The effect of simulation on the self-confidence of newly licensed graduate nurses




Mante, Rosario

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Newly licensed graduate nurses (NLGNs) enter practice with basic critical thinking skills and minimal experience. However, they are often placed in clinical areas based on the needs of the facility rather than their clinical interest or expertise. New graduate nurses are assigned roles that are not based on their levels of proficiency but the needs of the facility. The transition from nursing student to independent practice causes stress as they apply their learning to real-world practice. They experience reality shock when exposed to the complexity of patient care, heavy workloads, technological advances, and lack of communication skills. All these factors contribute to role dissatisfaction and nurse turnover. Nurse turnover is costly and negatively impacts hospital budgets, staff, and patient outcomes. Ninety-one percent (91%) of NLGNs feel stressed by their jobs. Within 1–2 years, 33% leave their first nursing job. In January 2018, Nursing Solutions Incorporated (NSI) published the results of their study that showed 28.3% of all new registered nurse (RN) hires left within a year and 49.8% exited after less than two years of service. New graduate nurses benefit from additional training through continuing education and simulation during their first year as licensed graduate nurses. Additional training helps to minimize the transition gap between student and independent practice (Dyess and Sherman, 2009). New graduate nurses who successfully transition reduce the rate of nurse turnover, thereby helping healthcare organizations show a positive return on investment to (Silvestre et al., 2017). This project study explored NLGNs’ perceptions of their simulation experiences and determined that there is no sufficient evidence that simulation has an impact on enhancing self-confidence. However, there is evidence that simulation has an impact on the overall anxiety level when making clinical decisions. The results of this study demonstrate the value of using simulation as a supplement to traditional standard clinical experiences and identify ways to enhance NLGNs’ self-confidence and decrease anxiety when making clinical decisions. The data may assist nursing educators in creating educational programs that improve NLGNs’ self- confidence in practice as registered nurses.



Simulation, Self-confidence, Anxiety, Clinical decision making, Newly licensed graduate nurses, NLGNs, CDM, NASC-CDM