Download or read book Student Nurses Perception of Self efficacy and Perceived Clinical Judgment Through the Use of Multi patient Simulation written by Laura J Corson and published by . This book was released on 2015 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: New nurse graduates may be ill-prepared to care for multiple patients in the acute care setting due to limited clinical experience. Nurse educators must find ways of bridging the theory-to-practice gap. High-fidelity simulation is one mechanism for bridging this gap. This pilot study explored the effect of multi-patient simulation (MPS) on students' self-efficacy and perceived clinical judgment. This quasi-experimental study sought to explore the readiness of BSN students to care for multiple patients through the use of MPS and a self-efficacy survey measuring perceived level of confidence (LOC) in clinical care. Findings were inconclusive regarding whether MPS as a teaching method helped nursing students increase their perceived LOC and improve clinical judgment skills. Students agreed that the design should be part of nursing education and it identified gaps in their knowledge. This study raised an awareness of what students lack in terms of prioritization management when caring for multiple patients.

Download or read book Baccalaureate Nursing Students Perceptions of Clinical Judegment and Self efficacy Following High fidelity Simulation written by Vicki Carol Pierce and published by . This book was released on 2011 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nurse education literature reflects that educators face a problem of how to provide meaningful clinical learning experiences that help undergraduate nursing students develop clinical judgment and increase self-efficacy. Many schools of nursing are incorporating high-fidelity simulation as an alternative clinical teaching strategy, yet there is little quantitative evidence to support the effectiveness of this teaching method in undergraduate nursing education, particularly regarding the development of clinical judgment. The purpose of this quasi-experimental time series design study was to explore the effectiveness of using multiple high-fidelity simulation experiences to increase perceptions of clinical judgment and self-efficacy in baccalaureate nursing students. Self-report data was collected following three different high-fidelity simulation experiences at three points in time. Data analysis revealed a statistically significant increase (p = .041) in students' perceptions of clinical judgment occurred between Time 1 and Time 3. Students' perceptions of self-efficacy also increased significantly from Time 1 to Time 3 (p = .003) and Time 2 to Time 3(p = .001). Regression analysis revealed a slight positive correlation (sig. = .003) between students' perceptions of self-efficacy and clinical judgment.

Download or read book Health Promotion in Health Care Vital Theories and Research written by Gørill Haugan and published by Springer Nature. This book was released on 2021-03-11 with total page 382 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access textbook represents a vital contribution to global health education, offering insights into health promotion as part of patient care for bachelor’s and master’s students in health care (nurses, occupational therapists, physiotherapists, radiotherapists, social care workers etc.) as well as health care professionals, and providing an overview of the field of health science and health promotion for PhD students and researchers. Written by leading experts from seven countries in Europe, America, Africa and Asia, it first discusses the theory of health promotion and vital concepts. It then presents updated evidence-based health promotion approaches in different populations (people with chronic diseases, cancer, heart failure, dementia, mental disorders, long-term ICU patients, elderly individuals, families with newborn babies, palliative care patients) and examines different health promotion approaches integrated into primary care services. This edited scientific anthology provides much-needed knowledge, translating research into guidelines for practice. Today’s medical approaches are highly developed; however, patients are human beings with a wholeness of body-mind-spirit. As such, providing high-quality and effective health care requires a holistic physical-psychological-social-spiritual model of health care is required. A great number of patients, both in hospitals and in primary health care, suffer from the lack of a holistic oriented health approach: Their condition is treated, but they feel scared, helpless and lonely. Health promotion focuses on improving people’s health in spite of illnesses. Accordingly, health care that supports/promotes patients’ health by identifying their health resources will result in better patient outcomes: shorter hospital stays, less re-hospitalization, being better able to cope at home and improved well-being, which in turn lead to lower health-care costs. This scientific anthology is the first of its kind, in that it connects health promotion with the salutogenic theory of health throughout the chapters. the authors here expand the understanding of health promotion beyond health protection and disease prevention. The book focuses on describing and explaining salutogenesis as an umbrella concept, not only as the key concept of sense of coherence.

