Document Type

Dissertation - Open Access

Award Date


Degree Name

Doctor of Philosophy (PhD)

Department / School

Graduate Nursing

First Advisor

Karin Emery

Second Advisor

Heidi Mennenga


participant roles, process-based role, response-based role, simulation effectiveness, simulation-based learning experiences


Background: Universities face challenges in preparing future nurses for the workforce. It is essential to guide educators on strategies to achieve similar learning objectives to overcoming these challenges. Educators widely use the observer role in simulation, but researchers do not study the role thoroughly in current simulation research. There is a lack of discipline-specific research exploring how observers learn in simulation and if they can engage in the experiential learning intended in the simulation activity.

Objectives: The objective of this research is to determine the difference in simulation effectiveness between the process-based role versus the response-based role (observers) in participants during simulation-based learning experiences.

Design: This research used a quasi-experimental posttest only design to determine differences in simulation effectiveness among learner roles using the Simulation Effectiveness Tool-Modified (SET-M).

Setting & Participants: The researcher collected data from 193 prelicensure nursing students enrolled in any semester of one Midwestern undergraduate baccalaureate nursing program.

Methods: Nursing students completed the assigned face-to-face simulations in their current curriculum plan. Each participant was randomly assigned to a participant role: direct participant role as either a primary or secondary nurse, non-directed observer with no briefing or observer guide, direct observer with an observation guide, or in-scenario observer assigned to a non-clinical or other professional role within the scenario. After debriefing of the simulation, participants completed the demographic survey and SET-M.

Results: There were no significant differences found in prelicensure nursing students’ simulation effectiveness among the four participant roles studied.

Conclusion: This study suggests simulation effectiveness (learning and confidence) happens regardless of the participants role during the simulation activity. Educators should consider what roles are necessary within each scenario and assign observation roles as needed.

Library of Congress Subject Headings

Participant observation.
Nursing -- Study and teaching (Higher) -- Simulation methods.
Simulation methods -- Evaluation.



Number of Pages



South Dakota State University

Available for download on Wednesday, May 15, 2024



Rights Statement

In Copyright