title: The effect of simulation on clinical performance: a junior nursing student clinical comparison study.
abstract: BACKGROUND
  Patient simulation has been used to augment the traditional clinical model, but its value is unclear. The aim of this study was to evaluate the effects of a theory-driven pediatric simulation curriculum on nursing students' clinical performance.
  
  
  METHODS
  The convenience sample included 116 junior nursing students enrolled in a pediatric course. Using a staggered timing model, students attended simulation instead of clinical for 2 weeks (25%) of an 8-week semester. The students spent the same amount of time in simulation as in clinical (12 hours per week). Student clinical performance was assessed using a Likert-style tool at 2-week intervals by the clinical faculty. Scores of students who attended simulation in the first 2 weeks were compared with students who had not yet attended simulation. Data were analyzed using repeated measure analysis with the mixed model, and covariate effects were considered. A Compound Symmetry covariance model was used to control the correlation between weeks within each subject. Statistical significance was determined at the 5% level.
  
  
  RESULTS
  Faculty rated students with patient simulation experience higher than those who had not yet attended simulation (mean ± standard error: 1.74 ± 0.75, P = 0.02). On item-level analysis, therapeutic skills were positively impacted by simulation (P = 0.02).
  
  
  CONCLUSIONS
  Time in simulation enhanced clinical performance, as simulation students achieved higher scores more quickly than those without simulation and maintained high performance levels. These findings suggest patient simulation is a valuable addition to augment the apprenticeship model.
authors.affiliation: University of Kansas School of Nursing, Kansas City, KS 66160, USA. mmeyer4@kumc.edu
authors.forename: Mary N
authors.initials: MN
authors.lastname: Meyer
authors.forename: Helen
authors.initials: H
authors.lastname: Connors
authors.forename: Qingjiang
authors.initials: Q
authors.lastname: Hou
authors.forename: Byron
authors.initials: B
authors.lastname: Gajewski
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004506:Education, Nursing / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D012579:Schools, Nursing; D013338:Students, Nursing