Download or read book The Effect of Multiple patient Simulation on Baccalaureate Nursing Students Perceptions of Readiness to Provide Care written by Charlie Dharmasukrit and published by . This book was released on 2015 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Due to the intricacies of delivering nursing care to an increasingly complex patient population, new graduate nurses must be prepared to provide competent nursing care with sound clinical judgment in order to ensure patient safety and promote positive patient outcomes. Therefore, refinement of nursing education to improve registered nurse (RN) competency and readiness to provide care in clinical practice should be a key initiative. The use of patient simulators is an effective teaching strategy because it allows for practice of clinical and communication skills and standardization of patient care experiences. Despite RNs being responsible for multiple patients in the clinical setting, research on the use of multiple-patient simulation to teach undergraduate nursing skills and concepts is very limited. The purpose of this study was to explore how multiple-patient simulation relates to Bachelor of Science in Nursing (BSN) students' perception of their readiness to care for multiple patients in the clinical environment. Using a qualitative approach, the researcher facilitated a multiple-patient simulation experience and followed the experience with a semi-structured interview of nine senior-level undergraduate BSN students at a Northern California university. Content analysis of the interview responses indicated that students found the simulation experience promoted their perception of readiness to care for multiple patients in the clinical setting. As clinical practice becomes increasingly complex, multiple-patient simulation is a promising modality to adopt in nursing education to assist in the transition of nursing students into successful practicing nurses.

Download or read book A Comparison of Nurses Self assessed Clinical Judgment Abilities Compared to Observed Clinical Judgment Skills During a Simulated Activity written by Cynthia Lynne Fenske and published by . This book was released on 2013 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this study is to determine how closely nurses' perceptions of their clinical judgment abilities match their demonstrated clinical judgment skills when participating in a simulated patient care situation. This study is essential for nursing given the vast amount of data indicating nurses' struggle to make sound clinical judgments during their first year of practice, coupled with the lack of awareness of their limited clinical judgment skills. A descriptive, correlational pilot study was conducted using 74 registered nurses currently practicing in an acute care setting. The nurses participated in a simulation using a video media format. Following the simulation the subjects completed the Lasater Clinical Judgment Rubric (LCJR) indicating their self-assessment of their clinical judgment abilities based on their performance on the simulation. The LCJR was then used to rate the nurses' actual performance with the simulation acitivity. The results of this study indicate that there is a significant discrepancy between nurses' perception of their own clinical judgment skills and their demonstrated clinical judgment abilities. The nurse's age, gender, educational level, and length of nursing experience all were factors that enhanced the difference between the factors of self-assessment and observed performance. Younger nurses and those with one year or less of nursing experience were significantly more likely to have self-assessed their abilities at a level much higher when compared to their actual ability. With the large gap between perception and reality for the younger, inexperienced nurse, it is recommended that nurses and nursing students be trained in self-assessment and receive feedback to close the gap between current and desired performance. The LCJR appears to be a useful tool for self-assessment, as well as for expert evaluation with simulation.

Download or read book Faculty Perceptions of Human Patient Simulation and Student Learning for Clinical Practice written by Sherry Silvia and published by . This book was released on 2013 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: Human patient simulation has become an integral facet in preparing student nurses for practice across the United States. However, it was not known how well human patient simulation augments the critical thinking and skill acquisition that is required for safe, component nursing practice as perceived by the nursing instructors who are required to utilize this form of technology in the classroom. The purpose of this qualitative case study was to explore how the human simulation interactive environment influenced the execution of safe, competent nursing practice as a means of enhancing critical thinking and skill acquisition for undergraduate nursing students as perceived by undergraduate nursing educators in the state of Arizona. The study population was 14 baccalaureate nursing faculty who had experience with the use of simulation in the classroom. Data collection consisted of interviews and optional qualitative questionnaires from these nursing faculty plus field notes for primary data collection. Secondary data of existing information on the use of simulation in baccalaureate nursing programs in the state of Arizona was also used. Student involvement theory was used for the theoretical framework that guided this study. Four themes emerged pertaining to safe environment, enhancement of student learning for safe clinical practice, assisting with critical thinking skills, and helps with skill acquisition through repetition. The results provide practitioners and faculty with a better understanding of how student nurse learning is influenced by human patient simulation and its use in safe, clinical practice. Further research on this

