Data Spotlight: The Impact of Insufficient Clinical Sites on Baccalaureate Program Admissions

For more than a decade, schools of nursing have struggled to increase enrollments due primarily to an insufficient supply of faculty and clinical placement opportunities for students. While the COVID-19 pandemic has increased the demand for nurses, it has further limited access to clinical sites.

In Fall 2020, AACN found that 368 schools (38.5% of all respondents) reported that 66,274 applications to generic baccalaureate nursing programs were rejected. While the students who submitted the applications were qualified for admission, schools reported several reasons why they were not able to admit the students, such as insufficient availability of clinical sites, faculty, and preceptors, budget limitations, and other factors. The most frequently reported reason (254 schools, 69%) was insufficient availability of clinical sites. More importantly, 150 schools (40%) reported that insufficient availability of clinical sites was the single most important reason for not accepting all qualified applicants. Turning away qualified applicants from generic baccalaureate nursing programs is widespread and occurs in all regions roughly in proportion to the regional distribution of nursing schools in the U.S (Table 1). However, fewer Midwest schools report insufficient clinical sites as a reason, and a disproportionately large percent of nursing schools in the West cite this reason (25% give this reason, despite making up only 14% of respondent schools).

In 2020 public schools made up 41% of all survey respondents, and 65% (240 of the 368 schools) reported rejecting 51,417 qualified applications to generic baccalaureate nursing program.  Public schools comprised 68% of the schools who indicated that insufficient clinical sites were a reason for rejecting applications (Table 2).

From 2016 to 2020 the percentage of schools rejecting qualified applications to generic baccalaureate programs declined slightly, from 42.7% to 38.5% (Figure 1). However, the percent citing insufficient clinical sites has remained relatively steady over that period, and the percent of public schools with this issue has remained high (Table 3).

Table 1. Schools Rejecting Qualified Applications to Generic Baccalaureate Programs by Region, Fall 2020
 

Table 2. Schools Rejecting Qualified Applications to Generic Baccalaureate Programs by School Type, Fall 2020

 

Table 3. Public Schools Rejecting Qualified Applications to Generic Baccalaureate Programs , 2016-2020

 

Figure 1.