The Influence of Clinical Placements on Final Grades in an Undergraduate Nursing Course: A Comparative Study

Purpose:

The purpose of this presentation is to report the effects on nursing student academic performance of deferred clinical placements, outside scheduled teaching sessions. Increasing nursing student enrolments in undergraduate pre-registration courses, clinical workforce pressures, and changes to health service structures have resulted in more students attending clinical placements.

Methods:

Within a Bachelor of Nursing (BN) degree six subjects involving a graded clinical placement component were identified and included in the study. In all subjects, a proportion of enrolled students were routinely allocated a deferred clinical placement. Following ethics approval all student results from the six identified subjects offered in one calendar year were extracted from existing university data bases. These results included overall final grades and associated components, including theoretical grades, Objective Simulated Clinical Assessment (OSCA) results and clinical practicum evaluations. Once collected, all data were de-identified. In all, over 5500 individual student results from across the 3 years of the BN course were included in the data-set. Comparative analysis was undertaken to compare individual academic performance against the timing of clinical practicum.

Results:

Within the overall data-set more than 40% of all students were allocated a deferred clinical in at least one subject. The overwhelming majority of deferred clinical placements occurred immediately after finalisation of all theoretical and OSCA results. Overall, students who completed their clinical practicum as scheduled during teaching sessions achieved higher academic results than those who were allocated a deferred clinical placement. For those students who experienced a deferred clinical placement for one of their two clinical subjects during a single teaching session, academic performance was indicative of the timing of clinical placement.

Conclusion:

The results from this study reinforce the importance of clinical placement for undergraduate nursing students. Being able to integrate theoretical knowledge and an actual clinical practice context, within a nursing course, has been reflected in the academic performance of nursing students across a 3 year pre-registration course. Results from this study support the importance of praxis in the practice based discipline of nursing. It is imperative for providers of undergraduate pre-registration nurse education to ensure students undertake clinical placements when planned in a program of study.