STANDARDS FORCLINICAL NURSING EDUCATIONANDSTANDARDS FORADVANCED PRACTICE NURSECLINICAL EDUCATIONSINGAPORE NURSING BOARD1 | P a g ePrefaceClinical nursing education focuses on developing, refining and applying students’classroom knowledge and skills to manage care as part of an interprofessional team in aclinical setting.Clinical practice placements expose students to practical issues such as technologicalinnovations, unpredictable care transitions, fast-paced environment and … Continue reading “Clinical nursing education focuses on developing | My Assignment Tutor”
STANDARDS FORCLINICAL NURSING EDUCATIONANDSTANDARDS FORADVANCED PRACTICE NURSECLINICAL EDUCATIONSINGAPORE NURSING BOARD1 | P a g ePrefaceClinical nursing education focuses on developing, refining and applying students’classroom knowledge and skills to manage care as part of an interprofessional team in aclinical setting.Clinical practice placements expose students to practical issues such as technologicalinnovations, unpredictable care transitions, fast-paced environment and complex systemissues. Clinical nursing education will allow students to learn from their experiences androle models on the ground to prepare them for entry-level practice in a complex anddiverse healthcare environment.Nursing programs must ensure sufficient clinical placements across a range of practicesettings and across the continuum of care. Placements must be safe, supportive, andconducive for groups of students to practice and to develop their professional roles withindefined scopes of practice.Singapore Nursing Board’s (SNB) Education Committee and Advanced Practice Nurse(APN) Training Committee have reviewed and established standards and measurablecriteria for clinical education. The objective is to ensure that students are provided withsufficient breadth and depth of learning to hone their competencies for entry levelpractice and post-registration preparation. Students will also be exposed to diversepatient population across the life span in various types of settings.Laboratory and simulation experiences provide students with an effective and safeenvironment to learn and apply the cognitive and performance skills needed for actualpractice. Simulation is a valuable element of clinical preparation. Patient careexperiences with actual patients form the most important component of clinical education.Direct patient care clinical experiences provide valuable opportunities for studentlearning not found in other settings.These Standards will complement the Standards for Nursing Education/ Standards forAdvanced Practice Nurse Education and sets the requirements by which SNB accreditsthe clinical areas to facilitate holistic clinical education.RegistrarSingapore Nursing Board1 March 2017Standards for Clinical Nursing Education and Standards for Advanced PracticeNurse Clinical Education2 | P a g eCONTENT PAGE Standards for Clinical Nursing EducationStandard OneCollaboration between Education Institution and ClinicalPlacement Provider4Standard TwoLearning Environment6Standard ThreeClinical Learning7Standard FourRole of Clinical Instructors and Clinical Preceptors8Standard FiveAssessment and Evaluation11Standards for Advanced Practice Nurse Clinical EducationStandard OneCollaboration between Education Institution and ClinicalPlacement Provider13Standard TwoLearning Environment15Standard ThreeClinical Learning16Standard FourRole of Clinical Instructors and Clinical Preceptors17Standard FiveAssessment and Evaluation19Glossary20Acknowledgement21 3 | P a g eSTANDARDS FORCLINICAL NURSING EDUCATION4 | P a g eSTANDARD ONE:COLLABORATION BETWEEN EDUCATION INSTITUTION AND CLINICALPLACEMENT PROVIDERThe Education Institution and Clinical Placement Provider are jointlyaccountable for providing clinical placements that achieve the goals andoutcomes of the nursing education program.Criteria 1.1The Education Institution is responsible to seek out appropriateClinical Placement Provider(s) that meets the clinical education outcomes of their programmes. 1.2The Education Institution has a formal and written agreement with theClinical Placement Provider(s). 1.3 The Education Institution and Clinical Placement Provider areresponsible to ensure and maintain standards of clinical nursingeducation.1.4 The Education Institution and Clinical Placement Provider shall applyto the Singapore Nursing Board (SNB) for accreditation of their clinicalarea(s) for clinical nursing education. 1.5The Clinical Placement Provider shall be responsible to apply for reaccreditation of their clinical area(s) every three (3) to five (5) years. This shall be done at least 6 months before expiry of accreditationperiod. 