Love this question. If you have run simulations with students, or listened to them as they debrief and evaluate a scenario, there is almost no student who doesn't say they learn more in simulation than in real clinical. (So, 2 hours of simulation =4 hours of "real" clinical) This is probably because things can be taken to their natural progression in a safe environment. Tanner or Oermann said, we need to stop focusing on hours in clinical and start focusing on what is happening in those hours. This would be a great dissertaion topic, using the work of Hodnett in labor and delivery several years ago. Is a student learning anything if they do the same thing every single day in clinical and nothing happens? We have almost no support for what we do now, except tradition. In fact what the data shows is that what we are currently doing does NOT prepare a student to practice well. (re" Del Bueno, multiple citations)
A smarter approach might be to say that in this semester or quarter, we will make sure that every student takes care of a diabetic crisis of some sort, an acute coronary syndrome, a pulmonary embolus, has the opportunity to recognize the need to call a code, start it, and act appropriately till the code team arrives, calls and gives a report to a doctor and uses SBAR appropriately, demonstrate the abilty to recognize hypovolemic shock and act appropriately. Because I can guarantee you that most students will not get this opportunity while in clinical, but will be expected to do all of these things almost immediately upon graduation.
I know anecdotally from students coming to find me after summer jobs, that simulations the previous semester helped them recognize and act appropriatly when others did not know what was happening. One student actually told me, "I recognized what was happening, started to freak out and then said to myself, wait, I didn't do this well in simulation, but I KNOW what to do now". So she did.
Bottom line, simulation should be worth more than clinical hours. BUT, simulation does not replace all clinical hours. Perhaps students should do required simulated clinical hours prior to real hospital hours, so they get maximum bang for the buck while they are using this increasingly precious commodity of time on a clinical floor.