Nursing Commons^™

Neonatal Assessment And Vr: Designing 3d Simulation Training For Prehospital Clinicians, Michella G. Hill, Luke Hopper, Belinda Flanagan, Sara Hansen, Alecka Miles, Jess Watson, Sean Cashman, Kirstie Balding, Peggy Dysktra, Joshua Johnson, Brennen Mills

Research outputs 2022 to 2026

Prehospital emergency care requires clinicians to manage a vast array of medical and trauma incidents, including rare events such as obstetrics (i.e., childbirth) emergencies. Emergency births can have life-threatening complications such as neonatal respiratory distress potentially leading to cardiopulmonary resuscitation. Management of low-frequency high-risk (LFHR) events such as birthing and immediate neonatal care occurring outside the planned place of birth require expert clinical management. Underutilised skill and knowledge of LFHR events decay within 12-months of being taught. LFHR events are often overlooked for refresher training due to the low occurrence of such cases, putting LFHR patients at even greater risk …

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

The Effect Of Escape Room Simulation On The Self-Efficacy And Communication Levels Of Novice Critical Care Nurses, Lauren A. Femino, Kim Chapman, Julie A. Marshall, Shelby A. Trull, Jennifer A. Dibenedetto

The Lahey Journal

Abstract 

Introduction: Novice critical care nurses often report having low self-confidence and effective communication skills when transitioning to the ICU practice, often due to stress, limited experience, and unfamiliarity with critical care environments. These challenges can not only affect their job satisfaction and retention rates, but also pose serious risks to patient safety and outcomes. The purpose of this evidence-based practice (EBP) project was to assess the impact of an escape room simulation on the self-efficacy and communication skills of novice critical care nurses.

Methods: An evidence-based practice (EBP) project with pre-test and post-test design was conducted to …

Quality Improvement Project Simulating Ethics: Improving Ethical Decision-Making In Nursing Undergraduates Through Simulation And Faculty Training, Shannon Brown

Doctor of Nursing Practice Projects

Nursing faculty often report limited confidence in teaching ethical principles, despite the essential role ethics plays in preparing students for complex clinical decision-making. This quantitative, quasi-experimental pre/post quality improvement project evaluated whether a structured ethics education module incorporating simulation could impact faculty confidence in teaching ethical principles. Guided by Lewin’s Change Theory and the Jeffries Simulation Framework, the project examined how organizational readiness for change and structured simulation design influence faculty development outcomes. Nursing faculty in a baccalaureate program participated in a single simulation-enhanced ethics session. Data were collected through anonymous pre/post Qualtrics surveys, and faculty confidence was measured using …

Exploring Perceptions Of Self-Efficacy Among Newly Graduated Nurses In The Labor And Delivery Unit After The Use Of Rapid Cycle Deliberate Practice For Obstetric Emergencies, Amber L. Hulsey

Dissertations

Background: The average turnover rate among newly graduated nurses (NGNs) in the United States is 25-30% within their first year, with increased rates in high-stress units like obstetrics and critical care. Many risk factors contribute to the high turnover rate of NGNs, but one modifiable factor is feelings of self-efficacy. Studies have shown that simulation training can increase self-efficacy in obstetric emergencies. This study was conducted to explore feelings of self-efficacy among NGNs working in the labor and delivery unit after a rapid cycle deliberate practice (RCDP) simulation of an OB emergency.

Methods: The study used a descriptive …

Quality Improvement Project: Improving Confidence And Clinical Judgment Through Simulation Remediation In Nursing Students, Erica Gillespie

Doctor of Nursing Practice Projects

Simulation is a critical component of nursing education, providing students with a safe environment to develop clinical judgment and confidence before entering clinical practice. However, students may experience anxiety and difficulty meeting competency expectations during simulation. This quality improvement project evaluated whether structured simulation remediation improved confidence and clinical judgment among associate degree nursing students. The project was guided by the NLN Jeffries Simulation Framework, and Kotter’s 8-Step Change Model supported implementation. A quantitative, quasi-experimental pre-/post- intervention design was used. Nine nursing students voluntarily participated. During remediation, students reviewed recordings of their initial simulation experiences and completed guided reflection questions …

Utilizing Remote Patient Monitoring With Dnp Students To Provide Pre-Natal Care, Sara Mccumber

InnovateHER Meeting 2026

This educational project introduced Nurse Practitioners to the use of RPM during pre-natal care for a patient with pre-natal hypertension. Hypertension is a risk factor in 16% of pregnancies and 5-8% of US births are impacted by hypertensive disorders and preeclampsia (CDC, 2023).

