Debate: Clinical placement hours

That this meeting of Congress urges RCN Council to demand that the NMC reduces student nurses' clinical placement hours in line with international comparators.

The current requirement of 2,300 hours spent in clinical placement as part of pre-registration nursing training, set by the NMC, has no research evidence base to support it. Whilst the curriculum varies from university to university, the clinical hours are consistent as stipulated by the NMC, despite accepting Australian trained registered nurses who are currently required to complete only 1,000 hours of clinical practice for qualification. Is it not the quality of the clinical placements rather than the quantity of clinical hours that make a competent nurse?

A reduction of 300 placement hours across the three years equates to no more than one and a half hours per week. This will provide additional clinical placement places at no extra cost and is a real opportunity for a cost neutral increase in student nursing placements.

Placement hours may be subject to consultation as part of the wider NMC review of nursing education standards. The consultation has involved the RCN across the UK and is due to be released in June, with the new standards implemented in autumn 2019.

Placement hours are mandated by EU Directive and after the UK exits the European Union, there will be the opportunity to repeal directives in UK law. This could include parts or all of the EU directive on the Recognition of Professional Qualifications which contains the provision for a minimum of 4,600 hours required in the training of general care nurses (split equally between theoretical and clinical).

Most EU member states stipulate 4,600 hours in total, but differences are apparent in the percentage allocated to clinical placement as mandated by EU Directive 2013/55/EU. Australia, New Zealand and the USA have far fewer hours allocated both in terms of total hours and hours designated for placement.

Given current issues regarding limited placement allocations, reducing the required hours would provide more student placements whilst not increasing the strain on mentorship requirements.

While most placements appear to be offered in hospital/ward settings, there is limited reporting in literature about the provision of placements across community, primary and mental health settings.

In Scotland, the importance of students gaining experiences across a range of practice placement settings beyond the NHS is widely recognised. Currently the focus is on widening access to a range of placement opportunities and to ensure they are properly supported. In Wales, many universities utilise practical laboratories for student skill acquisition.

The Northern Ireland Practice and Education Council for Nursing and Midwifery led the development of a regional evaluation framework, to assist HSC Trusts to demonstrate the effectiveness of the infrastructure, to support learning and assessment in practice. In addition, data collection tools were developed and are used to facilitate the evaluation processes. The project included collaboration with the five HSC Trusts and other key stakeholders, including higher education Institutions in Northern Ireland who provide NMC-regulated education programmes.

The benefits of longer placements have been identified as providing students with a sense of belonging and being part of a team greater scope for experiencing a mutually beneficial student-mentor relationship, leading to improved clinical learning and higher levels of student satisfaction.

There is also emerging evidence supporting the use of high fidelity simulation to complement clinical placement experience as a way of preparing students for practice together with the potential to reduce the need for prolonged exposure to clinical placements.

Clinical placement hours, was a topic that clearly divided the hall at Congress today. Delegates clearly and strongly debated the topic, bringing much experience with them.

Hannah O’Farrell, proposer, and a student nurse at Liverpool University told Congress that student nurses wanted quality learning so they would feel prepared for their nursing career. She argued that a reduction in clinical placement hours would improve the quality of learning, reducing the strain on mentors. Graham Revell agreed that a reduction in hours would offer student nurses the time to reflect and consolidate their learning. He called for Congress to get it right for the next generation of nurses.

Gail Brookes however held a different view as a mentor. She argued that the students she’s mentored say they want more clinical placement hours as they feel they get the majority of their learning on the job.

In agreement was Loretta Johnson, Northern Branch member. She, as a newly qualified nurse, was confused why anyone would want less time in placement. Nurses need the chance to learn the skills and the chance to practice. She asked Congress, “It’s not quantity versus quality – surely students should be able to expect both from their placements?”

Charlene Lobo, a member of the Education Forum highlighted that it was a matter of looking at the model of practice education, not the hours, and we should be addressing both the quality of learning as well as capacity issues.

Maureen Dolan, Agenda Committee Member, said as a mature student she valued clinical placement. She said: “You can’t learn empathy out of a book.”

A card vote showed overwhelmingly that the majority of those in the hall were against the resolution.

Vote: rejected

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14 May 2017 11:15 - 11:45

Location To Be Confirmed


Resolution, submitted by the RCN Greater Liverpool & Knowsley Branch

Page last updated - 05/09/2018