Date of Award
Spring 2024
Document Type
Dissertation
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Kristina Thomas-Dreifuerst
Abstract
Situation awareness (SA) is linked with actionable decision-making and clinical judgment in nursing practice. The cognitive processes used in developing SA, outlined in Endsley’s (1995) model, is the framework underpinning this study and are interwoven into the National Council of State Boards of Nursing Clinical Judgment Measurement Model (NCJMM). Cultivating these cognitive processes through prebriefing and simulation designed to intentionally develop SA, is a recommended practice currently seen in aviation and military training. There is a lack of vigorous research testing whether a specific intervention during clinical simulation can develop SA in nursing students. In addition, fostering SA in the preparation and prebriefing phase of simulation has not been studied. The purpose of this study was to test the effectiveness of an intentional, structured prebriefing intervention designed to foster SA and implemented prior to high-fidelity manikin simulation. A quasi-experimental study was conducted with a convenience sample of 132 traditional baccalaureate prelicensure nursing students from a large Midwestern private university. SA was measured utilizing an objective, subjective, and performance SA measure. Group differences between the intervention and control group and associations between SA measures and prebriefing experience were examined. The SA-focused preparation and prebriefing intervention group reported statistically significant difference in satisfaction compared to the control group. However, there were no significant differences in SA between the intervention and control group. Future research is needed to examine differences in a larger population that utilizes the SA-focused preparation and prebriefing for a longer duration. Since SA is inexorably linked with making good decisions informed by and resulting in clinical judgment in nursing practice, these results contribute to the further testing of SA interventions and implementation of preparation and prebriefing best practices to foster the cognitive processes needed in SA.