Identification and effective management of hypertension in pregnancy recently was an initiative of the Minnesota Perinatal Quality Collaborative (MPQC, 2022).

Improving The Quality Of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation And Supervised Procedures, Ethel C. Estrada

Doctor of Nursing Practice Final Project Abstract

Improving the Quality of Bone Marrow Specimen Collection Through Powered Bone Marrow Device Simulation and Supervised Procedures

Purpose

This quality improvement (QI) project aimed to implement powered bone marrow simulation training and supervised procedures for the Advanced Practice Provider (APP) proceduralists to increase proceduralists' use of powered bone marrow devices and reduce poor bone marrow sampling.

Background

This project was implemented within the Bone Marrow Aspiration Clinic (BMAC) of an academic cancer center in Houston, Texas.

Methodology

Five APP proceduralists completed powered bone marrow device simulation training on the Bone Marrow (BM) Skills Simulator, followed by supervised procedures. Data were …

Quality Improvement Project: Impact Of An Escape Room Simulation Tool On Nursing Confidence, Farren M. Moore

Doctor of Nursing Practice Projects

This quality improvement project aims to address the need for innovative teaching strategies to meet the demands of licensure exams and the increasing complexity of patient care. Evidence supports simulation-based learning as an effective method to enhance critical thinking and clinical judgment; however, faculty members lack confidence in implementing innovative strategies in their courses. The purpose of this project is to determine whether a standardized escape room simulation tool would impact faculty’s self-confidence in developing and implementing simulation-based activities. Guided by the National League for Nursing (NLN) Jeffries Simulation Theory and Lewin’s Change Theory, the project evaluates the change in …

Quality Improvement Project: Improving Interdisciplinary Care In Nursing Education Through Simulation, Anna Williams

Doctor of Nursing Practice Projects

Interprofessional education (IPE) is essential in preparing nursing students for effective teamwork and communication in clinical practice and is supported by the literature as improving these outcomes. However, limited faculty training in interprofessional simulation design contributes to reduced IPE opportunities within nursing curricula. A needs assessment at the project site identified a lack of structured, hands-on training for simulation faculty, resulting in decreased faculty confidence and limited implementation of IPE simulations. The purpose of this quality improvement project was to evaluate whether a structured training intervention improved simulation faculty self-efficacy in developing and implementing IPE simulations. Bandura’s Self-Efficacy Theory guided …

Quality Improvement Project: Gpt Prompts As Tools For Cultural Competence In Undergraduate Nursing Education, Elizabeth K. Hobbs

Doctor of Nursing Practice Projects

In rural nursing programs, student exposure to diverse cultures is limited, which can hinder development of cultural competence. Artificial intelligence (AI) simulation is an evidence-based strategy to improve cultural competence and clinical decision-making, a practice gap exists due to lack of structured, accessible tools. This quality improvement project evaluated whether Generative Pre-trained Transformer (GPT)–based structured prompts would increase culturally inclusive simulation activities and improve faculty perceptions of usefulness and ease of use at a rural community college. The guiding PICOT asked: Among nursing faculty, how does the use of GPT-based structured prompts, compared to an unstructured approach, impact perceived usefulness, …

Associate Degree Nursing Students’ Lived Experiences With Simulation: A Qualitative Phenomenological Study, Jamie O'Connor Florez

Doctoral Dissertations and Projects

This qualitative phenomenological study examined the lived experiences of prelicensure associate degree nursing (ADN) students related to skills acquisition and workplace readiness through simulation-based learning at community colleges in California. Skills acquisition and workplace readiness were defined as students’ perceptions of their ability to competently perform nursing skills and prepare for entry into the healthcare workforce. Guided by Kolb’s experiential learning theory, data were collected from 13 ADN students through questionnaires, semi-structured interviews, and reflective journaling and analyzed using Braun and Clarke’s six-phase thematic analysis.

Three themes emerged: varying emotions from excitement to feeling overwhelmed; experiences of collaboration and unprofessionalism …

Cervical Dilation Assessment Simulation For Development Of Student Nurse Competency, Ashley Romans

SACAD: Scholarly Activities

Assessment of cervical dilation is an important component in care for the pregnant and laboring patient. However, nursing students frequently encounter barriers to acquiring this assessment skill in the clinical setting. Through application of the ACE Star model, a simulation-based teaching trainer is utilized to promote achievement of student competence while respecting the limitations of the hospital clinical experience. Varied opportunities for purchasing or constructing these simulation tools allows for beneficial learning experiences at different price points, promoting the implementation of this important tool in the most appropriate method for an individual setting. Implementation of the cervical dilation simulator allows …

Pediatric Simulation And Emergency Nurse Confidence, Katherine E. Wright

Student Scholarly Projects

Practice Problem: Nurses working in a general emergency department (GED) with a low (3.3%) pediatric patient volume expressed a lack of confidence caring for complex pediatric patients.

