Track: Research: study or review follows a systematic process (If human subjects are involved, prior approval from review board is required.)
Simulation to clinical replacement ratios: An evaluation of the research
Introduction: Simulation is widely used as a replacement for traditional clinical in prelicensure nursing programs. Some state boards of nursing have begun regulating both the substitution percentage and the ratio of simulation-to-clinical replacement hours in prelicensure nursing programs.
Purpose: The purpose of this presentation is to discuss the evidence related to simulation-to-clinical replacement ratios found in studies conducted over the last 5 years. THEORETICAL FRAMEWORKS: The theoretical frameworks utilized in the studies included Miller’s Pyramid of Competence and the National League for Nursing (NLN)/Jeffries Simulation Framework.
Methods: Panel members will discuss their individual research on the substitution of clinical with simulation in prelicensure nursing programs. Breymier et al. (2015) surveyed 1,400 prelicensure programs to determine the prevalent simulation-to-clinical ratio. Sullivan et al. (2019) compared the type, time-spent, number, and level of educational activity in the clinical versus simulation setting in 42 prelicensure nursing students. Zyniewicz (2019) compared the ATI Adult Medical Surgical Proctored Assessment Scores and NCLEX-RN scores of 878 prelicensure nursing students that experienced either a 1:1 or 1:2 simulation-to-clinical replacement ratio in their senior adult medical-surgical course.
Results: Zyniewicz found no significant difference existed between the 1:1 and the 1:2 group in the mean ATI scores. No relationship existed between simulation-to-clinical replacement ratio and NCLEX-RN pass rate.
Conclusion: Evidence indicates most prelicensure nursing programs are utilizing a 1:1 simulation-to clinical replacement ratio and show comparable results when using a 1:1 or 1:2 ratio. The evidence also indicates simulation is a more efficient educational method when compared to clinical.
Describe the different ratios of simulation-to-traditional clinical replacement used in prelicensure nursing programs and relevant State Board of Nursing simulation regulations
Evaluate the current evidence that supports using a 1:2 (i.e., 1 hour of simulation to 2 hours of traditional clinical) replacement ratio in prelicensure nursing programs
Compare the efficiency of meeting learning outcomes and the density of learning in simulation versus the clinical setting based on current research