Clinical instruction and student outcomes

Despite changes that have taken place in health care systems, few changes have occurred in undergraduate clinical nursing education. High patient acuity and great needs for skilled technical nursing care make demands for clinical competence among newly graduated nurses across the United States an on-going concern (Matsumura, Callister, Palmer, Cox, & Larsen, 2004; Orsolini-Hain & Malone, 2007). This integrated literature review explores factors that influence student clinical outcomes and examines ways current clinical nursing education best supports student learning outcomes. A literature search was conducted using the terms nursing education and clinical education using the CINAHL database. Fourteen articles that met the inclusion criteria and focused on student outcomes were included in this review. Findings indicated that wise use of skills laboratories, consistent clinical placement, supportive clinical learning environments, and effective coaching by clinical educators positively affect student outcomes. Findings indicate that more vigorous research is needed to determine optimal faculty-student ratios, clinical hours, and clinical sequence in undergraduate nursing education.