Experiential Learning in Nursing Education:

Comparing the Simulation and Clinical Environments

Nancy Sullivan, DNP, RN

Session Overview:
Experiential learning is a major component of nursing school education. Traditional clinical is perceived as the gold standard of experiential learning allowing students to gain the knowledge and skills necessary for safe patient care but, in reality, each student’s experience in clinical is unique.  Learning is impacted by the variability of the clinical setting and patient care needs.  Simulation, an effective strategy in experiential learning, provides a partial remedy to the randomness of traditional clinical by standardizing the learning encounter.  Both forms of clinical learning are important but there is limited evidence comparing the two environments. Researchers across three schools of nursing conducted an observational study of pre-licensure nursing students to compare the type, number and level of activities based on Miller’s pyramid and the amount of time spent in each activity between the traditional clinical and simulation environments. Twenty-one observational experiences were conducted in both environments. Differences were found in the type and numbers of activities and the level of learning experiences as defined by Miller’s Pyramid. In the clinical setting, safety interventions occurred more frequently, whereas physical assessment, teaching, skills, and debriefing occurred more frequently in simulation. Notably, it took less time to complete the same or more activities in simulation.  Also, students spent more time in higher levels of application-based learning in simulation, revealing greater opportunities for critical thinking experiences. Together this suggests a greater intensity and efficiency in simulation, providing evidence toward a 2:1 clinical to simulation ratio as well as evidence towards enhanced learning in simulation.  The goals for this presentation are to discuss the methods and results of the observational study focusing on the implications for both learning environments and discuss the overall implications for experiential learning.


  1. Discuss the study methods utilized for this study ​
  2. Analyze the results from the observational experiences ​
  3. Evaluate the implications for experiential learning in nursing school education