Substitution of Clinical Experience With Simulation in Prelicensure Nursing Programs: A National Survey in the United States

•Simulation is being substituted for supervised clinical experiences.•The ratio of simulation hours to supervised clinical hours varies.•Supervised clinical has a higher faculty-to-student ratio.•Confusion exist regarding percent of simulation substituted and the ratio used.

BackgroundSome states allow simulation substitution of supervised clinical instruction. However, a review of the literature found that a standard substitution ratio for simulation hours to supervised clinical hours does not exist among prelicensure nursing programs.MethodA descriptive survey was sent to more than 1,400 prelicensure schools of nursing.ResultsSchools of nursing reported various substitution ratios demonstrating ambiguity between institutions.ConclusionThis study provided an initial view of current practices related to simulation as a substitution for supervised clinical experiences.