Examining Nurse Educators’ Stages of Concern about the Teaching Innovation of Simulation as Clinical Experience

Abstract

There exists a critical need to boost the overall number of baccalaureate-prepared registered nurses to accomplish goals for providing high-quality healthcare for all United States citizens (Institute of Medicine, 2011). Given the limited number of sites needed to facilitate clinical learning experiences for pre-licensure baccalaureate nursing students, using simulation as a technologically modern innovation in nursing instruction is an approach to help overcome the lack of traditional clinical opportunities. The purpose of this study was to examine the nurse educators’ concerns about using simulation by determining 1) the intensity of nurse educators’ stages of concern about using simulation as clinical instruction; 2) if there are differences in nurse educators’ stages of concern by their demographics; 3) if nurse educators’ demographics predict their intensity of concern in each stage of concern dimension. The stages of concern model based on the Concerns-Based Adoption Model (George et al., 2006) and diffusion of innovation (Rogers, 2003) provided the theoretical framework. The 35-item Stage of Concern Questionnaire (George et al., 2006) was the data collection tool. Data were collected in March April 2020 from 231 nurse educators teaching in pre-licensure baccalaureate nursing programs located in the west north-central region of the United States and accredited by the Commission of Collegiate Nursing Education (CCNE). Descriptive statistical analysis was used to determine the intensity of nurse educators’ stages of concern. Results indicated four independent categorical variables support a significant difference in nurse educators' stage of concern: education level; years the nurse educator has used simulation; years of BSN teaching experience; and the number of students the nurse educator has in a simulated clinical experience. Regression analysis demonstrated that two independent variables were the strongest predictors of six of the seven stages of concern dimensions: number of years that the nurse educator has used simulation; and the amount of BSN teaching experience. Using simulation technology as clinical experience is a change in teaching pedagogy, and change creates concern. Supporting nurse educators experiencing change is critical for simulation to take hold in the nursing education environment to accommodate the increased demand for BSN prepared RNs in the workforce.