DNP Scholarly Projects



Simulation-based experiences (SBEs) allow learners to use clinical decision-making, clinical judgment, and hands-on skills to analyze and respond to realistic clinical situations in a controlled, interactive environment. Psychological safety (PS) is essential for increasing a learner's engagement in an SBE. Psychologically safe learning environments allow students to feel valued and comfortable speaking up and taking risks without consequences to themselves or others, promoting learning and innovation. Measuring PS may help simulation faculty improve their learning environment by supporting learning-oriented behavior and boosting students' clinical competency.


The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to examine the level of PS experienced by pre-licensure nursing students while participating in SBEs at a Tennessee university's school of nursing simulation program.


A cross-sectional descriptive survey design was used to examine the level of PS experienced by pre-licensure nursing students while participating in SBEs. Park & Kim's (2021b) Psychological Safety in High Fidelity Simulation was used to obtain the mean overall PS score for the sample group of 545 students was 45.4 (SD = 10.7).


Results indicated that senior-level students have the highest mean PS score of 51.6 (SD = 10.4). Certain simulations, such as an Opioid Withdrawal and Eating Disorder Simulation, had lower PS scores of 42.3 (SD = 9.6) and 43.5 (SD = 10.6).


The results of this study support previous studies that demonstrated higher levels of PS in senior-level students. This project highlighted the need to examine grading and faculty training in SBE at this simulation center. Evaluation and feedback on student performance are necessary in simulation-based learning, but it also may place psychological pressure on participants. Simulation faculty should support the PS of students by creating a supportive, respectful, confidential, non-threatening, and non-punitive learning environment.


Spring 4-27-2022

First Advisor

Kathryn Dambrino DNP, APRN, FNP-BC

Scholarly Project Team Member

Beth Hallmark, Ph.D., MSN, RN, CHSE-A, ANEF

Scholarly Project Team Member

David Phillippi, Ph.D., MS


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


psychological safety, simulation-based experiences, pre-licensure nursing students, nursing education, high-fidelity patient simulation

Included in

Nursing Commons