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Comparing Outcomes of Active Student and Observer Roles in Nursing Simulation

Bates, Teresa A. DNP, RN; Moore, Leslie C. PhD, RN, CNE, MBA; Greene, Debbie PhD, RN, CNE; Cranford, Joan S. EdD, RN

doi: 10.1097/NNE.0000000000000603
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Background Because of large class sizes and limited resources, students participating in high-fidelity simulation experiences may be assigned to an observer role as opposed to an active nursing role.

Purpose Educators need to determine if anxiety levels and student learning outcomes are comparable for students in active and observer roles.

Methods A quasi-experimental study was conducted with 132 prelicensure baccalaureate students. Active nursing roles consisted of primary care, documentation, and medication nurse roles. Observer role students were provided with resources to guide them with developing their observational skills and achieving the simulation objectives.

Results There were no significant differences between simulation roles for anxiety levels, satisfaction with learning, self-confidence in learning, clinical ability, problem solving, confidence in clinical practice, and collaboration.

Conclusions These findings suggest that either role is an appropriate assignment during simulation. Educators should identify ways to be supportive and reduce anxiety in students during simulation experiences.

Author Affiliations: Clinical Assistant Professor (Dr Bates), School of Nursing, Georgia State University, Atlanta; Associate Professor (Drs Moore and Greene), School of Nursing, Georgia College & State University, Milledgeville; Assistant Dean (Dr Cranford), School of Nursing, Georgia State University, Atlanta.

The authors declare no conflicts of interest.

Correspondence: Dr Bates, Georgia State University, 140 Decatur St, Urban Life Building 927, Atlanta, GA 30302 (

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Accepted for publication: August 1, 2018

Published ahead of print: September 17, 2018

Cite this article as: Bates TA, Moore LC, Greene D, Cranford JS. Comparing outcomes of active student and observer roles in nursing simulation. Nurse Educ. 2019;44(4):216-221. doi: 10.1097/NNE.0000000000000603

Online date: September 17, 2018

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