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Bay Area and Los Angeles
Nursing Resource Centers
Clinical Placement Trends in California Nursing Schools
The California Board of Registered Nursing collects information on clinical placement experiences and trends as part of their annual pre licensure school report with the most current academic year report recently completed. (Annual BRN 2013-2014 School Report)
Competition for clinical space due to the number of nursing students in the region continues to be the most frequently reported reason that clinical placement requests are declined as reported by 46.9% of schools.
Various reasons reported in further detail by schools that impact the availability of clinical space exhibit the complexity of the processes and systems involved in providing sufficient aggregate access to clinical education in for each region:
- Insufficient number of qualified nursing staff (45.7%)
- School displaced by another program (43.2%)
- Decrease in patient census (28.4%)
- Facility closure or partial closure (25.9%)
- Organizational change or operational event such as implementation of EHR (22.2%) or regulatory site visit (21.0%)
Despite these challenges, the availability of clinical placements have continued to show consistent improvement in each of the past 4 academic years with 71.4% of schools reporting a lack of placements in 2010-2011, now down to 46.9% in 2013-2014.
Factors likely to contribute to this level of improvement and success in securing needed clinical placement capacity include:
- Stabilization of the number of students enrolled in pre licensure nursing programs compared to the prior 5 years of rapid growth
- Simulation methods have been adopted by more schools in the past six years with 68 nursing schools in 2007-2008 and 120 schools reporting use of simulation in 2013-2014. A portion of simulation time is used to provide clinical experiences not otherwise available (81.0%), or to make up for needed clinical time (63.5%). Evidence that simulation has supported increased student enrollment capacity is reported by 13.5% of schools.
- Diversification in the type of clinical settings and expansion of the number of affiliated practice partners is consistent with programs providing a broader range of student experiences in progressive nursing roles.
- Effective decision making in addressing challenges and change in dynamic practice settings involving shared planning, flexibility, and evaluating alternative options to assure patient safety while meeting core student learning needs.
The importance of developing effective academic practice partnerships is essential to clinical placement planning. While hard to measure, certainly utilizing standardized systems among academic institutions with healthcare organizations across a region, and extending leadership commitment and contributions of clinical placement coordinators and leaders working together are successful strategies to achieving shared results.
A copy of the complete BRN Annual School Report can be found on the California BRN website BRN 2013-14 Annual School Report (pg 13-18), with separate regional reports Bay Area Region (pg 11-16) and Los Angeles Region (pg 10-14). | 
