Simulation in nursing education: an evaluation of students' outcomes at their first clinical practice combined with simulations.

BACKGROUND: Nursing students frequently report feeling anxiety prior to entering their first clinical setting. Education through simulations reduces the anxiety level of nursing students and contributes to various outcomes for students' learning processes.
OBJECTIVES: The purpose of this study was twofold: to evaluate the effectiveness of simulations in reducing anxiety and promoting self-confidence, caring ability, and satisfaction with simulation; and to investigate the predictors and mediators for caring efficacy among nursing students. The authors examined concepts that have been studied only minimally in the literature.
DESIGN: A descriptive quantitative study.
SETTING: Zefat Academic College, Nursing Department, Zefat, Israel. PARTICIPANTS: 61 second-year nursing students at their first clinical practice.
METHOD: Data was collected before the first clinical and simulations practice (T1), and four months later (T2) after they had finished their first clinical practice in a hospital setting. Hierarchical linear regression was applied to examine the research hypotheses.
RESULTS: The results revealed that anxiety scores decreased, while self-confidence and caring ability scores increased after using simulations. Caring efficacy was negatively predicted by anxiety, and positively with self-confidence, caring ability and satisfaction with simulation.
CONCLUSIONS: The use of simulations before and during nursing students' first clinical practice is a useful and effective learning strategy. Nursing educators should be aware of the high level of anxiety among nursing students during their first clinical practice, and design a program to reduce the anxiety through simulations.