PICOT: In general emergency department nurses (P), how does participating in a pediatric simulation event (I), compared to current practice (C), affect nurse confidence scores caring for pediatric patients (O) over 6 weeks (T)?

Evidence: A review of over 17 evidence-based resources found good quality evidence that suggested participating in a simulation event can improve nurse confidence.

Intervention: Over six weeks, GED staff members participated in a pediatric simulation event. The simulation utilized …

Dnp Final Report: Poverty Stigma: The Effects Of A Poverty Simulation On Undergraduate Nursing Students And Their Attitudes Toward Caring For Impoverished Patients, Jessica P. Bowen

DNP Final Reports

Background: Current evidence demonstrates that stigma toward individuals living in poverty persists among undergraduate nursing students and negatively influences patient outcomes. Evidence-based educational strategies addressing social determinants of health have been shown to improve nursing students’ perceptions of vulnerable populations.

Purpose: This quality improvement project intended to evaluate the feasibility of integrating an interactive Community Action Poverty Simulation© (CAPS) activity into an undergraduate nursing (BSN) program at an academic health system university in East Texas.

Methods: Guided by the Plan Do Study Act (PDSA) quality improvement framework and The Johns Hopkins Evidence-Based Practice (JHEBP) Model, Missouri's Community Action Poverty Simulation …

Supporting New Graduate Nurses: Residency, Mindfulness, And Simulation, Shaianne Kaye S. Intal

Nursing | Senior Theses

The purpose of this research proposal is to examine the effectiveness of support systems in helping new graduate nurses bridge the potential gap between nursing education and clinical practice. It aims to address the inconsistencies in nursing education and clinical practice, and how these strategies can better support new graduate nurses. This study will focus on new graduate nurses within their first 2 years of practice in an inpatient setting. A mixed-methods convergent parallel design approach will be used by combining quantitative questionnaires with qualitative interviews at the same time. This will evaluate the effectiveness of nurse residency programs, mindfulness-based …

Sepsis In Sight: Immersive Vr Simulation For Pediatric Training, Kelsey Wagler

DNP Projects

Abstract

Objectives: This project aimed to decrease the time required to administer antibiotics and fluid boluses to pediatric patients with sepsis by implementing a virtual reality (VR) simulation program. The initiative sought to enhance bedside nurses’ and pediatric residents’ knowledge, clinical reasoning, and confidence in sepsis assessment, early recognition, and evidence-based management. A secondary objective was to evaluate the effectiveness of VR simulation as an educational strategy for nurses in a high-acuity pediatric setting.

Design: This quality improvement project used a quasi-experimental design that incorporated a VR simulation intervention followed by a structured debriefing and targeted education session. Participants completed …

Storytelling & Simulation-Based Experiences (Sbes): Immersive Environments That Support Student Learning, Meredith Deegan, Lauren Goeke, Kristina Sandberg, Josh Blubaugh, Kimberly Davis, Mary Murigi

School of Nursing Publications

Storytelling and Simulation-Based Experiences (SBEs) offer a powerful, equity-minded approach to teaching population health. Drawing on the NLN Jeffries Simulation Theory, Kolb’s experiential learning model, and the AACN 2021 Essentials, this session presents a SBE that integrates narrative design to immerse learners in community-centered care through a simulated Federally Qualified Health Center (FQHC) waiting room experience.

This SBE places students in a crowded FQHC waiting room to explore cultural humility, empathy, and health promotion in underserved settings. After the prebrief establishing purpose and psychological safety, students enter a conference room transformed with tight seating, limited walking space, and ambient noise. …

Improving Prostate Cancer Patients’ Experience And Understanding With A Pre-Ct Simulation Checklist In Genitourinary Radiation Oncology, Christopher Le

Doctor of Nursing Practice Final Project Abstract

Improving Prostate Cancer Patients’ Experience and Understanding With a Pre-CT Simulation Checklist in Genitourinary Radiation Oncology

Purpose

The purpose of this quality improvement (QI) project was to implement a Pre-CT Simulation checklist for Prostate cancer patients in the outpatient Radiation Oncology Genitourinary clinic to improve patients’ experience and comprehension on their Simulation Day.

