Roehrs, Carol Joy

Committee Member

McNeill, Jeanette

Committee Member

Meriill, Alison S.


Nursing Education


University of Northern Colorado

Type of Resources


Place of Publication

Greeley (Colo.)


University of Northern Colorado

Date Created





178 pages

Digital Origin

Born digital


Dramatic changes in the health care environment today are changing the role of the registered nurse (RN) from a narrow task-oriented focus to assuming much greater responsibility in the management of patient care. Inexperienced students report significant anxiety when anticipating their first clinical day in an acute care facility. This leads to decreased self-confidence in clinical judgment necessary to provide safe care for patients. Nurse educators must be aware of anxiety levels and self-confidence to intervene appropriately to foster the best learning outcomes for students. Using human patient simulation learning experiences in the nursing lab, the purpose of this experimental, pretest-posttest design study was to determine whether the prebriefing activity of expert role modeling had an impact on novice baccalaureate students’ self-assessed anxiety/self-confidence and clinical judgment. The sample included 43 junior level students randomly assigned into control (21) and treatment (22) groups. Both groups received standard preparation for simulation including a patient chart, verbal report of patient status, and orientation to the simulation laboratory. The treatment group received the intervention of viewing an expert nurse video role modeling care of a standardized patient prior to participation in each scenario. Descriptive data analysis indicated that the groups were equivalent. Findings indicated that both the control and treatment groups demonstrated a significant decrease in mean anxiety scores and increase in mean self-confidence scores obtained with the Nursing Anxiety/Self-Confidence with Clinical Decision Making scale (NASC-CDM). These findings suggest that participating in a simulation seminar reduces anxiety and increases self-confidence in novice nursing students, though the expert nurse video intervention did not make a difference. Findings from expert review of recorded student performance in the scenarios using the Laster Clinical Judgment Rubric (LCJR) indicated large differences between treatment and control groups, with the treatment group means consistently greater than the control group. The data reflected highly significant differences (p = 0.000) between the control and treatment groups in the noticing, interpreting, responding and reflecting scales that comprise clinical judgment. Further research needs to be conducted to determine best practices for use of specific prebriefing strategies for simulation in nursing education. This study provided evidence that student participation in a simulation seminar can reduce anxiety and increase self-confidence in novice nursing students. In addition, incorporating an expert nurse role modeling video had a positive effect on the students’ use of clinical judgment in simulation scenarios.

Degree type


Degree Name




Local Identifiers


Rights Statement

Copyright is held by author.