09/08/2025
Canadian schools are admitting and graduating more nurses than ever, yet the pipeline continues to face significant bottlenecks where it matters most: in faculty, placements, and practice-ready transitions. Recent data show that 19,631 students entered RN entry-to-practice programs in 2022-2023, and 11,923 graduated in 2023. However, only 30 percent of the 8,943 teaching faculty hold permanent roles, with many nearing retirement. That mix strains quality, continuity, and growth.
Clinical education is the other bottleneck. Schools report saturated placement sites, stretched instructors, and heavy reliance on short-term contract educators. Provinces are expanding seats, but seats without supervisors, faculty, and sites do not deliver safe graduates.
The workforce need is real. CIHI reports growth in nurses employed in direct patient care in 2024, but per capita availability has not kept pace. That keeps pressure on units and on students trying to learn in high-acuity environments. (CIHI)
Why this matters for patient care and retention
When faculty are mostly short-term, programs lose mentorship continuity, curriculum stewardship, and research capacity. It also becomes harder to scale quality improvements like simulation, debriefing, and preceptor development. CASN data link recruitment challenges to lower academic salaries relative to practice, a thin pool of master's and doctoral prepared nurses, and the location or cost of living. That is a structural constraint, not an individual problem.
When placements are scarce or uneven, students miss the repetitions that build judgment. CASN warns that cutting corners in education to push out more graduates backfires, since underprepared new nurses leave early. Strong practice-based learning, residency-style onboarding, and well-equipped simulation labs are essential.
Simulation is part of the answer. During and after the pandemic, many Canadian programs responsibly replaced a portion of clinical time with high-quality simulation. Evidence from the NCSBN study and subsequent reviews indicates that up to half of traditional clinical hours can be replaced with well-designed simulation without compromising outcomes, provided programs align their objectives, quality, and debriefing. Use it to expand capacity and consistency, not as a shortcut. (PubMed Central, casn.ca)
Seat expansions must be paired with faculty and placement funding. Jurisdictions are adding seats, for example, Ontario's 2,200 new nursing spaces and other targeted expansions. Still, without funded clinical teaching time and preceptor supports, we shift the burden to already strained units. Alberta also invested in adding more than 1,800 IEN bridging seats, which helps, provided clinical integration is resourced. (news.ontario.ca, Alberta.ca)
Internationally educated nurses can help relieve pressure, yet they face fragmented pathways. New federal funding through the Foreign Credential Recognition Program and the PASS program improves navigation, but provincial capacity for assessment, bridging, and supervised practice must grow in tandem. (Canada.ca)
What to do next, practical actions to implement
For governments and funders
Tie every new academic seat to a funded clinical teaching package, including preceptor stipends, guaranteed teaching time, and backfill for units hosting students. Publish a per-seat clinical education funding rate so health systems can plan staffing and track placements using provincial dashboards like BC's student practice education metrics. (spe.healthcarebc.ca)
Create targeted salary top-ups or retention awards for doctoral and master's-prepared nurse educators in high-need regions, aligned to CASN's reported recruitment barriers. Pair with loan forgiveness for educators who teach a minimum load over three to five years.
Expand simulation infrastructure with capital grants and operating dollars for technician roles and faculty development, using evidence-based standards for scenario design, facilitation, and debriefing. (PubMed Central)
Scale IEN pathways by funding clinical bridging cohorts and supervised practice hours, connected to Pre- and Post-Arrival Supports and Services Program (PASS) and Foreign Credential Recognition Program (FCR) funded navigation supports, and report output and time to licensure. (Canada.ca)
For schools of nursing
Convert more short-term contracts to multi-year appointments where possible. Use cohort hiring to stabilize teaching teams and succession plans as senior faculty retire. CASN's data show that the permanent fraction is low and aging. Fixing that increases capacity.
Adopt a simulation-first strategy for hard-to-place competencies. Map where simulation demonstrably equals clinical experience for learning outcomes, then allocate scarce placements to the competencies that truly require bedside exposure. Document your replacement ratios and outcomes. (PubMed Central)
Establish a structured preceptor program with micro credentials, on-demand teaching resources, and prompt consultation support for addressing complex student concerns. Recognize preceptors publicly and financially, measure student and preceptor experience, and adjust loads mid-term. (PubMed Central)
Partner with health systems on nurse residency models for new grads, so education quality gains are not lost at the transition. CASN highlights residency as a retention lever.
For health system leaders and preceptors
Ensure that preceptor time is prioritized in the schedule. Offer differential pay while precepting, reduce assignment complexity on teaching days, and cap student-to-preceptor ratios. Studies show that support and recognition improve preceptor effectiveness and student outcomes. (PubMed Central)
Treat units as learning environments. Standardize student huddles, assign a charge nurse mentor for escalation, and schedule faculty presence during peak learning windows.
Share placement data with schools monthly, including cancellations and reasons, to help manage demand and minimize last-minute changes..
For policy and pathway teams serving IENs
Ensure that every Internationally Educated Nurse (IEN) applicant is linked to PASS pre-arrival services as early as possible. Once in Canada, facilitate their transition to provincial programs and supervised practice. Provide funding for case management to minimize drop-off at each step. Monitor the licensure process closely and take action on any delays that arise. (Canada.ca)
Use FCR funds to expand assessment capacity and create rolling intakes for bridging and workplace integration placements, not just single annual cohorts. (Canada.ca)
Conclusion
By aligning available seats with funded faculty, ensuring dedicated preceptor time, and implementing effective simulation practices, we can produce practice-ready nurses on a larger scale. Additionally, when we expand seat availability alongside enhanced Internationally Educated Nurse (IEN) pathways and residency-style onboarding, we can retain more nurses in active practice. Establish quarterly goals, share straightforward metrics, analyze the data's findings, and continuously improve.
If you want practical tools and templates to get started, visit www.fearlessstrides.com
References
CASN Registered Nurses Education in Canada Statistics 2022-2023: Faculty and Admissions Trends.
CASN Quality Nursing Education National Insights, clinical placements, residency, and investment guidance.
CIHI Nursing Workforce Snapshots: RNs and NPs Employed in Direct Care. (CIHI)
Evidence on simulation hour substitution and Canadian use during the pandemic. (PubMed Central, casn.ca)
IRCC Pre-Arrival Supports and Services, PASS program for nurses. (Canada.ca)
Foreign Credential Recognition Program funding for health professionals. (Canada.ca)
Alberta IEN bridging seat expansion. (Alberta.ca)