Defense Date


Graduation Date

Spring 2014


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Melanie Turk

Committee Member

Charles Larew

Committee Member

Katie Adamson-Haerling


clinical nursing judgment, performance, pre-licensure education, simulation, simulation design, theory-based


Simulation is an experiential learning process used in nursing education to develop and evaluate competencies, including clinical judgment (Berragan, 2011; Jeffries, 2012), yet the effectiveness of simulation in nursing education is not sufficiently evaluated (Foronda, Liu, & Bauman, 2013) and simulation design is not adequately theory-based (Kaakinen & Arwood, 2009; Rourke, Schmidt, & Garga, 2010; Jeffries, 2012; Rodgers, 2013). In this study, Kolb's Model of Experiential Learning (Kolb, 1984; 1999) was employed to create an experiential learning simulation design. A quasi-experimental study was used to test the effects of this new design on clinical nursing judgment development and its relationship to simulation performance. An independent samples t-test showed clinical nursing judgment development of students engaged in a simulation experience using the experiential learning simulation design (M = 27.81, SD = 4.84) was significantly higher than clinical nursing judgment development of students who were engaged in a traditional design, (M = 20.75, SD = 3.96), p < .001. There was a significant positive correlation between clinical nursing judgment development and simulation performance (r = .69, p < .001) in the experiential learning group. Regression analysis showed 47% of the variance in simulation performance as measured by the C-SEI was associated with clinical nursing judgment development as measured by the LCJR, R2 = .467, p < .001. Findings suggest that when simulation design is fully based on the experiential learning model clinical nursing judgment is more highly developed. This judgment is significantly positively correlated with competency in simulation performance. It is recommended for future research that the study be repeated using different samples, scenarios, and points in the trajectory of clinical nursing judgment development. The relationships between clinical nursing judgment development, simulation performance, and clinical performance also need to be analyzed.