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
