High-fidelity Simulation and the Development of Self-confidence in Clinical Decision Making When Delivering Patient Care

The competition for available clinical practice sites has increased the need for alternative measures to provide the means for nursing students to develop self-confidence in clinical decision making when providing patient care. The purpose of this one-group, pretest-posttest correlational study was to determine fourth semester associate-degree-seeking nursing students’ perceived levels of self-confidence and anxiety with clinical decision making when delivering patient care after completing a standardized high-fidelity simulation (HFS) following the pandemic. Kolb’s experiential learning theory provided the theoretical framework for this study explaining the connection between experiential learning and HFS. The Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale (NASC-CDM©) was utilized to obtain the data. After consenting, the participants completed a demographic survey, a pre-survey before completing a standardized HFS experience, and a post-survey. Of the 144 potential participants, 67 consented to participate. The participants were predominantly female (85.1%), white (59.7%), 18–24 years old (32.8%), and had previous healthcare experience (68.7%). Both parametric (paired samples t test, two-tailed and Pearson’s r, two-tailed) and non-parametric (Wilcoxon signed rank, matched pairs, two-tailed test, and Spearman’s coefficient, rs, two-tailed) statistics were conducted; each revealing statistically significant results (p < .001) and large effect sizes. Thus, the findings of this study indicate that HFS has a statistically significant positive effect on self-confidence in clinical decision making with a decrease in anxiety levels for the participating fourth-semester associate-degree-seeking nursing students. One recommendation is to control for previous healthcare experience in similar one-group, pre-test, post-test correlational studies.