Newly Licensed Registered Nurses' Experiences With Clinical Simulation

The purpose of this study was to understand how new graduate nurses perceive the value of simulation in making the transition into professional practice. This study will use a descriptive qualitative approach with a sample of first year nurses. Kolb’s Experiential Learning Model serves as this study’s conceptual framework. For the current study, the sample consisted of 10 newly graduated, female nurses with less than one year of experience working in the hospital setting were interviewed. Data analysis included interviews and transcription by the researcher. Finally, participants were asked about themes to increase rigor. Four themes emerged from this research: 1) how simulation is being used, 2) the perceived value of simulation, 3) simulation versus “real life,” and 4) simulation and preparation for practice.

The nursing education system is facing increasing pressure to adapt to the requirements of a constantly evolving profession (Hegarty, Walsh, Condon, & Sweeney, 2009). The most significant of these requirements is addressing the nursing shortage. In response to the current nursing shortage, the number of nursing students and nursing programs has grown exponentially and overwhelmed clinical sites (the hospitals and clinics where nursing students are taught the practicalities of patient care). In addition, the shortage has left staff nurses overwhelmed with their patient care workloads, a problem compounded by the need to supervise an increasing number of nursing students on hospital units. Another complicating factor of the nursing shortage is the distressing rise in morbidity and mortality among hospitalized patients throughout the United States (Institute of Medicine, 2000). These rates have heightened concerns about professional competency among nurses. Other factors affecting the nursing profession include globalization, technology proliferation, increasingly educated consumers, managed care challenges, skyrocketing healthcare costs (Heller, Oros, & Durney-Crowley, 2000).
Increasing pressure to provide excellent clinical education experiences, which allow nursing students to practice their didactic learning, amid a profound nursing shortage has led to an increasing demand for the limited clinical sites available, making such sites increasingly harder to obtain (Lasater, 2007). Also affecting the nursing students’ ability to obtain a quality clinical experience is the decreasing length of stays for a growing majority of patients, as mandated by the managed health care industry (Lasater, 2007). With patients staying in acute care areas for shorter lengths of time, nursing students have fewer opportunities to practice and gain competency in many of the skills they will be expected to perform on the job. These factors result in a marked deficit in clinical experiences for baccalaureate nursing students (Hickey, 2009). This deficit may be one reason for the increasing criticism of nursing programs by healthcare employers who feel nursing students are not being adequately prepared for the workforce (Candela & Bowels, 2008).