1.6Both Education Institution and Clinical Placement Provider havepoliciesandproceduresthatincorporatebestpractice/quality assurance statement(s) to support students’ clinical learning.5 | P a g e1.7 The Clinical Placement Provider shall provide a named RegisteredNurse to serve as a Clinical Placement Coordinator to liaise with theEducation institution to facilitate clinical education for nursing students.This Clinical Placement Coordinator has oversight of the clinicalplacement’s schedule and provides resources and support forstudents’ learning in the clinical setting.1.8 The Education Institution shall appoint a named nursing educationstaff member as a Clinical Programme Coordinator. The ClinicalProgramme Coordinator plans, develops and organises clinicaleducation activities to achieve the programme’s learning goals andoutcomes.1.9 The Clinical Programme Coordinator together with the ClinicalPlacement Coordinator shall oversee and co-ordinate the students’overall clinical education in order to achieve their learning outcomes.1.10 The Clinical Placement Provider uses the evaluations of clinicalpracticum experiences to improve the quality of clinical placement.1.11 Clinical Programme Coordinator provides ongoing communication tothe Clinical Placement Provider about any change in nursingcurriculum or assessment methodology and/or clinical grading criteria.This is to ensure compliance to changes made.1.12 The Clinical Placement Provider shall submit to SNB, an AnnualReport (template to be obtained from SNB) to provide an update onthe accredited clinical area’s collaboration with education institutions,learning environment and evaluation of students’ clinical learning. Anyimprovements/ innovations initiated to enhance clinical learning to beincluded.6 | P a g eSTANDARD TWO:LEARNING ENVIRONMENTThe Clinical Placement Provider is responsible for setting up a favourablelearning environment; introduce best practices in clinical education toachieve students’ clinical learning outcomes.Criteria2.1. The Clinical Placement Provider shall assign Clinical Preceptors tosupervise, guide and assess student’s performance.2.2. The student is orientated to the healthcare facility on the first day ofclinical placement.2.3. The Clinical Placement Provider shall support and embrace/promote: i)the provision of a learning environment that facilitates integrationof theory into practice; andnursing practice that adheres to SNB Standards of NursingPractice.ii) 2.4. Students will have access to learning resources such as relevantbooks, journals, e-learning facilities and equipment.2.5. The number of students assigned in each clinical area shall be:i) one student to at least 2 beds for inpatient acute/intermediate/long term care; and ii)two students to 1 client for independent services such as homenursing and counselling service. The number of students assigned to each clinical area shall be determinedcollaboratively by both education institution and clinical practice placementprovider, to achieve optimal learning outcomes for students.7 | P a g eSTANDARD THREE:CLINICAL LEARNINGThe Education Institution and Clinical Placement Provider are accountablefor facilitating students’ clinical learning and outcomes appropriate to theirlevel of competency.Criteria 3.1The student is allocated with an appropriate patient care workload andis able to demonstrate expected levels of competencies and management skills. 3.2The clinical learning practicum shall include:i)setting achievable learning outcomes at the beginning of theclinical placement;opportunities to experience holistic patient care at their level oftraining; andopportunities to demonstrate and be assessed on nursingcompetencies when caring for patients.ii)iii) 3.3The student is given opportunities to:i)ii)set their learning objectives; andreflect on their clinical learning and evaluate whether theirlearning objectives have been achieved. 8 | P a g eSTANDARD FOUR:ROLE OF CLINICAL INSTRUCTORS AND CLINICAL PRECEPTORSThe Education Institution and Clinical Placement Provider are accountablefor allocating Clinical Instructors and Clinical Preceptors to optimisestudents’ learning during clinical practicum.Criteria4.1. The Clinical Instructor is from the Education Institution and/or ClinicalPlacement Provider. He/she provides guidance, supervisionassessment and support for a group of students during their clinicalplacement period.4.2. The Clinical Instructor (CI): i)ensures that the clinical practicum facilitates the achievement ofthe stipulated clinical learning outcomes;ensures that the clinical placement promotes integration oftheory to practice;provides regular feedback to the Clinical Placement Provider toimprove the quality of students’ clinical experiences; andconducts clinical assessment of students.ii)iii)iv) 4.3. The Clinical Instructor is a Registered Nurse/Midwife: i)ii)iii)with minimum 3 years’ clinical experience;has recognized skills in the area of practice;has an interest in teaching & learning and have successfullycompleted a ClinicalInstructor (CI) and/or teaching andassessing course facilitated by healthcare institutions and/or theSpecialist Diploma in Clinical Education; andCIs supervising post-registration specialty nursing courses musthave an Advanced Diploma and/or its equivalent in the area ofrelated practice and have a minimum of 2 years’ experience iniv)the area of specialty. 