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Leslie Hussey


The benefits of simulation in nursing education are well established. Yet, there is a paucity of literature on the psychological effects of the performance aspect of a student demonstrating skills in the simulation setting. Vocational nursing students may experience anxiety in the simulation setting that is distinctly different than in other testing settings and it can contribute to withdrawal from a nursing. The purpose of this study, guided by Lazarus' transactional model of stress and coping, was to understand if vocational nursing students experience performance anxiety while demonstrating clinical skills in the simulation setting versus other settings such as the clinical and computerized testing settings. The research questions explored anxiety in the simulation setting as described by vocational nursing students. Participants were recruited from a vocational nursing program in the southwestern United States and 17 were interviewed in person, by phone, and by Skype. Data were transcribed and coded with open coding. Data analysis revealed themes of completing skills check offs, receiving a forewarning, what was at stake, working with mannequins, feeling nervous, comparing to other settings, familiarity, coping skills, and resources. Participants described anxiety as unique to the simulation setting indicating that significant performance anxiety exists in this setting. Recommendations include providing education for faculty to recognize performance anxiety and continued research on interventions. Positive social change comes from faculty who are sensitive to performance anxiety and are able to support student success to graduate compassionate, confident, and empowered nurses. These strong nurses will be able to provide stellar care for patients in all settings.

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