Nursing -- Study and teaching -- Simulation methods, Nursing students, Obstetrics -- Study and teaching -- Simulation methods


Simulation using computerized patient mannequins may be a useful mechanism to teach safe and effective nursing care, thus improving the quality of education for nurses. As nursing program enrollments grow, clinical placement is becoming more difficult and may not offer consistent learning opportunities that reinforce safe and effective nursing practice. This study applied Ford, Smith, Weissbein, Gully, and Salas’ (1998) model of learning transfer as the theoretical framework to design a simulated obstetric clinical learning experience to augment the current clinical practice model, an approach that may lead to an improved educational experience. The purpose of this study was to compare learning outcomes of two clinical teaching strategies for obstetric clinical content for undergraduate nursing students: standard clinical instruction and a simulation-enhanced clinical experience. A mixed-method approach was used. A randomized cluster design was chosen to compare the learning outcomes for students participating in a simulation-enhanced clinical experience versus students participating in a traditional clinical rotation. From the study population of 124 students, 40 participated in the simulation-enhanced clinical group, with the remainder of students serving as controls. Four instruments (Obstetric Nursing Self-Efficacy instrument, Goal Orientation Scale, Proxy Measure, and examination knowledge items) were used to measure student characteristics or achievement of outcomes. Learning outcomes for self-efficacy, knowledge, skills, and transfer were compared between the groups using ANCOVA, independent sample t-test, iv and chi-square analyses. A qualitative descriptive analysis of clinical evaluations for all students was also conducted. Demographic characteristics between the groups were not statistically different. The analysis of covariance (ANCOVA) revealed no difference in ONSE posttest scores between the groups after adjusting for goal orientation and ONSE pretest scores. An alternative ANCOVA for sequence (time in semester when the simulation occurred) and group was not significant. However, after adjustment for the covariate of ONSE pretest scores, ONSE posttest scores varied with sequencing (p


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Graduation Date





Sole, Mary Lou


Doctor of Philosophy (Ph.D.)


College of Nursing








Release Date

December 2015

Length of Campus-only Access

5 years

Access Status

Doctoral Dissertation (Open Access)


Dissertations, Academic -- Nursing, Nursing -- Dissertations, Academic

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Nursing Commons