Download or read book Comparing Perceptions and Self efficacy of Student Nurses Actively and Passively Participating with High fidelity Simulation in Nursing Education written by Karen Mastrippolito and published by . This book was released on 2009 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Relationship Between Using Human Patient Simulation and Student Clinical Self efficacy written by Gunnar Ward Larson and published by . This book was released on 2006 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Perceptions of Nursing Students of the Impact that Human Patient Simulation Had on Their Clinical Experience written by Susan Ogilvie and published by . This book was released on 2008 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Virtual Patient Simulation Use Across Disciplines written by Ruby Alumasa and published by . This book was released on 2017 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: The ability to reason clinically is an essential competency for students training to become clinicians, nurses and pharmacists aiming to provide safe and effective treatment to patients within complex and constantly transforming health care institutions. Medical, nursing and pharmacy educators are charged with the ethical and professional obligation to instruct students in ways that prepare them for the workforce. Educators generate learning opportunities through which students' clinical reasoning abilities are cultivated. Simulation provides learning opportunities through which clinical reasoning abilities are developed and utilized (Kaddoura, 2010). This descriptive qualitative study aimed to explore the ways in which undergraduate health care students from different disciplines utilise clinical reasoning strategies to navigate the virtual patient simulation 'Ready to Practice?' and if there are any marked differences between the groups. A sample of seventeen undergraduate Bachelor of Medicine and Bachelor of Surgery (MBChB), Bachelor of Nursing (BNurs) and Bachelor of Pharmacy (BPharm) students participated in the study. The sample was comprised of fourth year medicine (n=10) and pharmacy students (n=5) and third year nursing (n=2) students. Data was collected through completion of the VPS and semi-structured interviews. Utilising an inductive approach to thematic analysis (Crabtree & Mill, 1999), interview transcription data of the participant's discourse was analysed to establish themes. Four main themes arose from this analysis including 1) the reasoning strategies described by participants: hypothetico-deductive, pattern recognition, inductive and prioritising, 2) the value of education and experience 3) the desire for support and 4) the importance on interdisciplinary learning.

Download or read book What is the Perception of the Effectiveness of Simulations in Nursing Education written by Shana Jane Feldman and published by . This book was released on 2013 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this Honor's Thesis was to determine the effectiveness of simulation learning methodologies within nursing education. Bandura's Theory of Self-Efficacy guided this research study (p. 24). Multiple facets of simulation learning methodologies were explored in order to understand the components, purpose, usage, and effectiveness of simulation in nursing education. Simulations included "[m]anikins . . . models of the human combined with technology . . . equipped to give feedback, such as vital signs" (p. 13; cf. p. 35). A quantitative study was conducted using a Likert scale survey to assess both pre-licensure student nurses' and post-licensure nurses' perception of how simulation impacted their nursing education and to determine the ability of simulation to prepare nurses for the clinical setting. The results of this study determined that simulations are most beneficial in the area of debriefing, and least beneficial in areas of communication and anxiety. The perception of the effectiveness of simulations is dependent on if the participant was still in school, or how long they have been out of school at the time of the survey.

Download or read book The Use of an Unfolding Case Study to Enhance Self efficacy in Nursing Students written by Hettie V. Peele and published by . This book was released on 2015 with total page 188 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nurse educators are challenged with preparing new nurse graduates that can function in the current healthcare practice environment of high patient acuity, morbidities, and information technology while maintaining patient safety and quality care management (Cronenwett et al., 2007). Therefore, nurse educators are amenable to exploring alternative teaching pedagogies that provide students with engaging learning opportunities that simulate real-life clinical scenarios they may encounter in professional nursing practice. This study explored the use of an unfolding case study as an innovative teaching strategy to enhance the perception of student self-efficacy. A one-group pretest-posttest descriptive design with a convenience sample of 17 second year associate degree nursing students enrolled in a complex health concepts course was utilized. The General Self-Efficacy Scale was used to measure perceived self-efficacy pre- and post- participation in an unfolding case study. The pretest mean was 3.20 (sd = 0.356) and the posttest mean was 3.38 (sd =0.396). The paired t-test result was 0.182 (sd = 0.300) with a statistical significance of 0.024.The results of this study supported the use of an unfolding case study as a teaching pedagogy to enhance nursing students’ self-efficacy as they transition to enter professional nursing. Bandura’s theory of self-efficacy (Bandura, 1977, 1986) and situation learning theory (Lave & Wenger, 1991) guided the conceptual framework of this study.

