Date of Award


Document Type


Degree Name

Master of Science in Nursing (MSN)


Nursing (Graduate)

First Advisor

Louann B. Zinsmeister

Second Advisor

Anne B. Woods


The use of simulation-based activities is a growing trend in nursing pedagogy and requires evaluation to assess and improve outcomes. This project completed a review of multiple research studies and reviews to evaluate the effects of simulation and simulation methods on students’ sense of self-efficacy and confidence. The findings support the use of simulation and found that simulation does increase students’ perception of confidence and self-efficacy. The data collected included both qualitative and quantitative data. A few studies lacked generalizability due to small sample size and scenario selection. However, multiple methods were noted to improve the simulation experience and they include high-fidelity simulation, multiple patient scenarios, reflection exercises, debriefings, realism, skills practice, group work, role-play, active learning, and facilitation. Weaknesses identified included stress, potential for rote learning, contempt for artificial patients, differences in self-efficacy of those with a history of clinical experience and those without, and lack of relationship between self-efficacy over time. The research provided insight into the strengths and weaknesses of simulation as a teaching method and provided a vision for potential future research and changes to improve simulation as a teaching method based on their effects on student confidence and self-efficacy.


This is an evidence-based practice capstone project submitted to the faculty of the graduate program in nursing in partial fulfillment of the requirements for the degree Master of Science in Nursing.