Student Perceptions, Experiences and Outcomes in Two Studies of Precepted and Traditional Clinical Learning Environments

As health care increases in complexity, clinical learning continues remains a critical issue in nursing education. This session compares the findings from two similar studies undertaken at two Midwestern public universities with comparable curricula, each with a different precepted clinical model. Both studies considered student perceptions of learning facilitation, practice opportunities with skills, and learning outcomes in the related didactic coursework among students in the precepted and traditional model groups. The first study considered a precepted clinical learning model in which students were placed in a single health care system and worked with preceptors from that agency with a consistent faculty member for multiple semesters. In this study students in the precepted model reported more “hands on” practice across many of the skills, and in the first semester of the program, perceived more support and satisfaction with the clinical experience than those in traditional clinical groups.  In the second study, students in dedicated education units (DEU) were compared with students in a hybrid/combination model and a traditional clinical. Like the first study, students in the DEU reported more psychomotor skills opportunities. Student satisfaction was uniformly high across groups.  In both studies, student learning outcomes measured by standardized examinations were compared with no significant differences. Both studies additionally sought qualitative student remarks, which provided a rich context for considering student perceptions of their learning environments. As it is critical to create graduates who have developed the knowledge, thinking skills and psychomotor capacity needed to practice effectively, this session will compare and contrast positive and non-significant findings from these two studies, complementing this analysis with qualitative student perceptions. Conclusions will be drawn regarding advantages of precepted clinical models, and the areas where both innovative and traditional clinical models fall short. Next steps in the study of clinical learning environments will be explored.