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The mysterious case of the missing clinical hours

April 22, 2022 | 3 min read

By Elsevier Connect contributors

Nurse checking intravenous line

Due to the pandemic, nursing shortage, and more, your new graduate nurses have massive gaps in their clinical hours.

Your new graduate nurses have massive gaps in their clinical hours. The pandemic, nursing shortage, and other challenges mean that they’ve missed out on significant chunks of learning and clinical experience.

You can’t roll back the clock, but it’s essential that you find ways to fill those gaps by offering a safe, virtual environment that lets them practice interviewing, examining, and taking care of patients in a realistic setting.

There’s a lot at stake—for both your new nurses and your hospital: one study found that 40% of new graduate nurses reported making medication errors [1]. And 50% of new graduate nurses said they would not recognize life-threatening complications [2].

The case for simulation

Amid such a variety of persistent challenges, many new nurse orientation or residency programs have begun to substitute in-person education with some form of simulation, focusing on high-fidelity virtual patient versions as they provide a high level of interactivity and realism for the learner [3].

Over the years, research has further supported the effectiveness of this approach:

  • Simulation allows learners to strengthen skills; develop clinical reasoning abilities; and to become competent in caring for patients/families in a safe environment [4].

  • Other studies have found that learners get more engaged with virtual patient scenarios and value having a safe environment to practice reasoning skills before seeing real patients in a clinical setting [5].

  • And recent studies found that online, virtual simulation experiences can lead to increases in learners’ knowledge and self-confidence in a similar fashion to face-to-face traditional simulations [6].

Shadow Health from Elsevier: An array of realistic patients at the new nurses’ fingertips

Shadow Health educates novice nurses in a cutting-edge simulated environment populated by a collection of multi-dimensional, realistic patients.

They’ll strengthen their communication skills with our patented conversation engine that allows learners to communicate with virtual patients naturally – free from prompted dialogue. Also, your nurse leaders will have the ability to accurately track and measure new nurses’ clinical readiness with clear metrics and performance analytics to offer the right support.

Request a demo nowopens in new tab/window and learn how you can effectively replace your nurses’ lost clinical hours.


  1. del Bueno D., (2005), A Crisis in Critical Thinkingopens in new tab/window, Nursing Education Perspectives, 26(5), 278-82.

  2. Spector, N., Blegen, M.A., Silvestre, J., Barnsteiner, J., Lynn, M.R., Ulrich, B., Fogg, L., & Alexander, M. (2015). Transition to practice study in hospital settingsopens in new tab/window. Journal of Nursing Regulation, 5(4), 24-38.

  3. Meakim, C., Boese, T., Decker, S., Franklin, A. E., Gloe, D., Lioce, L., & Borum, J. C. (2013). Standards of best practice: Simulation standard I: Terminologyopens in new tab/window. Clinical Simulation in Nursing, 9(6) (Supplement), S3-S11.

  4. Aebersold, M., (2018). Simulation-based learning: No longer a novelty in undergraduate educationopens in new tab/window. OJIN: The Online Journal of Issues in Nursing, 23(2).

  5. De Gagne, J.C., Oh, J., Kang, J., Vorderstrasse, A.A., & Johnson, C.M. (2013). Virtual worlds in nursing education: A synthesis of the literatureopens in new tab/window. Journal of Nursing Education, 52(7), 391-400. 


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Elsevier Connect contributors