Awarding Credit Hour for Clinical Experiences

Undergraduate Programs

One credit hour for clinical practicum is 48 hours of direct care hours.

Direct Care refers to the nursing care provided to individuals or families that is intended to achieve specific health goals or achieve selected health outcomes. Direct care may be provided in a wide range of settings, including acute and critical care, long-term care, home health, community-based settings, and educational settings (AACN Essentials, 2011). This can include student teaching to a community group, diabetes screenings, or a flu vaccine clinic. A poster presentation based on assessment of community health needs and designed to improve health outcomes does count toward direct care hours. Note: Direct care is not observation. To earn three-hours of clinical credit over one 15-week term the student is required to be at the clinical site: Formula 3 credits x 48 hours = 144 hours for one 15-week term. Preconference, debriefing, and post conference are included in this 144-hour calculation.
The Missouri State Board of Nursing and therefore GSON does not allow ‘orientation to clinical’ to be counted toward the earned clinical hours.
Examples that are NOT direct care include:
1. Poster presentation in a library not based on current assessment or any follow-up evaluation.
2. Skills lab practicing clinical skills
3. Assessment of virtual, simulated, and/or standardized patients
4. Windshield survey without follow-up assessment and use of data to improve population health
Use of simulation lab, with high-fidelity mannequins, and or standardized patients can be counted toward but not replace the entire clinical direct care experience. Skills lab does not count toward the direct care experience. Following Missouri State Board of Nursing’s directive, no more than 25% of total earned clinical hour credits can be completed using high-fidelity mannequins, case-study, role-play, or standardized patient type simulation.
Skills lab is psychomotor focused and is used to teach, demonstrate, give return demonstration and hours of practice to learn the skills of the nursing profession. Hours in the skills lab are calculated 1:1. One credit in the skills lab requires 48 hours in the lab to see, learn, and practice to build skills and confidence to apply the same skills in a direct care clinical setting. Learners can be videotaped practicing the skill to use for review, practice, and improvement. Students are encouraged to attend open lab hours for additional faculty supported practice time.
Use of simulation for clinical hours is based on review of other accredited and leading university BSN nursing education programs. GSON does allow the 2:1 ratio in the actual simulation environment. One hour in the simulation labs can be calculated as two hours of direct care clinical. Simulation activities must follow INACSL Standards of Best Practice:
Simulation. https://www.inacsl.org/inacsl-standards-of-best-practice-simulation/

Simulation designs must be detailed, documented and include learning outcomes and objectives as well as evaluation strategies of each planned scenario/case study. This information must be presented to simulation faculty prior to facilitating the simulation scenario. Pre-briefing and debriefing must be part of the simulation experience.

Course faculty will file with their Program Director: copy of the simulation design completed prior to the class time, analysis of the student evaluations, and comments of strengths and opportunities for improvement.
Missouri State Board of Nursing requires that no more than 20-25% of clinical credit hours may be completed in a simulation lab. We are reminded, nursing is a practice profession and students must have appropriate practice in direct care with patients and families across settings to be safe in practice.

Graduate Programs

The graduate programs of GSON follow the same definition for credit hour for theory/didactic credit as our undergraduate programs. The award of graduate clinical credit hours varies by program and is defined as follows. Refer to program course syllabi and student supplements for additional information on graduate program clinical credit hours.

Adult-Gerontology Acute Care Nurse Practitioner: One (1) clinical credit hour is equivalent to 56 hours.
Adult-Gerontology Primary Care Nurse Practitioner: One (1) clinical credit hour is equivalent to 56 hours.
Nurse Anesthesia: One (1) clinical credit hour is equivalent to 1 day.
Nurse Educator: One (1) clinical credit hour is equivalent to 112 hours.
Health Systems and Population Health Leadership: One (1) clinical credit hour is equivalent to 56 hours.
Doctor of Nursing Practice: One (1) clinical credit hour is equivalent to 100 hrs.

Procedures Relevant to Awarding Credit Hours

All course syllabi at Goldfarb School of Nursing at Barnes Jewish College must identify the total number of credit hours for the course, the number of theory credits (1 credit = 15 hours/term) and the number of clinical credits (1 credit= 48 hours/term for undergraduate). Goldfarb offers three terms annually. Each term is 15 weeks in length.
The definition of credit hour is listed in the college catalog, website, financial aid materials, and student and faculty manuals and supplements.

Course faculty will document the amount of work necessary to earn course credit as part of the orientation to the course in syllabi. For each 1 credit = 1 hour/week x 15 weeks PLUS 2 hours of out-of-class work for each credit hour earned to be used for assignments, readings, study, and class preparation