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Simulation Experience and Clinical Education in Nursing Education Programs

On October 17, 2023, the New York State Board of Regents adopted by emergency action, amendments to Section 52.12 of Commissioner’s regulations that establish a definition and core requirements for clinical education across all licensure-qualifying nursing education programs and provide for an expedited process for institutions seeking a curriculum change to implement one-third of their existing clinical education hours through simulation experience.

This webpage provides information and resources to assist institutions in meeting the requirements of Section 52.12 and in applying for a curriculum change to implement up to one-third of a programs existing clinical education hours through simulation experience.

Resources

Memo regarding changes to Nursing Education requirements including Simulation Experience

Application to Request a Program Change to Implement New Simulation Experience in Nursing Programs

Verification Form – Clinical Education in Nursing Education Programs

Frequently Asked Questions

Below are answers to frequently asked questions. The information is a work in progress, and new questions and answers will be added on an ongoing basis as the needed. Any specific questions can be sent to  opnurs@nysed.gov.

Definitions
1. What is the definition of clinical education?

Commissioner’s regulation 52.12(a)(1) defines clinical education or clinical training as planned practice-based learning experiences designed for the purpose of developing proficiency in the provision of safe and effective patient care, specific to the role and level of licensure or certification that the program leads to and that shall adhere to the standards of section 52.12. Simulated experience which meets the requirements, and within the limits of, section 52.12 is a form of clinical education or clinical training. (10.31.2023).

2. What is the definition of simulation experience?

Commissioner’s regulation 52.12(a)(2) defines simulation experience as planned learning experiences that represent actual or potential situations in clinical nursing practice that shall adhere to the standards of section 52.12. Such learning experiences allow participants to develop or enhance clinical nursing competencies and provide an opportunity to analyze and respond to realistic situations in a simulated environment. (10.26.2023).

 

Simulation Experiences & Technology
3.  What types of technology can be used to deliver simulation experience acceptable to the Department for the purposes of meeting clinical education requirements?

The statutory and regulatory definitions of simulation experience are intended to allow programs to take advantage of technologies in innovative ways. Because the terms for technology-mediated simulation experience (e.g., virtual simulation, virtual reality, online simulation, etc.), are not defined in law or regulation and do not have common definitions, it is their specific uses that determine whether and how they can be used in support of simulation experience acceptable to the Department. It is the responsibility of the program to describe, to the satisfaction of the Department, their uses and how they meet the statutory and regulatory standards for meeting the clinical education requirement. (10.31.2023).

4.  Must a program utilize high-tech mannequins in order to implement simulation experience acceptable to the Department?

No. While programs are not precluded from using high-tech mannequins or other innovative technologies for certain simulation experiences, they are not required. In general, equipment and technologies should be similar or the same as those technologies actually in use in the clinical nursing practice the simulation experience is designed to replicate, and the technologies used should be appropriate to the learning activity and specific learning objectives. (10.31.2023)

5.  Can a registered program use virtual simulation, virtual reality, or other technology-mediated learning experiences to meet the clinical education requirement?

Possibly, depending on their actual uses. If the program’s uses of virtual simulation, virtual reality, or other technology-mediated learning in their totality meet the statutory definition and conditions for simulation experience, then it would be acceptable for a program to offer up to one-third of its clinical education hours through those experiences upon approval of the Department. It is important to note that acceptable simulation experience requires active student engagement and guided skills-practice with instructional feedback. As such teacherless, online-only, self-study is not acceptable simulation experience for the purposes of meeting clinical education requirements.

If the program’s uses of virtual simulation, virtual reality, or other technology-mediated learning experiences do not meet the statutory definition and conditions of simulation experience, this would not preclude a program from using them for clinical learning, however those experiences would not in themselves be sufficient to replace the number of in-person clinical education hours the program was approved for by up to one-third. (10.31.2023).

6. Do pre-briefing and debriefing activities that are subparts of a planned simulation experience count toward the hours of simulation experience acceptable to the Department?

Yes. Pre-briefing and debriefing activities that are a part of a simulation experience count toward the hours of simulation experience acceptable to the Department. (10.31.2023).

 

Application, Compliance, & Timelines
7.  When can a registered program submit an application to request a program change to offer up to one-third of its clinical education hours through simulation experience?

Institutions may submit an application beginning October 25, 2023. The Department will begin to review applications as they are received, however, no approvals can be granted prior to the effective date of the law, November 11, 2023. (10.31.2023).

8. Must a registered program that is already using a form of simulation experience submit an application to request a program change?

No. A request for a program change is only required when the program is seeking to replace up to one-third of the currently approved clinical education hours with simulation experience acceptable to the Department. (10.31.2023).

9. Can registered programs seek a program change to utilize up to one-third simulation experience to meet clinical education hours only as back-up plan?

No. Both clinical education and simulation experience require careful planning and institutions are expected to offer registered programs to students in the manner in which they are approved by the Department. This is an important student protection. If the need arises to request a program change to implement up to one-third of clinical education hours through simulation experience, Commissioner’s regulation 52.12(d)(3) provides an expedited process for seeking that change. (10.31.2023)

 

Population-Specific Patient-Care Experience Requirements
10. By what date must a registered PN or RN education program verify to the Department that its clinical education program meets the requirements for in-person patient-care experiences across the four patient populations required in regulation?

Programs registered on or before November 11, 2023, have until November 11, 2024, to demonstrate they meet the population and patient-care experience requirements. This is done through submission of the Verification Form. At the time of verification, programs will also document and verify the total dedicated hours clinical education, including the dedicated hours of simulation experience and traditional/non-simulated clinical education in accordance with definitions set forth in regulation. New programs registered on or after November 11, 2023, must meet the in-person patient-care experience requirements as a condition of registration. (10.31.2023).

11. What can programs do if there is difficulty finding a clinical placement for an in-person experience with a specific patient population?

On or after November 11, 2024, the only required setting for in-person patient care experience is the acute care setting for adult patients. For the other required in-person patient care experiences, there is flexibility as to where the patient care experiences can be obtained. In-person patient care experiences with the other populations may be obtained in a variety of nontraditional settings where students can have meaningful exposures to these patient populations while functioning in the role of a nurse. Some examples can be community settings, homeless shelters, local clinics, etc. Additionally, the regulation is flexible in that it does not have specific hour requirements for each population only that the program ensures that each student have adequate experiences in enough breadth and depth to meet the program learning outcomes and demonstrate preparedness for entry-level practice. (10.31.2023).