Exploring the Relationships of Realism, Engagement, and Competency in Undergraduate High-Fidelity Nursing Simulation

Objective: To examine the relationship between nursing students’ perceived realism, level of engagement, and competency in simulation to inform educators in competency-promoting simulation design. Design: Quantitative, correlational. Setting: One private, midsized university in the northeast part of the United States. Participants: Forty -six undergraduate students enrolled in a second-degree nursing program. Methods: Participants completed two Likert-style surveys after participating in a high-fidelity simulation. The researcher used audiovisual recorded simulations and an observational participant competency assessment. Results: Key findings included a positive correlation between the levels of perceived realism and engagement in a high-fidelity nursing simulation and a positive correlation between hospital experience and competency demonstrated in a high-fidelity simulation. Perceived realism and level of engagement were not predictors of competency in a simulation. Conclusion: Results of this study illustrate that when students’ perception of realism of a simulated experience increases their engagement in the simulation tends to increase. Engagement is considered valuable as an antecedent to learning, yet the level of engagement was not a predictor of competency. Health-care experience is correlated with higher levels of competency; however, the amount and exact nature were beyond this study\u27s scope. Competency in nursing, essential to patient safety, is complex and related to many variables, including healthcare experience. Therefore, understanding how individual and simulation design variables relate to competency is valuable in nursing education