Brokered clinical experiences in nursing education: Addressing variability and equity through concept analysis.
Heather M Englund, Brent MacWilliams
BACKGROUND: Persistent variability and inequity in undergraduate nursing clinical education challenge assumptions that competence develops through traditional, opportunistic clinical placements. Emerging practices suggest the need for more intentional, structured approaches; however, brokered clinical experiences remain conceptually underdefined. AIM: To clarify the concept of brokered clinical experiences and establish a theoretical foundation for its application in undergraduate nursing education. METHODS/DESIGN: This concept analysis was conducted using Walker and Avant's eight-step method. A systematic search of CINAHL, PubMed, ERIC, PsycINFO, and Scopus was performed to identify relevant literature published between 2004 and 2024. Search terms included preceptorship, scaffolding, guided participation, competency-based clinical education, and intentional learning design. Eighty-six peer-reviewed and regulatory sources were included and analyzed to identify defining attributes, antecedents, consequences, cases, and empirical referents. DATA SOURCES: Peer-reviewed nursing and health professions education literature, supplemented by international and national regulatory and competency-based education frameworks. RESULTS: Six defining attributes of brokered clinical experiences were identified: intentional curation, shared agency, preceptor-student engagement, reflective interpretation, equity of exposure, and developmental progression. Antecedents include clinical capacity constraints, prepared preceptors, institutional support, student readiness, and academic-practice partnerships. Consequences span student, preceptor, programmatic, and regulatory domains, including enhanced competency development, improved equity in clinical exposure, and greater alignment with competency-based education standards. CONCLUSION: Brokered clinical experiences represent an intentional, equity-oriented approach to clinical learning that extends beyond traditional supervision models. This concept provides a framework for structuring clinical education to ensure equitable exposure, developmental progression, and demonstrable competency attainment. Findings support the integration of brokered approaches into curriculum design, preceptor development, and clinical evaluation systems in nursing education.
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