Date of Award

Spring 2019

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

School

Leadership and Advanced Nursing Practice

Committee Chair

Dr. Kathleen Masters

Committee Chair School

Professional Nursing Practice

Committee Member 2

Dr. Tonya Breymier

Committee Member 3

Dr. Janie Butts

Committee Member 3 School

Leadership and Advanced Nursing Practice

Committee Member 4

Dr. Rebecca Newton

Committee Member 4 School

Professional Nursing Practice

Committee Member 5

Dr. Kyna Shelley

Committee Member 5 School

Education

Committee Member 6

Dr. Lachel Story

Committee Member 6 School

Leadership and Advanced Nursing Practice

Abstract

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a 1:2 simulation-to-traditional clinical time replacement ratio in an advanced-level adult medical-surgical nursing course. The ATI Adult Medical Surgical Proctored Assessment Scores and NCLEX scores were used to measure outcomes.

A total of 878 pre-licensure nursing students participated in this study from 6 different nursing programs across the United States. The 1:1 study group had 680 participants and the 1:2 study group had 198 participants, which reflects the prevalent use of 1:1 simulation-to-traditional clinical replacement ratios in pre-licensure nursing programs. Analysis of the data indicated that students in the 1:1 replacement ratio study group had a statistically significant higher mean score on the ATI Adult Medical Surgical Proctored Assessment, but the difference did not have applied meaning. Both study groups had mean scores that fell within the proficiency level in adult medical-surgical nursing knowledge that exceeded minimum expectations. Additionally, data analysis indicated that there was no correlation between simulation-to-traditional clinical replacement ratio (1:1 or 1:2) and NCLEX pass scores. Finally, no significant or meaningful interactions existed between program type (BSN or RN) and mean scores on the ATI Adult Medical Surgical Proctored Assessment or on NCLEX pass rates. This study provides strong evidence that pre-licensure nursing programs can utilize a 1:1 or 1:2 simulation-to-traditional clinical replacement ratio in an advanced-level Adult Medical Surgical clinical course without having significant differences in ATI Adult Medical Surgical Proctored Assessment scores or NCLEX pass rates.

ORCID ID

https://orcid.org/0000-0001-7640-0498

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