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NCSBN National Simulation Study

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Email: simulationstudy@ncsbn.org

NCSBN is conducting a landmark, national, multi-site, longitudinal study of simulation use in prelicensure nursing programs throughout the country. Collaborating with learning institutions across the U.S., the NCSBN is embarking on a research initiative exploring the role and outcomes of simulation in pre-licensure clinical nursing education.

The NCSBN National Simulation Study is being conducted in three phases. Phase I involved a national survey of simulation use in pre-licensure nursing programs. Phase II is a randomized, controlled study examining the outcomes of various amounts of simulation to replace a portion of the hours spent in traditional clinical settings. Phase III is a longitudinal study that will follow the nurse graduates into their clinical practice as new registered nurses.

Phase I

A survey was developed to determine the prevalence of simulation use—types of equipment used and the courses in which simulation is used; faculty training and development to use simulation; and if simulation is used as a substitute for clinical hours. The survey was sent to all pre-licensure nursing programs in the US in January 2010. Responses were received from 1060 programs, representing all 50 states (a 62% response rate). Results of the national survey were initially published in the Journal of Nursing Regulation in October, 2010. The results from a qualitative analysis of the written responses and open-ended questions obtained from the survey, were published in Clinical Simulation in Nursing's, April, 2012 issue.

Phase II

The second phase of the National Simulation Study involved randomizing nursing students to receive varying amounts of simulation in place of traditional clinical hours. In August 2011, new nursing students were randomized to one of three study groups: clinical as usual (control), 25% simulation or 50% simulation. Students remained in their assigned study group for all of the core clinical courses in their nursing program. Each semester and in each of the core clinical courses, students were assessed on their nursing knowledge, clinical competency and how well they perceived their learning needs were met in both the clinical and simulation environments. Students in the study cohort graduated in May of 2013, with data collection on NCLEX pass rates continuing through December, 2013.

Study groups

  1. Control Group (clinical as usual)
    Up to 10% of clinical time can be in simulation
  2. 25% simulation in place of traditional clinical hours
  3. 50% simulation in place of traditional clinical hours
simulation study quick facts

Research questions

  1. Are there differences in clinical competency among graduating nursing students in the three study groups?
  2. Are there differences in knowledge among graduating nursing students in the three study groups?
  3. Are their perceived differences in how well learning needs are met in the clinical and simulation environments among the three study groups?
  4. Are there differences in clinical competency among the three study groups in each of the core clinical courses?

This study is designed and powered to test the null hypothesis—there are no differences between the three study groups in clinical competency, nursing knowledge, or learning needs being met.

Participating Sites

Ten nursing programs, across the US, have been selected to participate as sites for the National Simulation Study. Five associate degree and five baccalaureate programs were selected based on an application process and the ability to meet study eligibility criteria. Sites were selected in November 2010. Schools appointed a study team responsible for conducting the study for the entire two years that the study cohort students were enrolled. Members of the study team attended three training sessions from November 2010 through June 2011 to review the study procedures, receive training on the use of study assessment instruments, and learn and practice the debriefing model being used for the study.

The 10 nursing programs include:

College of Southern Nevada, Las Vegas, NV
Florida International University, Miami, FL
Ivy Tech Community College, Indianapolis, IN
Johns Hopkins University, Baltimore, MD
Johnson County Community College, Overland Park, KS
Pennsylvania College of Health Sciences, Lancaster, PA
Metropolitan Community College-Penn Valley, Kansas City, MO
The University of Southern Mississippi, Hattiesburg, MS
University of South Carolina, Columbia, SC
Washington State University, Spokane, WA

Phase III

The study cohort of nursing students have graduated, and they are being followed in a longitudinal study of their clinical practice as newly graduated registered nurses. The new nurse graduates will be followed for up to one year of practice. This final phase of the study will examine how well the new graduate nurses were prepared for practice. This phase of data collection began when the study cohort graduated in May 2013, and will continue through December 2014, allowing time for the graduates to take their licensing examination and obtain positions.

Study Timeline

Study Results

Results of Phase I

Results from the National Survey of Simulation Use in Prelicensure Nursing Programs, representing nursing programs in all 50 states, have been published in the Journal of Nursing Regulation. Hayden, J. (2010). Use of Simulation in Nursing Education: National Survey Results. Journal of Nursing Regulation, 1(3): 52-57.

An additional analysis of the survey’s open–ended responses was conducted and these results have been published in Clinical Simulation in Nursing. Kardong-Edgren, S., Willhaus, J., Bennett, D., Hayden, J. (2012). Results of the National Council of State Boards of Nursing (NCSBN) National Simulation Survey: Part II. Clinical Simulation in Nursing, 8(4), e117-e123.

Results of Phases II and III

A full report of the research study and results of the multi-site, randomized study of simulation during the nursing program and the results of the follow-up study on how well the students were prepared for clinical practice will be published in a special supplement of the Journal of Nursing Regulation in August, 2014.

Results from the first year of data collected from the cohort of study participants and clinical faculty was presented for the first time at the NCSBN Scientific Symposium, September 11, 2012 in Arlington, VA.

For additional information on the study, please contact Jennifer Hayden, project director, simulationstudy@ncsbn.org


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