Date of Conferral



Doctor of Education (Ed.D.)




Mary Anne Ramirez


Graduate nurses are being employed to provide care in high acuity care areas, and this becomes a problem of significance as the literature suggests that graduate nurse's experience a deficit in integrating theoretical concepts in the clinical environment, described as the theory-practice gap; which can result in a risk to patient safety and the potential for negative outcomes. Cognitive constructivism was the conceptual framework that guided this study. A qualitative phenomenological design was used to explore the lived experiences of 13 graduate nurses employed at a community hospital in northern New Jersey. After recruiting the participants through purposive sampling, semi-structured interviews were conducted with them utilizing a researcher-developed interview protocol based on the Casey-Fink Graduate Nurse Experience Survey. The research questions addressed the graduates' clinical experiences and their perceptions of simulation in facilitating the integration of theory to practice. Interviews were transcribed verbatim, coded, and analyzed to identify 4 themes: (a) the theory-practice gap, (b) effective educational pedagogy, (c) theory-practice integration, and (d) simulation-based learning. The crucial finding was that graduate nurses perceived the theory-practice gap could be reduced through the use of high-fidelity simulation utilizing scenario-based learning exercises in prelicensure programs prior to entry to practice. Based on these findings, the recommendations presented in a white paper will help the administration of the school of nursing at the local site make informed decisions to effect curricular changes that promote the students' integration of theory into practice. Further, the results of this study impact social change by serving as a model for similar programs to improve the preparation of graduate nurses to provide care to optimize positive patient care outcomes.