DNP Scholarly Projects


Given the imperative of success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination, academic proficiency rather than clinical competence remains the primary focus of nursing education. It is imperative that nursing programs have an intentional remediation plan to provide resources designed to monitor, evaluate and improve clinical competence, distinct from those necessary for academic success. Simulation is an established nursing pedagogy in the development of clinical competency, as it facilitates and grounds the application and reinforcement of abstract and theoretical concepts. and may be useful as a formative strategy when students show faltering clinical proficiency. Clinical and academic competency are both essential for successful completion of an undergraduate nursing program. When students struggle to perform academically, remediation efforts have often targeted academic rather than clinical proficiency given the imperative of NCLEX-RN examination success. Few nursing programs have clinical remediation plans designed to provide support for development and remediation of the more subjective and variable elements of clinical competence. And little is known about how clinical remediation may improve academic performance. One result is students who are succeeding academically despite being marginally prepared to effectively execute the role of professional registered nurse. However, a review of literature revealed a dearth of studies exploring simulation as a tool for clinical remediation in undergraduate nursing education. Using Kolb’s Experiential Learning theory as a framework, the purpose of this project was to evaluate the impact of simulation on clinical competency in students with identified clinical deficiencies. A pilot study was done using a quasi-experimental pre-test post-test design to evaluate the effects of an extra simulation on clinical competency in 33 undergraduate nursing students who were divided into control or intervention groups. Statistical analysis indicated that although both groups demonstrated improved clinical competence scores after participating in the course simulations, the intervention group did not evidence improvement beyond that of the control group after participating in an extra simulation. Further study is necessary to validate the use of simulation for clinical remediation to foster development of nursing graduates who are fully prepared to begin nursing practice.



First Advisor

Morse, Elizabeth

Second Advisor

Price, Joseph

Third Advisor

Legge, Tammy


Nursing, School of


Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project


Doctorate of Nursing Practice (DNP)

Degree Level


Degree Grantor

Belmont University


Clinical competence; Nursing--Study and teaching; Simulated patients

Included in

Nursing Commons