Capstone projects are an important way for nursing students to demonstrate their accumulated knowledge and skills before graduating. There are several challenges programs may encounter in establishing and carrying out capstone requirements.

One major challenge is finding sufficient clinical placement opportunities and preceptors for students to complete their projects. Capstone projects usually involve an immersive clinical experience where students take on responsibilities similar to an entry-level nurse. This requires partnering with healthcare organizations that have the capacity and willingness to host students. Clinical sites are already busy and short-staffed. It may be difficult to find enough sites and experienced nurses who can serve as dedicated preceptors to guide each student through their capstone experience. Programs will need to invest significant time developing relationships with organizations and promoting the value of preceptor roles.

Closely related is ensuring capstone experiences provide meaningful learning opportunities for students. With limited clinical placements, there is a risk some students end up with preceptors or assignments that do not allow them to fully demonstrate their abilities or work on the types of patients/cases needed. Programs must have structured processes for vetting potential capstone sites, preceptors, and developing individualized objectives for each student placement. Close coordination is also needed between the program, preceptors, and students to optimize the learning experience. This level of oversight requires substantial administrative resources from the program.

A challenge involves assessing and evaluating student performance during their capstone experience objectively and fairly. As the final evaluation before graduation, the capstone project carries significant weight. If done in a real clinical setting by a single preceptor, there are concerns about reliability and potential biases influencing grades. Programs need to establish standardized evaluation tools and processes that incorporate input from multiple assessors like faculty site visits. This can be difficult to implement consistently across all student placements. Programs also have to balance evaluation rigor with the reality of limited faculty/staff resources.

Financial constraints may limit a program’s ability to support robust capstone requirements. Developing relationships with new clinical partners, providing preceptor training, conducting faculty site visits, and overseeing complex evaluation procedures all require funding. Nursing program budgets are often strained. Costs associated with capstone management could clash with other budget priorities or regulatory/accreditation standards limiting spending per student. Programs must advocate effectively for necessary resources or pursue cost-saving approaches to capstone implementation and management.

Logistical coordination between the nursing program and its numerous clinical partners is an ongoing challenge. With capstones dispersed across multiple healthcare organizations, clear communication and streamlined processes are critical. Maintaining consistent interfaces between numerous fast-paced clinical sites and a school administration can be difficult. Effective project management, use of technology, and dedicated staff are needed. Personnel transitions at either end also risk disruption. Significant effort is necessary to optimize coordination between academic and practice settings for capstone programs.

Programs must manage stakeholder expectations and address concerns from partners that arise during capstone implementation. Clinical staff worry about student preparation and the perceived demands of precepting. Schools worry about placement availability and evaluation consistency. Students worry about securing appropriate experiences. Programs need strategies to engage stakeholders, establish reasonable policies, and resolve issues transparently as capstones evolve. Change is never easy, and new requirements will face questions that require diplomatic responses.

While capstone projects are invaluable for nursing education, successful implementation presents programs with complex challenges around clinical placement capacity, learning experience quality, objective assessment, financial constraints, logistical coordination between academic and practice partners, and stakeholder expectations. Programs must invest in strategic planning, partnership development, resource advocacy, and change management to establish sustainable capstone models that meet objectives despite these barriers.