9 | P a g e4.4. The Clinical Instructor should supervise a realistic number of learners.i) Pre-registration & pre-enrolment nursing students:One CI is to supervise and assess not more than 12 students.Contact time (for supervision, assessment and feedback)between CIs and students (one-on-one and or as a groupdepending on the learning/assessing need) should be at leasttwice a week, with each contact time not less than 30 minutes.ii) Post-registration nursing students:One CI is to supervise and assess not more than 8 students.Contact time with students (one-on-one and or as a groupdepending on the learning/assessing need) should be at leastonce a week, with each contact time not less than 30 minutes.4.5. The student is allocated to a Clinical Preceptor who providesindividualised guidance, supervision, support and assessment forstudent’s learning experience.4.6. The Clinical Preceptor is responsible for: i)ii)supporting and enabling student’s learning;providing appropriate supervision of nursing students that isrelevant to the student’s level of learning; andconducting clinical assessment of students.iii) 4.7. The Clinical Preceptor is a nurse/midwife from the Clinical PlacementProvider i)ii)iii)with minimum 3 years’ clinical experience;has recognized skills in the area of practice; andhas completed a structured and formal preceptorship/clinicalsupervision course. 4.8. Each Clinical Preceptor shall be assigned to a maximum of 2 studentsat any one time.10 | P a g e4.9. The Clinical Preceptors will receive assistance, guidance and supportfrom the Clinical Placement Coordinator and Clinical Instructor inperforming their preceptor roles and responsibilities.11 | P a g eSTANDARD FIVE:ASSESSMENT AND EVALUATIONThe Clinical Instructor and Clinical Preceptor are responsible to performformative and summative assessment of the students and to providefeedback on their clinical performance. Both Clinical Placement Coordinatorand Clinical Programme Coordinator are jointly responsible to ensure thatformative and summative assessments are done and feedback given tostudents.Criteria5.1. Clinical assessments are conducted at: i)mid-point during the placement period with feedback given forimprovements (formative); andthe end of the placement period (summative).ii) 5.2. Specific feedback on students’ performances are given regularly andin a timely manner to reinforce good performances and to encourageand respect students’ efforts.5.3. Clinical Instructors and Clinical Preceptors conduct debriefingsessions to facilitate students’ reflection of their practice andevaluation of their clinical performance.5.4. Clinical Preceptors and Clinical Instructors communicate andcollaborate as a team to facilitate student assessments and evaluatethe effectiveness of the overall clinical education.5.5. The evaluation of the clinical placement is: i)obtained from students and Clinical Preceptors at the completionof each clinical placement;ii)facilitated by the Clinical Instructor in collaboration with theClinical Placement Coordinator to evaluate the effectiveness ofclinical learning; andiii)usedby theClinicalPlacementProvider andEducation Institutions to make improvements to the clinical learningexperience and adopt best practices.12 | P a g eSTANDARDS FORADVANCED PRACTICE NURSECLINICAL EDUCATION13 | P a g eSTANDARD ONE:COLLABORATION BETWEEN EDUCATION INSTITUTION AND CLINICALPLACEMENT PROVIDERThe Education Institution and Clinical Placement Provider are jointlyaccountable for providing clinical placements that achieve the goals andoutcomes of the Advanced Practice Nurse education programme.Criteria1.1 The Education Institution is responsible to seek out appropriate ClinicalPlacement Provider(s) that meets the clinical education outcomes oftheir programmes.1.2 The Education Institution has a formal and written agreement with theClinical Placement Provider(s).1.3 The Education Institution and Clinical Placement Provider areresponsible to ensure and maintain standards of Advanced PracticeNurse clinical education.1.4 Both Education Institution and Clinical Placement Provider havepolicies and procedures that incorporate best practice/qualityassurance statement(s) to support students’ clinical learning.1.5 The Clinical Placement Provider shall provide a named