Simulation and Clinical Competency in Undergraduate Nursing Programs: A Multisite Prospective Study.

Background: In prelicensure nursing education, there is a need to better understand the roles that simulation and traditional clinical instruction play in the development of clinical competence. Method: A prospective cohort study was conducted across four prelicensure nursing programs. Four undergraduate nursing programs tested an intervention cohort with a redesign of the use of simulation, a redistribution of clinical hours, and an implementation of these new educational approaches into simulation experiences. Results: The final sample consisted of 271 control students and 315 intervention students who were assessed at the end of five clinical courses. There was no significant difference between the control and intervention groups on licensure examination pass rates and no uniform differences in clinical competency. Conclusion: These findings suggest that the redistribution of clinical hours from traditional to simulation did not affect clinical competency or licensure examination results. Such redistributions have the potential to yield comparable results.