Download or read book The Effects of High Fidelity Simulation on Associate Degree Nursing Students Perceived Self Efficacy and Perceived Practice Readiness written by Kristina Nappi and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Nursing educators are increasingly utilizing high-fidelity simulation to provide realistic educational experiences to prepare students to enter the workforce. High-fidelity simulation is utilized with the belief when students encounter real-life patients they will be more confident in their ability to care for them. This quantitative study examined the effects of high-fidelity simulation on senior nursing students perceived self-efficacy and perceived practice readiness. The sample (N=48) consisted of senior associate degree nursing students at a community college in the Southeast. The findings showed high-fidelity simulation had a positive effect on students perceived self-efficacy and perceived practice readiness at certain points in the study, while other times not demonstrating a positive correlation. Implications for use of simulation as a teaching strategy in nursing education and recommendations for future research were proposed.

Download or read book Factors Contributing to Clinical Judgment Development in Nursing Students During Simulation Using the Creighton Competency Evaluation Instrument written by Susan Etheridge Kidd and published by . This book was released on 2017 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt: It is imperative that nurse educators find inventive ways to advance nursing practice by developing a dynamic and divergent nursing workforce. Health care environments can be unpredictable and unsettling due to high acuity levels of patients. The development of excellent clinical judgment is necessary for nurses to meet the workforce demands that this type of environment poses. Nurse leaders report dissatisfaction with new graduates' ability to adequately perform competencies such as critical thinking. Nurse educators must establish approaches that teach, enforce, and evaluate the development of higher level thinking in nursing students. This non-experimental descriptive correlational study explored factors that affect the development of clinical judgment in Bachelor of Science nursing students during a synthesis simulation. The Creighton Competency Evaluation Instrument (CCEI) was used to measure clinical judgment. Tanner's Clinical Judgment Model provided the theoretical foundation for this study. The clinical judgment of 108 BSN students in their fourth semester of a traditional nursing program was assessed by the researcher using the CCEI in the lab during a synthesis simulation. Students also completed a demographic questionnaire. Statistical methods used to analyze the data included descriptive statistics, independent samples t-tests, one way analysis of variance, and Pearson product correlation. Males were found to have significantly higher overall clinical judgment. Males also scored statistically higher on the communication subscale. There were no other statistical differences in demographics or the subscale scores of the CCEI. Work experience had no significant impact on total clinical judgment scores. Participants that reported working in healthcare scored significantly higher on the patient safety subscale of the CCEI that those reporting working but not in healthcare. The unemployed group did not differ significantly from the employed in healthcare or the employed not in healthcare groups on the patient safety subscale. Small correlations were found between HESITM (E2) raw scores and CCEI total as well as communication and clinical judgment subscale scores. The findings of this study contributed to the overall knowledge about clinical judgment and the CCEI as a means to evaluate clinical judgment. Application of findings could be used to increase the use of simulation and foster the development of clinical judgment in nursing students. Clinical judgment terminology should be a standard part of every nursing curriculum. Simulation, with an emphasis on clinical judgment, could be used to increase HESI[trademark] (E2) scores of students thus better preparing them for NCLEX. It is recommended that future studies use a longitudinal approach to measuring clinical judgment. This would provide more discernible data to evaluate the development of clinical judgment over time. It is also recommended that more research be done to establish the CCEI as a valid and reliable tool to measure clinical judgment as well as faculty perceptions of the CCEI.

