Award Date


Degree Type


Degree Name

Doctor of Nursing Practice (DNP)



First Committee Member

Karyn Holt

Second Committee Member

Angela Silvestri-Elmore

Third Committee Member

Jay Shen

Number of Pages



Clinical experiences in nursing programs may take many forms and the goal of integrating clinical is to combine knowledge and skills learned in the classroom into the clinical practice setting. The Dedicated Educational Unit is an innovative approach in the State of Nevada and has demonstrated success in closing the gap between education and clinical practice. The Dedicated Educational Unit model is used for the medical-surgical clinical rotations at a local university and has been largely successful. However, some challenges affecting student learning have recently arisen that are not inherent to the Dedicated Educational Unit model. Challenges voiced by nursing students and their clinical instructors included fatigue and hindered clinical experiences as a result of students experiencing 12-hour biweekly shifts. Based on student feedback, clinical instructors’ feedback, and a literature review, this Doctor of Nursing Practice project proposes the implementation of 6-hour weekly clinical rotations instead of 12-hour biweekly clinical rotations to improve student learning outcomes and reduce student fatigue. The literature was reviewed to identify areas needing improvement. Multiple research studies have found that 12-hour working days have numerous negative effects on nurses, which may have similar effects on nursing students considering the competing demands of their challenging academic program. The purpose of this project was to evaluate the change from biweekly 12-hour clinical rotations to weekly 6-hour clinical rotations and compare the differences in student learning outcomes and student fatigue on the Dedicated Educational Unit. The theoretical foundation guiding this Doctor of Nursing Practice project is Lewin’s Theory of Change. Lewin’s theory allowed to identify areas of improvement by implementing “unfreezing-change-refreezing” stages which helped to raise the odds of this project’s success. This Doctor of Nursing Practice project was implemented on the Dedicated Educational Unit at a local project hospital. Nursing students at a state university who attended 12-hour biweekly or 6-hour weekly clinical rotations in the medical-surgical nursing course between Spring 2019 and Spring 2020 were eligible to participate in this project. Student clinical outcomes and fatigue levels were measured with two psychometrically tested and validated instruments. Student fatigue levels were measured by the Occupational Fatigue Exhaustion Recovery scale, and student learning outcomes were measured by the Health Education System Incorporated scores. The evaluation plan provided findings through data analysis about sample characteristics, including demographics. These findings demonstrated that there are no significant differences between the clinical shift length and student fatigue levels, and also the clinical shift length and student learning outcomes. Thus, both weekly 6-hour and 12-hour biweekly clinical shifts may be integrated into other clinical experiences in the nursing program.


12-hour shifts; clinical hours; clinical performance; learning outcomes; long working hours; student fatigue



File Format


File Size

2500 KB

Degree Grantor

University of Nevada, Las Vegas




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Included in

Nursing Commons