Effect of a Prebrief on ADN Final Semester Student Anxiety during a High Fidelity Simulation: A Quasi-Experimental Study

Abstract

Quality clinical placement opportunities for associate degree nursing (ADN) programs are dwindling. According to the National Council of State Boards of Nursing (NCSBN), high quality simulation can replace up to 50% of student clinical hours without loss of practice readiness (Hayden et al., 2014, p. 36). However, students experience high levels of anxiety during high fidelity simulation (HFS) which impedes transference of learning. Inability to transfer HFS learning to clinical practice endangers patients. The prebrief is the first phase of HFS and has shown promise in decreasing student anxiety. Yet, there are sizeable gaps delineating prebrief design in the pedagogical literature. The National League for Nursing (NLN) Jeffries Mid-Range Theory incorporates teacher factors, student factors, educational practices, simulation design, and outcomes in a framework for HFS educational experiences. Furthermore, the NLN Jeffries Theory specifically identifies a well-designed prebrief as the first phase in effective HFS implementation. The purpose of this DNP project was to study how a prebrief impacted final semester nursing students’ state anxiety during HFS in an ADN program to begin to bridge the knowledge gap. A non-randomized, single site, one-group, pre-test, post-test, quasi-experimental design with final semester ADN nursing students (n = 19) was conducted to explore the research question. The data was analyzed utilizing a two-tailed, paired samples t-test with a nonsignificant result, p = .23. However, the effect size was small (0.28) indicating the need for further investigation of the phenomenon. Additionally, a standardized evidence based prebrief template was created for the DNP project site to improve consistency across the program.

Keywords: High fidelity simulation, anxiety, prebrief, ADN final semester students

JEL Classification: A22, I21