Student self-confidence with clinical nursing competencies in a high-dose simulation clinical teaching model

Abstract

Objective: This paper describes undergraduate nursing students' assessment of confidence in clinical practice within a model that uses a "high-dose" of clinical simulation to replace 50% of the traditional clinical experience hours in an upper division bachelor's degree program. We assessed changes in self-reported confidence between the middle and end of a two-year nursing curriculum. Design: Longitudinal design. We surveyed undergraduate nursing students to assess their perceived self-confidence in carrying out eight core competencies associated with generalist nursing practice with the Assessment of Nursing Education Scale (Robert Wood Johnson Foundation, 2009) at the mid-point (semester 2) and end of program (semester 4). Methods: Data were analyzed Generalized Linear models. To account for changes over time, we included program track (traditional BSN or 15-month accelerated second degree program) and gender (male/female) as co-variates in the models. Results: One hundred and twenty-two students completed the ANE at the two time points. Results for analysis of student confidence over time showed significant improvement on each of the eight domains of generalist nursing practice. There was no significant effect of gender or program type on student's perceived self-confidence. Conclusions: Overall significant improvement in students' self-assessed confidence from program mid-point to end-point lends support to the efficacy of a clinical teaching model that uses a high dose of simulation to substitute for traditional clinical hours.