The Effect of Virtual Simulation on Associate Degree Nursing Students’ Perceived Anxiety and Self-Efficacy Levels

Abstract

The benefits of simulation-based learning in nursing education are well documented throughout the literature. However, nursing students can experience heightened anxiety and low self-efficacy levels during high-fidelity mannequin-based simulations which can adversely affect performance and learning outcomes. Although there has been much research exploring high-fidelity simulation and the effect on anxiety in nursing students, a paucity of research exists evaluating the effects of virtual simulation, an emerging pedagogic tool in nursing education, on students’ anxiety and self-efficacy. Underpinned by Bandura’s Social Cognitive Theory, this study sought to measure the effect of a virtual simulation experience on student anxiety and self-efficacy levels. A quantitative, quasi-experimental 1-group pretest-posttest research design was used. The sample consisted of 26 2^nd-semester medical-surgical nursing students enrolled in a community college in the Mid-Atlantic Region of the United States. Data were collected using a self-report 27-item survey questionnaire administered pre- and post-intervention. Pre- and post-test scores revealed a statistically significant increase in self-confidence (p < 0.001) and a statistically significant decrease in anxiety (t(25) = 4.0, 95% CI [8.4, 26.1], p < 0.001). This study supports the use of virtual simulation as an alternative or complementary evidence-based pedagogical tool for experiential learning in nursing education. Analysis of participants’ perceptions indicated that virtual simulation had a positive impact on anxiety and self-efficacy outcomes.