Download or read book The Effect of Simulation on the Development of Clinical Judgment in Second Degree Nursing Students written by Mary Ellen Rush and published by . This book was released on 2019 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nurses are challenged to use critical thinking skills and make sound clinical judgment in achieving optimal patient outcomes and improving patient safety (Alfaro-LeFevre, 2017). Clinical judgment is the ability to interpret patient data, and develop appropriate and timely interventions (Bussard, 2018). The effect of simulation on the development of clinical judgment has been investigated extensively in traditional nursing students. The rapid development of second-degree nursing students to address the nursing shortage (Sedgwick, Kellet, & Kalischuck, 2014), requires further investigation of the effect of simulation on the development of clinical judgment in second-degree nursing students. Opportunities for simulation experiences promote the development of clinical judgment in second-degree nursing students (Mariani, Cantrell, Meakin, & Jenkinson, 2015). This study encompassed a regularly scheduled simulation experience for students enrolled in a gerontology course in a second-degree nursing program. The study used a cross sectional design and encompasses an educational preparation video and demographic survey prior to the simulation. The Lasater Clinical Judgment Rubric (Lasater, 2007) was used post debriefing and reflection to assess the effect of the simulation on the development of clinical judgment. Statistical analysis using SPSS software was used for data analysis, results, and understanding the implications for translating the evidence into practice.

Download or read book Learning from Experience written by Hui Zhang and published by Linköping University Electronic Press. This book was released on 2021-01-22 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Simulation enhances experiential learning through creating experience to form the basis of learning, and it has been recognized as an effective pedagogy in current health professions education. As an integral element of simulation, debriefing contributes to transforming the created experience to new knowledge. Video-assisted debriefing (VAD) refers to adding audio-visual capture and review to traditional verbal debriefing (VD). Despite being regarded as ‘gold standard’ for simulation, evidence reporting educational effects of VAD is mixed and its best practice remains absent. Aims: The aims of this thesis were to develop a framework for VAD, to test and compare its effects on prelicensure nursing students’ debriefing experiences, reflective abilities and nursing competencies with VD without video, as well as to explore its potential impact on facilitators’ perceptions and practices following high-fidelity simulation. Design and methods: This thesis comprised of four studies with different research designs. Study I was a systematic review which synthesized the characteristics of existing VAD practices in health professions education and evaluated its effectiveness on learners’ reactions, learning and behaviors. Study II was a proof-of-concept study which developed of a three-phase framework for VAD and tested its preliminary effects on nursing students’ debriefing experiences, reflective abilities, and nursing competencies using a pretest-posttest design. Study III adopted a qualitative method to explore nursing students’ experiences and perspectives of a structured VAD using focus groups. Data were analyzed using thematic analysis approach. Study IV employed a mixed-method research design to investigate the impact of a three-phase VAD on nursing students’ debriefing experiences, perceived stress, as well as facilitators’ perceptions and debriefing practices. Results: Study I showed that existing VAD offered comparable educational effects as VD in terms of learners’ experiences, attitudes, and performance, except on knowledge acquisition. Video did not demonstrate its continuous advantage in debriefing, which informed the absence of best practice. The preliminary results of Study II reported that a three-phase VAD significantly improved students’ debriefing experiences (p<0.001), reflective abilities (p<0.01), and nursing competencies (p<0.001). Study III disclosed an emotional roller coaster experienced by nursing students in VAD, from unwillingness and fear of being judged, followed by stress and defensiveness, to sense of appreciation and satisfaction. Most students agreed that VAD provided a good learning experience with few preferred not to receive peer feedback after video review. Study IV demonstrated that VAD improved nursing students’ debriefing experiences (p=0.01) and caused comparable stress as VD. Repeated exposure to VAD significantly reduced stress levels. VAD also enhanced facilitators’ perceptions and debriefing practices. Conclusions: This project developed a three-phase framework for VAD, and affirmed its educational effects on improving nursing students’ debriefing experiences, reflective abilities, and competencies following high fidelity simulation, with comparable stress experienced as in VD. The finding of an emotional roller coaster experienced by nursing students in VAD challenged the snapshot of negative emotions reported in other studies, offering some clarity to the inconsistent evidence regarding learners’ experiences of VAD and contributing to its best practice. This thesis also proved that this three-phase VAD held the potential to enhance facilitators’ debriefing practices towards student-centered learning. Bakgrund: Att simulera olika vårdsituationer är idag en väl använd pedagogisk metod inom hälsoutbildningarna eftersom erfarenheten av att träna simulering kan förbättra inlärningen. Debriefing ingår som en integrerad del i simuleringen och bidrar till att omvandla erfarenheten till kunskap. Video-assisterad debriefing innebär att simuleringssituationen filmas och filmen används sedan i debriefingen. Trots att det är vanligt att använda video-assisterad debriefing är bevisen för att det är bättre än debriefing utan video oklara. Syfte: Syftet med denna avhandling var att utveckla en strukturerad video-assisterad debriefing att använda i samband med simulering på sjuksköterskeutbildningen. Att sedan testa den på sjuksköterskestudenter för att se om den påverkade deras debriefing erfarenhet, reflektionsförmåga och omvårdnadskompetens jämfört med sjuksköterskestudenter som erhöll debriefing utan video. Syftet var också att utforska handledarnas uppfattning och genomförande av video-assisterad debriefing i samband med simulering. Design och Metod: Avhandlingen består av fyra studier med olika design. Studie 1 var en systematisk litteraturstudie där 23 artiklar innehållande tidigare erfarenheter av videoassisterad debriefing från hälsoutbildningar granskades och syntetiserades. I studie 2 utvecklades en strukturerad video-assisterad debriefing i tre faser som sedan testades på sjuksköterskestudenternas (n=63) debriefing erfarenhet, reflektionsförmåga och omvårdnadskompetens genom en före-efter design. I studie 3 användes en kvalitativ design för att med hjälp av fokusgrupper utforska sjuksköterskestudenternas (n=27) erfarenheter av att använda video-assisterad debriefing. Studie 4 var en mixed-methods studie som undersökte betydelsen av en strukturerad video-assisterad debriefing jämfört med debriefing utan video på sjuksköterskestudenternas (n=145) debriefing erfarenhet och uppfattning av stress i samband med debriefingen. I studie 4 undersöktes även handledarnas (n=8) uppfattningar och genomförande av video-assisterad debriefing. Resultat: Studie 1 visade att video-assisterad debriefing var jämförbart med debriefing utan video vad det gäller erfarenheter, attityder och genomförande men var inte bättre vad det gäller förvärvande av ny kunskap. Resultaten från studie 2 visade att den strukturerade videoassisterade debriefingen signifikant förbättrade sjuksköterskestudenternas debriefing erfarenhet (p<0,001), reflektionsförmåga (p<0,01) och omvårdnadskompetens (p<0,001). Studie 3 visade att strukturerad video-assisterad debriefing var som en emotionell bergodalbana

