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NLN Survey on Clinical Education Points to Barriers to Effective Clinical Education in Pre-licensure Nursing Programs and Need for Continued Research

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Survey Results Will Be Focus of Plenary Session at the 2009 NLN Education Summit in Philadelphia


New York, NY – August 28, 2009 – Lack of quality sites, lack of faculty qualified to teach on-site, and restrictions of the number of students or other limitations imposed by clinical agencies conspire to create barriers to effective clinical education in pre-licensure nursing programs. That is a key finding of the NLNs just completed survey on clinical education of 2,386 nurse educators, representing all types of RN nursing programs in all 50 United States. Results reflect the views of many leading nurse educators, who contend that advancements in clinical education are essential to easing the nationwide nursing shortage, noted Pamela Ironside, PhD, RN, FAAN, ANEF, the surveys lead investigator.

"Although faculty reported employing a wide range of strategies to address these barriers [identified by the survey], most of these strategies were perceived to be only minimally or somewhat effective," said Dr. Ironside.

"Clinical experiences are a critical part of pre-licensure nursing education and are widely considered to be vital to the preparation of a competent nurse workforce, ready and able to provide safe, quality care," said NLN CEO Beverly Malone, PhD, RN, FAAN. "For this reason, we deemed it a priority to investigate faculty perceptions and the realities they encounter in teaching and supervising students in clinical settings. We are gratified that so many nurse educators chose to respond, providing invaluable feedback and a foundation for continuing evidence-based scholarship in the field."

In addition to the challenges cited, the survey also revealed faculty frustrations with the time-consuming nature of supervising students skill performance in clinical settings. Faculty reported they use preceptors, staff nurses, teaching assistants, and other students to assist with skill supervision, strategies commonly utilized to free up their time to focus on helping students develop higher-level cognitive skills needed for practice, another time-consuming aspect of teaching in clinical settings. Yet, in general, these strategies, too, were considered only somewhat effective in addressing the challenges of either supervising skills or fostering higher level thinking, Dr. Ironside said.

"Clearly more research is needed," Dr. Ironside concluded. "While many innovative approaches to clinical education are promising, the need to advance the science of nursing education for clinical experiences is imperative to assure future pedagogical decisions are evidence based and that our educational practices keep pace with the rapidly changing field in which students learn."

The survey will be the focus of a plenary session on Thursday, September 24 at the 2009 NLN Education Summit in Philadelphia. Dr. Ironside will participate in the discussion of a panel drawn from the Nursing Education Advisory Council (NEAC) of strategies for improving clinical competencies across the spectrum in nursing education. Findings from the survey are also included in a chapter she co-authored with the surveys co-investigator, Angela M. McNelis, PhD, RN in a forthcoming book, Clinical Nursing Education: Current Reflections, edited by Nell Ard, PhD, RN, CNE, ANEF and Theresa M. Valiga, EdD, RN, FAAN, ANEF (NLN, 2009). The book will be available at the Summit as well.

Both Dr. Ironside and Dr. McNelis are associate professors at Indiana University School of Nursing in Indianapolis; Dr. Ironside is also director there of the Center for Nursing Education Research. Dr. McNelis heads up the schools Office of Undergraduate Special Programs.

Editors and reporters: To arrange an interview with Dr. Ironside and/or Dr. McNelis, please contact Karen R. Klestzick, chief communications officer, at 212-812-0376 or


Dedicated to excellence in nursing, the National League for Nursing is the premier organization for nurse faculty and leaders in nursing education. The NLN offers faculty development, networking opportunities, testing services, nursing research grants, and public policy initiatives to its 30,000 individual and 1,200 institutional members who represent all types of nursing education programs.