Background

The CT simulation is a critical step in treatment planning. Lack of clear, concise, consistent instruction and education preparation prior to simulation day can delay planning and treatment. Currently, there is no standardized checklist to ensure patients are educated and prepared for their CT simulation day. …

Experiences Of First-Year Nursing Students Using Community Volunteers As Simulated Participants For Teaching Safe Medication Administration: A Cross-Sectional Survey, Hugh Davies, Lea Aboo, Kristi Nicholls, Martina Costello, Carol Crevacore

Research outputs 2022 to 2026

Aims: To explore responses of first-year nursing students to simulated participant methodology and the level of difficulty playing the role of patient experienced by community volunteers. Background: Absence of therapeutic relationships between nurse and patient threatens medication safety. Simulation-based learning provides a safe environment for students to practice medication administration. Design: Cross-sectional survey incorporating Mezirow’s transformative learning theory. Methods: First-year Bachelor of Science Nursing students participated in a simulated medication administration scenario supported by volunteers playing the role of patients. A Likert and open-ended post-simulation questionnaire measured students’ perceptions of realism in the performance of simulated participant volunteers. Simulated participant …

A Competency Based Pressure Injury Management Program, Madina Qadir

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project aims to implement a simulation-based wound management program to address critical gaps in nurses’ competencies for managing pressure injuries (PIs). The initiative seeks to enhance nurses’ knowledge, clinical skills, and confidence in wound assessment and advanced therapies, fostering evidence-based practice and consistent care delivery. Effective PI management is vital for improving patient outcomes, reducing healing times, and minimizing complications. Yet, nursing education and competency gaps often lead to inconsistent care and increased healthcare costs. A structured competency-based pressure injury management (CB PIM) program integrates evidence-based didactic lectures and interactive simulation-based skills stations to cover essential topics, including wound …

The Effects Of Escape Room Simulations On Stress Levels Of Sophomore Baccalaureate Nursing Students: An Experimental Study, Bethany L. Mcfann

Doctoral Dissertations and Projects

The purpose of this quantitative experimental pretest -posttest design using an experimental and control group was to determine if gaming escape room simulation will decrease BSN nursing students' stress in high fidelity simulation (HFS). The sample size of 64 students had 32 students randomly assigned to each group, the control and the experimental group. The first-year sophomore Bachelor of Science in nursing (BSN) students at a state university were randomly assigned to either traditional or escape room simulation scenarios. Stress levels of each group were measured using the State-Trait Anxiety Inventory (STAI) tool before and after the simulations with statistical …

Quality Improvement Project, Communicating With The Dying Patient: A Simulation Experience For Nursing Students, Jason Weger

Doctor of Nursing Practice Projects

Effective communication with patients near the end of life is a crucial yet often underdeveloped skill among nursing students. Previous research highlights a persistent gap in training for end-of-life communication in nursing schools. This quality improvement project implemented a simulation-based educational intervention to improve end-of-life communication skills among first-semester nursing students at a community college in Oklahoma. A needs assessment identified significant gaps in students' readiness for emotionally charged patient interactions. Guided by Prosci’s Change Model and Jeffries Simulation Theory, the project used a faculty-led simulation experience to teach evidence-based communication strategies, including appropriate word choice, therapeutic presence, and active …

The Effect Of Simulation On Nurses’ Confidence With Providing Post-Fetal Death Support To Bereaved Parents, Monique Scholine, Shannon Zalewski, Erin M. Franklin, Sandria Jamieson, Janelle Diaz, Donna Davis, Kristi Vargo, Nicole Adokou, Kettia Antoine, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: Fetal death (FD) affects one in 10 women worldwide and is associated with negative sequelae such as complicated grief. The negative effects of FD may potentially be mitigated through provision of bereavement support (BS) by trained healthcare workers.

Purpose: The purpose of this study was to explore the effect of simulation on registered nurses’ (RN) confidence in providing BS following FD.

Methods: This was a quasi-experimental study conducted within a South Florida community hospital. Nurses were recruited via email/flyers. Participation in the study entailed attending a post-FD simulation session, and completion of the Perinatal Bereavement Care Confidence Scale (PBCCS) …

Building Adult-Gerontology Acute Care Nurse Practitioner Student Competencies For Telemental Health Treatment Through Simulation, Amy Dievendorf Dnp, Aprn, Fnp-Bc, Agacnp-Bc, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Beverly Baliko Phd, Rn, Pmhnp-Bc, Abbas Tavakoli Drph, Mph, Me

