First Advisor

Mary Kinnick

Term of Graduation

Summer 2008

Date of Publication


Document Type


Degree Name

Doctor of Education (Ed.D.) in Educational Leadership: Postsecondary Education


Educational Leadership




Clinical competence, Nursing -- Decision making, Nursing -- Study and teaching -- Simulation methods



Physical Description

1 online resource (2, xii, 269 pages)


There is little doubt that health care has changed dramatically in the last 20 years. Consequently, learning to think like a nurse has become an increasingly complex endeavor. Therefore, professional education must be re-designed to facilitate the development of knowledge, skills, and attitudes that are required of nurses in today's practice environment. High-fidelity simulation provides an education environment for nursing students to develop new professional competencies such as clinical judgment.

The How People Learn (HPL) framework is a comprehensive instructional model that can be used to design clinical learning activities. The HPL framework emerged from the new science of learning and is based on discoveries related to how experts solve ambiguous problems in complex situations. High fidelity simulation, uses advances in technology to provide clinical learning experiences in a near authentic hospital environment. The HPL framework provides guidance to the design of instructional strategies aimed at facilitating the development of clinical judgment in high-fidelity simulated learning laboratories.

The primary focus of this exploratory study was to better understand the development of clinical judgment in nursing students when using the HPL framework to design instructional strategies in high-fidelity simulation environments. A two group study design was applied to differentiate between the groups of students. Data sources incorporating both quantitative and qualitative methodologies were used.

Data analysis related to the research question did not identify statistically significant difference between the control and experimental group. The qualitative data analysis provided possible explanation for the results derived from the quantitative data. Additionally, the qualitative data analysis identified possible effective instructional strategies to use when designing and implementing learning activities that will facilitate the development of clinical judgment in high-fidelity simulation laboratories.


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