Ketty M. Holt


Clukey, Lory

Committee Member

Merrill, Alison S.

Committee Member

Dunemn, Kathleen

Committee Member

Softas-Nall, Basilia


Nursing Education


University of Northern Colorado

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Greeley (Colo.)


University of Northern Colorado

Date Created





195 pages

Digital Origin

Born digital


Affective domain learning is an integral element to developing nursing students who can provide holistic, patient-centered nursing care. Often an invisible objective in nursing education, affective learning is rarely described beyond the first two levels of the domain: receiving and responding. In this phenomenological inquiry, the experiences of undergraduate nursing students, while participating in high-fidelity simulation, were examined and described for affective domain learning. In addition, this study compared the descriptions of third- and fourth-year students in an effort to understand the progressive nature of affective learning. Twenty-five third- and fourth-year students from the baccalaureate nursing programs of two universities, one private and one state-supported, shared their experiences during individual interviews. The following themes emerged from the data: anxious about not knowing; confidence to create meaning; excited by growing and developing; enjoyed learning; pressured by being observed; ambivalent when relating to the manikin and/or scenario; and values, beliefs, and attitudes about nursing. The findings support the developmental nature of affective learning. Both junior and senior participants described anxiety anticipating their first simulation experiences. Generally, anxiety decreased and confidence grew with more simulation experiences. A noteworthy finding related to six students (four seniors, two juniors) who described persistent anxiety at a level that interfered with their learning. Junior participants described their first experiences with simulation as following a checklist and were concerned about making mistakes. Fourth-year students described simulation as more about learning and less about performing perfectly. They connected simulation with their future career as nurses and the complex scenarios they participated in as important to affective learning and the ethical issues significant to nursing. Future recommendations for nursing education include explicitly including affective learning expectations in preparing students for simulation and making affective learning visible during the debriefing phase of simulation. Nurse educators are encouraged to develop and adopt a more individualized approach to simulation participation and consider ways to incorporate affective learning elements in basic scenarios.

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