Jessica Doolen


Dingley, Catherine E.


Hayes, Janice S.

Committee Member

Roehr, Carol Joy

Committee Member

Bottenburg, Donna




University of Northern Colorado

Type of Resources


Place of Publication

Greeley (Colo.)


University of Northern Colorado

Date Created





174 pages

Digital Origin

Born digital


High fidelity simulation has become a widespread and costly learning strategy in nursing education because it can fill the gap left by a shortage of clinical sites. In addition, high fidelity simulation is an active learning strategy that is thought to increase higher order thinking such as clinical reasoning and judgment skills in nursing students. Nursing educators who utilize curriculum planned high fidelity simulation activities measure simulation learning outcomes with various instruments. However, few can quantify learning in nursing students due to high fidelity simulation and most are not supported by a theory of learning. This methodological study sought to test the psychometric properties of a new instrument--the Simulation Thinking Rubric. The purpose of the rubric was to assess higher order thinking during high fidelity simulation. A convenience sample of 22 first semester junior year and 22 fourth semester senior year BSN students participated in the study. Each of the 44 BSN nursing students engaged in a high fidelity simulation research scenario to allow six trained raters to score the simulation thinking rubric. Results for content validity were a scale content validity index average of .9764 and a scale content validity average of .92857 that provide evidence of content validity of the simulation thinking rubric. For construct validity, an exploratory factor analysis with a principle component analysis procedure found four components that clustered together but did not represent the four cognitive stages of development of higher order thinking. In addition, the one-way analysis of variance (ANOVA) indicated first semester junior year students scored (M = 3.20, SD = 0.74) in the pre-operational stage of cognitive development of HOT and fourth semester senior year BSN students scored (M = 4.11, SD = 1.12) in the concrete stage of cognitive development of HOT. Although the sample size was small and the ANOVA findings were not statistically significant, the magnitude of the difference (η2. 21) suggests that in the future, an additional ANOVA procedure with a larger sample size might be warranted. With respect to internal consistency reliability, a Cronbach's alpha of .74 provided weak evidence that the simulation thinking rubric was measuring the concept of higher order thinking The psychometric testing of the simulation thinking rubric did not provide strong statistical evidence of construct validity and internal consistency reliability. The knowledge gained from this study might assist other researchers in avoiding the same limitations in developing theoretically based evaluation instruments to measure learning related to high fidelity simulation. Without a strong theoretical basis that describes, defines, and explains the phenomena of higher order thinking, the results of psychometric testing of the simulation thinking rubric score had no meaning. The following recommendations are made for future research: (a) examine the literature for adult theories of learning, (b) conduct a concept analysis on the construct of HOT, (c) sample the domain of HOT based on the concept analysis, and (d) develop items for a new instrument.

Degree type


Degree Name




Local Identifiers


Rights Statement

Copyright is held by author.