WWC review of this study

Effectiveness of integrated simulation and clinical experiences compared to traditional clinical experiences for nursing students.

Curl, E. D., Smith, S., Chisholm, L. A., McGee, L. A., & Das, K. (2016). Nursing education perspectives, 37(2), 72-77.

  • Quasi-Experimental Design
    , grade

Reviewed: May 2020

No statistically significant positive
Meets WWC standards with reservations
Technical skill proficiency outcomes—Substantively important positive effect found for the domain
Comparison Period Sample Intervention
Significant? Improvement

Health Education Systems Inc. (HESI) Medical-Surgical Specialty Exam

Southeast Texas Regional Innovation Project on Effective Simulations (Nursing STRIPES) vs. Business as usual

0 Days

Full sample;
97 students





Evidence Tier rating based solely on this study. This intervention may achieve a higher tier when combined with the full body of evidence.

Characteristics of study sample as reported by study author.

  • Female: 43%
    Male: 57%
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The study was conducted in three associate-level nursing programs in Southeast Texas.

Study sample

Of the 124 study participants, 84.7 percent of students held a prior credential, and 71.8 percent had a vocational/technical certificate. A majority of students reported working in health care (78.2 percent), with most working 21 to 40 hours per week. The sample include 60.5 percent White students and 25.8% African-American students; 41 percent of the STRIPES group was female and 45 percent of the comparison group was female.

Intervention Group

Each STRIPES student participated in 20 simulation modules, 5 for each clinical specialty area. Each HFS module was four hours in length; simulations were usually conducted during afternoon or evening sessions in a central HFS laboratory at the university. Each simulation lasted 30 to 45 minutes followed by a 45- to 90-minute debriefing period. After each group completed the assigned activity (self-paced or HFS), the groups rotated. A wrap-up group discussion session for STRIPES students from one program at the end of the lab allowed all students and faculty to add final comments, further clarify issues brought out in the HFS, and participate in written evaluations.For the purpose of this study, student learning during four hours of HFS was considered equivalent to or better than eight hours of traditional clinical experiences when three criteria were met: a) prelab, to prepare students with the knowledge needed to be successful in the HFS, b) active participation in HFS, with each student having an active role, and c) debriefing (lasting as long as the HFS or up to twice as long as the HFS), focused on clinical reasoning with reflection on decision-making. When these three criteria were met, one hour of HFS replaced two hours of traditional clinical hours.

Comparison Group

Students in the comparison group were nursing students pursuing an Associate's degree that participated in traditional clinical (nursing) learning experiences.

Support for implementation

No additional details provided.


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