Replacing Traditional Clinical Rotations with
Nursing Simulation

A groundbreaking study done in the USA provided empirical evidence that substituting high-quality simulation-based experiences for up to 50% of traditional clinical hours was just as effective in providing learners with requisite knowledge and skills students would need upon graduation (Hayden, Keegan, Kardong-Edgren, & Smiley, 2014). In simulated based learning, learners work on complex problems in controlled environments that mimic real word scenarios (Lateef, 2010). Simulation-based education (SBE) is used in healthcare to facilitate students’ acquisition knowledge and skills through working with ‘ex-vivo’ patients in controlled safe learning environments without compromising the safety of real patients (Alinier & Oriot, 2022; Alinier & Platt, 2014; Aqel & Ahmad, 2014; Shin, Park & Kim, 2015).
Our project replaced 25% of clinical hours in medicine and surgery with simulations in a practical nursing program. A total of 22 students and their 3 instructors participated in this project. Evidence based approach was used throughout the design and implementation of the project to make sure that learning outcomes were met without compromising the quality of students’ learning. We documented the process of instructor training, curriculum development, implementation and feedback from students, staff and instructors. The project's main purpose was to explore ways of addressing three important issues:

1. Shortage of nurses and increase in enrolment,
2. Scarcity of clinical placements and
3. To address disparities of student experiences.

The modalities of simulation included medium to high-fidelity manikins (16%), standardized patients (SPs) (6%) and virtual reality (3%). EDI learning opportunities were woven into relevant scenarios. Students and instructor feedback shows that learners gained confidence, practiced skills they would not have encountered in traditional clinical, learnt the importance of critical reflective practice, collaboration, problem solving skills and resolving issues related to equity diversity and inclusion. The learnings from this project are being used to scale up the simulated based learning by replacing 50% of traditional clinical hours in continuing care for the internationally trained nurses that is currently running. The following academic year we will take these learnings and scale to over 400 students per semester at 25% replacement. Our presentation will focus on the disruption of traditional clinical students’ experiences and the relearning process of new pedagogical strategies in nurse education. We will outline the pre-implementation activities, implementation process, the outcomes of the project and what we learned as discussion the way forward.