AdvancedPractice Nurse to serve as a Clinical Placement Coordinator to liaisewith the Education institution to facilitate clinical education for nursingstudents. This Clinical Placement Coordinator has oversight of theclinical placement’s schedule and provides resources and support forstudents’ learning in the clinical setting.1.6 The Education Institution shall appoint a named Advanced PracticeNurse who is a staff member as a Clinical Programme Coordinator.The Clinical Programme Coordinator plans, develops and organisesclinical education activities to achieve the programme’s learning goalsand outcomes.14 | P a g e1.7 The Clinical Programme Coordinator together with the ClinicalPlacement Coordinator shall oversee and co-ordinate the students’overall clinical education in order to achieve their learning outcomes.1.8 The Clinical Placement Provider uses the evaluations of clinicalpracticum experiences to improve the quality of clinical placement.1.9 Clinical Programme Coordinator provides ongoing communication tothe Clinical Placement Provider about any change in nursingcurriculum or assessment methodology and/or clinical grading criteria.This is to ensure compliance to changes made.1.10 The Education Institution shall submit to SNB, within (3) months,notice of any significant change in resources or facilities that mayaffect students’ clinical learning.15 | P a g eSTANDARD TWO:LEARNING ENVIRONMENTThe Clinical Placement Provider is responsible in setting up a favourablelearning environment, including best practices in Advanced Practice Nurseclinical education to achieve students’ clinical learning outcomes.Criteria2.1. The Clinical Placement Provider shall assign Preceptors to supervise,guide and assess student’s performance.2.2. The student is orientated to the healthcare facility on the first day ofclinical placement.2.3. The Clinical Placement Provider shall support and embrace/promote:i) the provision of a learning environment that facilitates integrationof theory into practice; andii) advanced practice nursing that adheres to SNB Scope ofPractice for Advanced Practice Nurse.2.4. Students will have access to learning resources such as relevantbooks, journals, e-learning facilities and equipment.2.5. The number of students assigned to each clinical area may bedetermined collaboratively by both education institution and clinicalpractice placement provider, to achieve optimal learning outcomes forstudents.16 | P a g eSTANDARD THREE:CLINICAL LEARNINGThe Education Institution and Clinical Placement Provider are accountablefor facilitating students’ clinical learning and outcomes appropriate to theirlevel of competency.Criteria3.1 The student is allocated with an appropriate patient care workload andis able to demonstrate expected levels of advanced practice nursingcompetencies.3.2 The clinical learning practicum shall include: i)setting achievable learning outcomes at the beginning of theclinical placement;opportunities to experience holistic patient care at their level oftraining or stipulated milestones; andopportunities to demonstrate and be assessed on competenciesat the advanced nursing practice level.ii)iii) 3.3 The student is given opportunities to: i)set their learning objectives; andii)reflect on their clinical learning and evaluate whether theirlearning objectives have been achieved.iii)access to training resources in the clinical areas.iv)haveregularsessionswithpreceptorsforlearningand assessment purpose.17 | P a g eSTANDARD FOUR:ROLE OF CLINICAL INSTRUCTORS AND PRECEPTORSThe Education Institution and Clinical Placement Provider are accountablefor allocating Clinical Instructors and Preceptors to optimise students’learning during clinical practicum.Criteria4.1. The Clinical Instructor is from the Education Institution and/or ClinicalPlacement Provider. He/she provides guidance, supervisionassessment and support for a group of students during their clinicalplacement period.4.2. The Clinical Instructor: i)ensures that the clinical practicum facilitates the achievement ofthe stipulated clinical learning outcomes;ensures that the clinical placement promotes integration oftheory to practice;provides regular feedback to the Clinical Placement Provider toimprove the quality of the students’ clinical experiences; andconducts clinical assessment of students.ii)iii)iv) 4.3. The Clinical Instructor is an Advanced Practice Nurse: i)ii)iii)with minimum 5 years’ clinical experience;has recognized skills in the related area of practice andhas an interest in teaching & learning and have successfullycompleted a ClinicalInstructor (CI) and/or teaching and assessing course facilitated by healthcare institutions and/or theSpecialist Diploma in Clinical Education.4.4. The ratio of Clinical Instructors to students is not more