College of Science and Health Theses and Dissertations

Date of Award

Spring 6-12-2017

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Matthew Sorenson

Second Advisor

Kim Amer


Background: While simulation is a widely used pedagogy in nursing education, there is inconsistent evidence regarding its effectiveness in demonstrating positive learning outcomes. Therefore, further research is needed to establish the effectiveness of simulation in developing clinical competence, and the incorporation of this pedagogy into nursing curricula. Purpose: To explore how the integration of high-fidelity simulation into nursing curricula influences learning outcomes. More specifically, to examine differences in clinical competence as measured by the outcomes: knowledge, skills, critical thinking, and clinical judgment in nursing fundamental students taught using high-fidelity simulation versus traditional instructional methods. Design: A two-group time series experimental design was used to evaluate the impact of traditional or high fidelity simulation instructional methods on improving clinical competence at three time points. Findings: The results reveal significant improvements in knowledge, skills, and clinical judgment over time. However, instructional method did not have a significant effect on these learning outcomes. There was a significant interaction between time and instructional method on improving critical thinking, as both groups demonstrated significant improvements from pre to post intervention. The traditional group showed a significant decline in critical thinking ability 3 weeks post intervention, while the simulation group remained unchanged. Conclusions: The findings of this study support the inclusion of high-fidelity simulation into nursing curricula to facilitate improvements in clinical competence. This study provides evidence that high-fidelity simulation is a better approach than traditional instruction in developing critical thinking, and is analogous to traditional instruction in improving all other domains of clinical competence.

SLP Collection


Included in

Nursing Commons