Date
4-18-2025
Department
School of Nursing
Degree
Doctor of Philosophy in Nursing (PhD)
Chair
Kara Schacke
Keywords
simulation, multiple exposures, repeated exposures, critical thinking, direct patient care
Disciplines
Education | Nursing
Recommended Citation
Veltre, Dawn, "Effect of Multiple Simulation Exposures on Nursing Students' Critical Thinking in First Direct Patient Care Practice" (2025). Doctoral Dissertations and Projects. 6787.
https://digitalcommons.liberty.edu/doctoral/6787
Abstract
Critical thinking is a core competency essential for nursing practice, and nursing students must develop these skills to become competent nurses. The purpose of this quantitative quasi-experimental pretest-posttest design is to determine the effect of multiple simulation exposures on nursing students' critical thinking during their first direct patient care practice. A convenience sample of 39 first-year nursing students enrolled in an associate degree nursing program in the western United States participated in this study. Participants completed a demographic survey and the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills before multiple simulation exposures, two exposures, or four exposures and two weeks after direct patient care practice. Paired t-test was used to assess differences within groups. Independent samples t-test and two-way mixed analysis of variance (ANOVA) were used to compare differences between groups. The results revealed the multiple simulation exposures improved critical thinking in first direct patient care practice. The two simulation exposures had a statistically significant (p = .043) positive effect on critical thinking. The four simulation exposures (p = .106), the difference between two and four exposure conditions (p = .604), and the difference in change over time between the two and four simulation exposures (p = .604) were not statistically significant. Although not statistically significant, the results revealed increased critical thinking scores pretest versus posttest. Recommendations for future research include conducting studies at multiple nursing program sites, increasing the sample size, using an alternative testing instrument, and conducting longitudinal studies.
