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Learning Curve NURSING STUDENTS often think about cultural competence in terms of race and ethnicity, but it can be defined broadly to include many other cultural aspects as well, such as disability. The authors developed a novel simulation scenario at James Madison University that features a teenage patient with a disability. 1 The clinical skills incorporated into this controlled environment should prepare nursing students to provide high-quality care to individuals with disabilities.Simulation is an educational technique that can help nursing students with their competence and confidence in the delivery of culturally competent care. 1 This article describes the authors' simulation activity and highlights the importance of including similar scenarios in the curriculum to incorporate cultural education and ethical care into nursing practice. 2

Background: Studies of the clinical learning environment document the importance of the student's clinical learning process. Purpose: The aim of this study was to gather information on students' perceptions of their learning in the clinical environment. Methods: A mixed-method strategy was used to explore nursing students' (N = 194) perceptions of their clinical learning experiences. Data were collected using the Clinical Learning Environment Inventory (CLEI) survey and open-ended questions. Results:The results showed that significant CLEI factors were affordances and engagement, student-centeredness, valuing nurses' work, and fostering workplace learning and that these factors were important to prelicensure nursing students' learning in the clinical environment. In addition, the thematic concepts that enhanced their learning were clinical faculty who exhibited strong communication, encouraged and challenged learners, and were readily available. Conclusions: Clinical faculty in the clinical environment must be competent and able to support the prelicensure nursing student learner.