Degree Name
Nursing Practice, DNP
Publication Date
6-26-2026
First Advisor
Lisa Drake
Second Advisor
Brandi Castle
Abstract
Simulation is a critical component of nursing education, providing students with a safe environment to develop clinical judgment and confidence before entering clinical practice. However, students may experience anxiety and difficulty meeting competency expectations during simulation. This quality improvement project evaluated whether structured simulation remediation improved confidence and clinical judgment among associate degree nursing students. The project was guided by the NLN Jeffries Simulation Framework, and Kotter’s 8-Step Change Model supported implementation. A quantitative, quasi-experimental pre-/post- intervention design was used. Nine nursing students voluntarily participated. During remediation, students reviewed recordings of their initial simulation experiences and completed guided reflection questions structured around the Plan-Do-Study-Act cycle. Confidence was measured using the Simulation Improvement and Reflection Confidence Assessment (SIRCA), and clinical judgment was evaluated using the Lasater Clinical Judgment Rubric (LCJR). Because the paired data were non-normally distributed, Wilcoxon signed-rank tests were used. Confidence scores significantly increased from a median of 3.90 to 4.40, W = 1.00, p = .013, with a large rank-biserial effect (rrb = .956). Clinical judgment scores increased from a median of 3.18 to 3.73, but the change was not statistically significant, W = 9.00, p = .123, rrb = .600. Findings support structured video-review remediation with guided reflection as a feasible strategy for strengthening simulation remediation practices and student preparedness for clinical care.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Gillespie, Erica, "Quality Improvement Project: Improving Confidence and Clinical Judgment through Simulation Remediation in Nursing Students" (2026). Doctor of Nursing Practice Projects. 356.
https://arch.astate.edu/dnp-projects/356
