This paper examines the effects of simulation laboratory experiences on the self-confidence and critical thinking skills of nursing students preparing to become licensed practical nurses. Drawing on a broad review of literature, it defines the key dependent variables—self-confidence and critical thinking—and explores the independent variable of human patient simulation (HPS), including low-, medium-, and high-fidelity simulators. The paper discusses simulation as a teaching method, the structure of simulation labs, and the theoretical underpinnings of simulated learning, including Knowles' adult learning theory and experiential learning frameworks. It concludes with practical recommendations for nurse educators seeking to integrate simulation effectively into nursing curricula.
Nursing graduates must have self-confidence and critical thinking capabilities in order to resolve multifaceted patient care issues. The use of human patient simulators to supplement teaching in schools of nursing is rising; however, further research is needed in order to validate the claim that learning by way of simulation enhances critical thinking and self-confidence (Soucy, 2011). Nursing educators are increasingly utilizing technology to provide realistic educational experiences that prepare students to enter the workforce. Human patient simulation (HPS) is one type of technology that nursing educators are using, with the belief that when students encounter a real-life experience after simulation, they will perform in a more self-confident manner (Lyles, 2009).
Literature reviewed in preparation for this study included many articles, theses, texts, and dissertations about simulation and self-efficacy. Specific areas explored include simulation, simulators, simulation as an educational strategy and supporting theoretical foundations, application in healthcare and nursing education, self-efficacy in the education of healthcare providers, and the effect of simulation on self-efficacy.
Self-confidence is a highly significant characteristic that contributes to successful nursing practice. Nurses who project self-confidence put patients at ease, advocate for patients more assertively, and are better able to develop solutions to patient care problems. Nurses who radiate self-confidence augment patient comfort. Patients should feel that those providing their care are doing so with accuracy and proficiency. There are several characteristics connected with self-confidence. Nursing students with self-confidence believe in their capability to act in ways that benefit patients. In collaboration with the patient, nursing students establish a goal or patient outcome toward which both parties are willing to strive. This gives the student direction and can help increase self-confidence because the student can develop interventions to meet the objective. The student has both a reason and a direction.
Nursing students must also develop self-awareness and maintain an internal locus of control. For a nurse to be effective, they must believe they are capable of success. They begin by setting a goal for the patient, which helps nursing students to manage their own nervousness and to ask for help when needed. Of course, nursing students must acquire knowledge and skills before self-confidence can develop. Nursing students ought to be in a supportive environment and should be permitted to experience patient contact in skill-appropriate circumstances. "Nursing students without any prior clinical experience should not be placed in an emergency situation; instead, they should be allowed to care for a medically stable patient. Nursing students who develop self-confidence are able to advance effectively as practicing nurses" (Soucy, 2011).
Developing feelings of self-confidence can be achieved in nursing education, but it requires time and attention from nursing faculty and a commitment from nursing students. When students feel comfortable with the cognitive and psychomotor aspects of a patient situation, feelings of self-confidence will emerge. Students, however, need faculty support and guidance throughout the full range of learning in a nursing program. "For example, if students are participating in a learning activity involving a human patient simulator, the faculty member should require that students participate in a comprehensive, organized debriefing session after the activity. Organized debriefing sessions allow the faculty member to give feedback, answer questions, and praise the budding clinical competence demonstrated by the students" (Soucy, 2011).
Critical thinking is a complex skill for students to achieve but a necessary function of successful nursing practice. Nurses process large amounts of patient information and then make inferences, prioritize patient care needs, and creatively solve problems (Soucy, 2011). Nurses who are critical thinkers value and adhere to intellectual standards. Critical thinkers strive to be clear, precise, specific, rational, thorough, relevant, and fair when they listen, speak, read, and write. They think both deeply and broadly, and their thinking is adequate for its intended purpose. Nurses aim to eliminate irrelevant, contradictory, and irrational thoughts as they reason about client care. Nurses use language to communicate clearly and in detail the information that is important to nursing care. "Nurses who are critical thinkers hold all their views and reasoning to these standards as well as the claims of others, such that the quality of nurses' thinking improves over time, thus eliminating confusion and ambiguity in the presentation and understanding of thoughts and ideas" (Critical Thinking and Nursing, 2008).
Critical thinkers in nursing are skilled in using intellectual abilities for sound reasoning. These abilities include information gathering, focusing, remembering, organizing, evaluating, generating, synthesizing, and appraising. The focus of classroom and clinical activities is to develop the nurse's understanding of scholarly, academic work through the effective use of intellectual capacities and skills. As practitioners encounter increasingly complex practice situations, they are required to think through and reason about nursing at greater depth and to draw on deeper, more complicated understandings of what it means to be a nurse in clinical practice. Nursing is never a shallow or meaningless activity. All acts in nursing are extremely significant and require the nurse to be mindfully engaged. "This is the challenge of nursing: critical, reflective practice based on the sound reasoning of intelligent minds committed to safe, effective client care. To accomplish this goal, students will be required to reason about nursing by reading, writing, listening, and speaking critically" (Critical Thinking and Nursing, 2008).
"Simulator types and simulation as pedagogy"
"Lab structure, benefits, and curriculum role"
"Adult learning and NLN framework applied"
"Practical guidance for nurse educators"
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