Download or read book Self directed Simulation written by Kristen Leigh Mattox and published by . This book was released on 2020 with total page 155 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychomotor nursing skills are a fundamental part of curricula for all schools of nursing no matter the degree level of the program. Demands placed on schools to produce a generalist nurse with the ability to safely practice in the clinical setting is high. There is no standard method of teaching or evaluation regarding psychomotor nursing skills, and there is much room for studies to demonstrate best practice. On top of the already mentioned high demands placed on schools of nursing are the demands of content-saturated nursing curricula on the students. Nursing students are placed under stress-producing situations that create high levels of anxiety. Schools expect students to perform at very high levels and to demonstrate competency of skills learned in a practicum setting. There is a need for best practice in teaching and evaluating psychomotor nursing skills. There is also a need for experienced faculty to teach the skills. The purpose of this exploratory study was to evaluate student levels of self-efficacy in the performance of psychomotor nursing skills after implementation of the learning strategy self-directed simulation. Self-directed simulation is a strategy created by the researcher in response to students' level of anxiety and uses theoretical knowledge of ways to decrease student anxiety and increase learning and retention. Self-efficacy was measured in 94 students from a Midwestern school of nursing who were enrolled in a fundamentals of nursing course. Additionally, the researcher conducted 14 qualitative interviews to further investigate the self-directed simulation strategy, self-efficacy, and learning.