numbers of nurse preceptors led nursing schools to turn away thousands of qualified applicants. Due to a shortage of clinical sites, shortage of nurse preceptors, and an increase in simulation technology, nursing schools used simulation clinical in place of traditional clinical experiences. Much of the literature supported using simulation as a replacement for traditional clinical hours. The literature discussed a gap in transition to practice from student nurse to professional nurse and pointed to safety issues as the highest concern in practice settings. One Midwest community college faced the challenge of finding qualified nurse preceptors for senior nursing students to participate in traditional preceptored clinical experiences. The community college operated nursing schools on two campuses. One campus replaced the traditional preceptored clinical with simulation clinical experiences. The second campus continued the preceptored clinical experience. The researcher proposed a mixed-methods study to compare the nursing preceptored clinical learning experience to the nursing simulation clinical learning experience. First, the researcher utilized standardized nursing pre- and post-test exams, second the researcher utilized an andragogical assessment instrument seeking insights into students' beliefs, feelings, and behaviors during their participation in the clinical practicum experience. And, third the researcher interviewed students to explore issues, to examine use of andragogical principles, and to gain students' perspectives of the two types of clinical practicums. The data results from the standardized test showed a bias due to a difference in post-test policies on the two college campuses. The test data could not be used to compare the two practicum experiences, but proved useful for analysis of individual student data and standardized test policy changes. The assessment instrument revealed the simulation clinical experience scored higher on experience-based learning techniques/ learner centered learning processes. The key data from the student interviews revealed the simulation clinical experience provided students an opportunity to make clinical decisions on their own without the safety net of a preceptor or faculty. Recommendations within the study addressed implementing simulation clinical learning experiences to replace preceptored clinical learning experiences for senior nursing students' final clinical practicum.