Featured Article| Volume 25, P22-27, December 2018

The Influence of Simulation Experiences on New Nurses' Clinical Judgment

Published:November 30, 2018DOI:


      • High-fidelity simulation (HFS) was perceived by new nurses as contributing significantly to the development of clinical judgment.
      • New nurses recalled HFS as helpful in both specific ways (i.e. recalling a specific scenario) and in general ways (i.e. helping them learn to process multiple considerations).
      • Specific aspects of HFS were recalled as helpful in developing skills such as the ability to notice patient issues, respond appropriately, and reflect on patient care experiences.



      The increasing incorporation of high-fidelity simulation (HFS) in nursing education warrants further exploration of the contribution of HFS to subsequent development of nurses' clinical judgment.


      A thematic analysis was performed of in-depth audio-taped interview data from 20 registered nurses with one to three years of work experience.


      HFS provided students opportunities to think and act in the nursing role and thus supported their ongoing development of clinical judgment. HFS contributed to enhanced learning in clinical settings.


      The intersection of didactic instruction, clinical experience, and HFS experience is complex. HFS may provide valuable experiences for nursing students.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Simulation In Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Brien L.
        • Charette M.
        • Goudreau J.
        Nursing students’ perceptions of the contribution of high-fidelity simulation and clinical placement in a critical care course.
        Clinical Simulation in Nursing. 2017; 13: 436-441
        • Bussard M.E.
        Self-reflection of video-recorded high-fidelity simulations and development of clinical judgment.
        Journal of Nursing Education. 2016; 55: 522-527
        • Cappelletti A.
        • Engel J.
        • Prentice D.
        Systematic review of clinical judgment and reasoning in nursing.
        Journal of Nursing Education. 2014; 53: 453-458
        • Fawaz M.A.
        • Hamdan-Mansour A.M.
        Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students.
        Nurse Education Today. 2016; 46: 36-42
        • Gore T.
        • Thomson W.
        Use of simulation in undergraduate and graduate education.
        AACN Advanced Critical Care. 2016; 27: 86-95
        • Ironside P.M.
        • Jeffries P.R.
        Using multiple-patient simulation experiences to foster clinical judgment.
        Journal of Nursing Regulation. 2016; 1: 38-41
        • Lavoie P.
        • Pepin J.
        • Cossette S.
        Contribution of a reflective debriefing to nursing students' clinical judgment in patient deterioration simulations: A mixed-methods study.
        Nurse Education Today. 2017; 50: 51-56
        • Lee J.
        • Oh P.
        Effects of the use of high-fidelity human simulation in nursing education: A meta-analysis.
        Journal of Nursing Education. 2015; 54: 501-507
        • Mariani B.
        • Doolen J.
        Nursing simulation research: What are the perceived gaps?.
        Clinical Simulation in Nursing. 2016; 12: 30-36
      1. Office for Healthcare Workforce Analysis and Planning in the South Carolina Area Health Education Consortium (AHEC). (2014). Retrieved from:

        • Page-Cutrara K.
        • Turk M.
        Impact of prebriefing on competency performance, clinical judgment and experience in simulation: An experimental study.
        Nurse Education Today. 2017; 48: 78-83
        • Saldana J.
        The Coding Manual for Qualitative Researchers.
        Sage, Thousand Oaks, CA2016
        • Sandelowski M.
        Whatever happened to qualitative description?.
        Research in Nursing & Health. 2000; 23: 334-340
        • Tanner C.A.
        Thinking like a nurse: A research-based model of clinical judgment in nursing.
        Journal of Nursing Education. 2006; 45: 204-211
        • Thomas C.
        • Mraz M.
        Exploration into how simulation can effect new graduate transition.
        Clinical Simulation in Nursing. 2017; 13: 465-470
      2. University of Georgia Board of Regents Center for Health Workforce Planning & Analysis. (2010). Retrieved from:

        • Victor J.
        • Ruppert W.
        • Ballasy S.
        Examining the relationships between clinical judgment, simulation performance, and clinical performance.
        Nurse Educator. 2017; 42: 236-239