Date of Award

Spring 2024

Project Type

Clinical Doctorate

College or School




Program or Major


Degree Name


First Advisor

Cathleen Colleran

Second Advisor

Beth Ely



Background: Nursing education worldwide varies in duration and training process, with nurses often facing rapid immersion into patient care complexities when entering the workforce. While new nurses contribute significantly to the nursing community with contemporary knowledge, their transition to practice can be daunting, necessitating support for both competence and retention. As specialty care settings integrate more new graduate nurses (NGNs) to address workforce shortages, collaboration between leaders and educators becomes crucial. Simulation emerges as a vital tool in building confidence while learning, offering a safe space for skill development and growth of confidence.

Purpose: This project’s objective was to examine the current orientation process for NGNs in a rural community hospital. The project aimed to implement and evaluate the implementation of high-fidelity simulation and alternative education and its effect on the self-perceived confidence and competence of NGNs.

Method: In this descriptive, quality improvement project, a modified version of the Casey Fink Graduate Nurse Experience Survey© was used pre- and post-educational intervention for measurement to determine whether there was an effect on the self-perceived confidence and competence of the participants.

Intervention: NGN participants engaged in educational activities comprised of evidence-based case studies, drills, and high-fidelity simulations. The use of these scenarios not only facilitated the integration of theoretical knowledge but also promoted teamwork and interpersonal skills through experiential learning. Debriefing sessions facilitated using the PEARLS Healthcare Debriefing Tool©, provided a platform for reflection and skill development, supported by the project lead’s extensive experience in simulation and maternal-newborn nursing.

Results: The Modified Casey Fink Graduate Nurse Experience Survey© revealed some gains in NGNs’ self-reported confidence and competence levels in various clinical decision-making skills, patient care prioritization, and delegation abilities post-education. Discussion amongst NGNs echoed the sentiment of these findings, emphasizing the value of simulation-based learning in preparing nurses for real-world scenarios. Participants expressed a strong preference for incorporating high-fidelity simulation into orientation and training programs for all WCC nurses.

Conclusions: Overall, the findings suggest that simulation-based education can be a valuable learning tool for NGNs, fostering confidence, competence, and readiness for clinical practice. Participants’ expressed positive responses to high-fidelity simulation underscores its potential role in shaping the future of nurse education for the Women & Children’s Center (WCC).