Effect of online versus in-person clinical experiences on nursing student's competency development: A cross-sectional, quasi-experimental design

Background: Clinical experience is an important component of nursing education, yet placements in agencies are hard to secure, and evaluation of outcomes challenging. The shift to virtual, online clinical courses during the pandemic created the conditions of a natural experiment. Objectives: To compare differences in outcomes between an in-person and online design for a family and community health clinical course. Design: Quasi-experimental, 2-group, cross-sectional study. Methods: Competency evaluations were reviewed from a baccalaureate nursing program in Canada from 19 students who completed an in-person clinical, and 32 students who completed an online clinical. Quantitative analysis compared competencies achieved, interest in community health nursing, and linguistic analysis of unstructured narratives using natural language processing. Results: There are differences in competency evaluations for in-person versus online community clinical courses, and potential implications for future interest in community health. Natural language processing detected differences in content and psychological processes between the two groups. Conclusions: Nursing programs could apply this methodology to track impact of changes to clinical course design on achievement of competencies. There are important differences in outcomes between online and in-person clinical courses.