than 1 ClinicalInstructor to 6 students, in order to provide adequate supervisionthroughout the clinical practicum.18 | P a g e4.5. The student is allocated to a Preceptor who provides individualisedguidance, supervision, support and assessment for student’s learningexperience.4.6. The Preceptor is responsible for:iv) supporting and enabling student’s learning; v)providing appropriate supervision of nursing students that isrelevant to the student’s level of learning; andconducting clinical assessment of students.vi) 4.7. The Preceptor is medical specialist or an Advanced Practice Nursewith 5 years’ experience in the area of practice.4.8. Each Preceptor shall be assigned to a maximum of 2 students at anyone time.4.9. The Preceptor will receive assistance, guidance and support from theClinical Placement Coordinator and Clinical Programme Coordinatorin performing their preceptor roles and responsibilities.19 | P a g eSTANDARD FIVE:ASSESSMENT AND EVALUATIONThe Clinical Instructor and Preceptor are responsible to perform formativeand summative assessment of the students and to provide feedback ontheir clinical performance.Criteria5.1. Clinical assessments are conducted at regular interval as prescribedby the educational institution.5.2. Specific feedback on students’ performances are given regularly andin a timely manner to reinforce good performances and to encourageand respect students’ efforts.5.3. Clinical Instructors or Preceptors conduct debriefing sessions tofacilitate students’ reflection of their practice and evaluation of theirclinical performance.5.4. Clinical Instructors and Preceptors communicate and collaborate as ateam to facilitate student assessments and evaluate the effectivenessof the overall clinical education.5.5. The evaluation of the clinical placement is: i)obtained from students and Preceptors at the completion ofeach clinical placement;ii)facilitated by the Clinical Instructor in collaboration with theClinical Placement Coordinator to evaluate the effectiveness ofclinical learning; andiii)usedby the ClinicalPlacementProvider andEducation Institutions to make improvements to the clinical learningexperience and adopt best practices.20 | P a g eGLOSSARY AssessmentThe process of evaluating the extent to which students haveachieved their expected clinical learning outcomes.Clinical PlacementCoordinator:A nursing staff member (Registered Nurse from a ClinicalPlacement Provider who liaises with the Education Institution(s)to facilitate clinical education for nursing students. He/ She hasoversight of the clinical placement’s schedule and providesresources and support for students’ learning in the clinicalsetting.Clinical education of Advanced Practice Nurse (APN) will beprovided by an Advanced Practice Nurse (may be adjunct staffwith the Education Institution) of a Clinical Placement Provider.He/She may also serve as a Clinical Instructor if he/she meetsthe criteria.Clinical PlacementProviderA hospital, institution or healthcare service provider that isaccredited by the Singapore Nursing Board to provide studentsaccess to their clinical areas for their clinical education.Clinical Instructor(CI):A Registered Nurse (with at least 3 years clinical practiceexperience), employed by an Education Institution and/orClinical Placement Provider to provide guidance, supervisionand assessment for a group of students during their clinicalplacement period.For the clinical education of APN, the Clinical instructor is anAdvanced Practice Nurse with at least 5 years of clinicalpractice experience.Clinical Preceptor(CP):A nurse/midwife from the Clinical Placement Provider whoprovides individualised guidance, supervision, support andassessment for student’s learning experience.For the clinical education of APN, the Preceptor is a medicalspecialist from the Clinical Placement Provider or an AdvancedPractice Nurse, from the Clinical Placement Provider working inthe same area for at least 5 years.Clinical ProgrammeCoordinator:A nursing education staff member from an Education Institutionwho plans, develops and organises clinical education activitiesto achieve the programme’s learning goals and outcomes.EvaluationThe process of appraising the overall effectiveness of clinicaleducation programme and to make improvements to maintainthe quality of the programme. 21 | P a g eACKNOWLEDGEMENTThe Singapore Nursing Board acknowledges the contributions by the members of theSNB Education Committee (May 2015 to May 2018), the Advanced Clinical EducationWorkgroup (2014 to 2016) and Advanced Practice Nurse Training Committee (May 2015to May 2018).© 2017, 2012 by Singapore Nursing BoardWebsite: http://www.snb.gov.sgAll rights reserved.No part of this booklet may be reproduced without written permission from the Singapore NursingBoard.
