Date of Award

2011

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

First Advisor

Rebecca Beck-Little

Abstract

The clinical learning environment is an important component in the educational development of a student nurse. Nursing students have identified the clinical experience as one of the most stress producing components of their nursing education. Past research has shown high levels of stress can lead to decreased learning, affect clinical performance, increase clinical errors, and threaten physical or psychiatric wellbeing. Nurse educators' primary responsibilities are to help students effectively cope with their initial stress and facilitate student learning by applying the knowledge they gain in the classroom to the clinical environment. To allow students the opportunity to integrate theory into practice, the use of high-fidelity human patient simulation is becoming more widely accepted in nursing education as an instructional methodology. This study demonstrated a relationship between the use of high-fidelity human patient simulation and the reduction of stress levels in novice nursing students that has not been previously reported in the literature.

The purpose of this study was to investigate the effect of high-fidelity human patient simulation on the stress levels of associate degree novice nursing students prior to their first clinical experience. Fifty-five associate degree nursing students from one technical college tested the hypothesis that novice nursing students who receive practice on a high-fidelity simulator prior to their first clinical day will experience less stress and increased client system stability than those novice student nurses who do not.

This study used a quasi-experimental, pretest-posttest comparison group research design to examine self-reported stress levels on the Student Stress and Coping Inventory Clinical Experiences subscale (SSCI). Control group participants attended two days of clinical in a skilled nursing facility on a long-term care unit. Intervention group participants attended a simulated clinical experience with a high-fidelity human patient simulator followed by a clinical day the same skilled nursing facility as the control participants. Betty Neuman's Systems Model was used to investigate whether a simulated first day clinical experience will perform as a primary prevention as intervention method on associate degree novice nursing students' system stability to reduce stressor reaction and protect the flexible line of defense.

Study results confirmed the hypothesis and revealed that intervention participants who did not report any experience in healthcare and participants who reported no employment in healthcare identified significantly lower levels of stress on their SSCI posttests compared to control group participants whose posttest stress scores increased. Preparation using a simulated first day clinical experience with a high-fidelity mannequin demonstrated to be a primary prevention as intervention method and increased novice nursing student system stability. Research findings confirmed a significant difference in overall mean stress scores between the intervention and control group participants who did not report any experience in healthcare and those who were not employed in healthcare. Control group participants reported higher stress scores following their initial clinical experience whereas intervention participants reported a decrease in stress following a simulated first day clinical experience and their first clinical day.

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