Purpose: To identify the nursing clinical practice parameters that are influenced by simulation practice and to measure clinical performance improvement.

Method: The convenience sample consisting of 12 Senior Second Bachelor Nursing students of UMASS – Amherst were randomly assigned to an intervention and a control group. In addition to their clinical requirements, the intervention group participated in two practice simulation scenarios where they provided nursing care for two complex patients developed using the Laerdal simulation software. The control group completed their clinical requirements with no simulated practice. Using a complex two-patient simulation scenario, all the students were evaluated at the end of the semester based on their performance on safety, basic assessment skills, prioritization, problem focused assessment and consequent interventions. An evaluation tool developed was used to measure the student’s performance during simulations by a faculty evaluator who had no knowledge of the students’ group membership.

Results: Students who practiced with the HPS in addition to their usual clinical training performed significantly better than the control group (usual clinical training alone) on Patient Identification (a subcategory of the safety category; p = 0.001), and on Assessing Vital Signs (a subcategory of the basic assessment category; p = 0.009). The control and intervention groups’ performances were similar in every other category. Chi-square test was used for the comparison.

Conclusions and Implications: This quasi-experimental study linked the use of simulation practice with better performance in student nurses’ patient identification and assessment of vital signs in a complex two-patient assignment clinical scenario. The clinical simulation’s safe setting for clinical practice is ideal to practice high-risk procedures and low-volume, high-risk patient conditions.