Publications

Depressive disorders are common mental health conditions that are often undiagnosed or undertreated. Adult-Gerontology Acute Care Nurse Practitioners (AGACNPs) are educated in the management of acute and critically ill patients but are often uncomfortable identifying and treating mental health conditions. Telehealth instruction is useful in mental healthcare and is required as part of the AGACNP’s efficient patient care competencies. This article reports findings from a mental health-focused telehealth instructional activity integrated into an existing AGACNP curriculum. This instructional activity was designed to introduce students to telehealth delivery and build AGACNP competencies using telehealth technology to assess patients with depressive mood …

Quality Improvement Project: Impact Of Simulation Training On The Self-Efficacy Of Registered Nurses During A Code Stroke, Kakeya James

Doctor of Nursing Practice Projects

Self-efficacy levels affect decision-making skills and overall confidence in handling critical situations. However, knowledge gaps often hinder the maintenance of high self-efficacy. (Farčić, et al., 2020). The project site provides limited training opportunities that may not adequately prepare registered nurses with the confidence and skills needed to respond to stroke emergencies, potentially causing delays in patient care and adverse health outcomes. As a result, the quality improvement project aims to examine how simulation-based training impacts registered nurses’ self-efficacy in managing stroke emergencies. The project employed a quasi-experimental pretest/posttest design and was guided by the Plan-Do-Study-Act (PDSA) cycle, the Jeffries Simulation …

Quality Improvement Project: Responding Effectively With The Use Of A Defibrillator And Crash Cart: An Educational Intervention For Medical-Surgical Nurses, Josilyn Lusk

Doctor of Nursing Practice Projects

Appropriate and timely use of a defibrillator and crash cart is essential for patient survival during cardiac arrest, yet many medical-surgical nurses report limited preparedness due to inconsistent, non-standardized training. The purpose of this DNP project is to evaluate the impact of a structured didactic and simulation-based educational intervention on nurses’ self-assessed preparedness to respond to life-threatening events and their perceptions of educational best practices. The aim of the project is to demonstrate measurable improvements in nurses’ self-reported preparedness in responding to emergent events and their perceptions of effective teaching and learning strategies. Guided by Tanner’s Model of Clinical Judgment …

Cultural Humility In Patient Education: Development Of A Nutrition-Related Simulation For Nursing Students, Theresa G. Schnable, Sylvia Peña, Juanita T. Garcia, Marilyn Frenn

College of Nursing Faculty Research and Publications

Introduction:

The Latinx community is disproportionately impacted by social and structural inequities such as food insecurity and culturally and linguistically appropriate resources. To address a gap in culturally appropriate nutrition education with Latinx individuals among baccalaureate nursing students, a simulation learning experience (SLE) was developed.

Methodology:

The SLE was designed using best practice standards by faculty experts and reviewed by consultants. After the SLE, students and faculty provided feedback regarding simulation design and implementation.

Results:

Participants reported improved knowledge and confidence when providing culturally appropriate nutrition education and valued working with an interpreter.

Discussion:

This innovative strategy using simulation offers …

Experiences Of A Simulated Medical Malpractice Lawsuit On Nursing Students' Documentation Practices: A Transcendental Phenomenological Approach, Heide Thorne

Doctoral Dissertations and Projects

The purpose of this qualitative, transcendental phenomenological study is to understand the perspectives of first semester nursing students participating in a simulated medical malpractice lawsuit and documentation practices. The theory guiding this study is Kolb’s experiential learning theory (ELT), as it explains the relationship of learning and knowledge transfer through a simulation-based learning activity (SBL). Data collection approaches included observations, anonymous reflective journals, and individual interviews or questionnaire capturing students’ personal experiences and emerging themes. Bracketing enhanced reflexivity, reduced bias, and strengthened the study’s credibility and dependability. Results of the study support the efficacy of a specific, powerful SBL activity …

Understanding Interprofessional Co-Debriefing Practices Within Large Scale Ward-Based Simulation, Melanie Barlow, Robyn Dickie, Alycia Jacob, Shari Maver, Nick Flynn, Alison Blunt, Susan Darzins, Hugh Davies, Michelle Smith-Tamaray, Elisabeth Jacob

Research outputs 2022 to 2026

Background: Despite growing use of interprofessional simulation in healthcare education, there is a lack of published frameworks to guide structured, co-facilitated debriefing between professions. This study explored how nursing and allied health facilitators engage in interprofessional co-debriefing within a large-scale, ward-based simulation program involving over 2000 health students. Methods: Twelve interprofessional co-debriefings were observed and assessed using the debriefing assessment for simulation in healthcare (DASH) tool, with both rater (observer) and instructor (debriefer) versions. Mean debriefing assessment for simulation in healthcare (DASH) scores were compared across five core elements. Qualitative data from instructor short-answer responses and observer field notes were …