First Advisor

Cullen, Patricia L.

Second Advisor

Crewell, Judy


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

63 pages


Executive Summary
Evaluating Development of Critical Thinking Skills in Simulation Learning Problem
Critical thinking is the key to nurses' ability to make sound decisions in clinical practice. It was determined nurses, hired within the last three years at an Intermediate Care Facility for the Mentally Retarded (ICFMR), required additional education and practice to manage high-risk low frequency events, specifically respiratory emergencies. Project questions for this quality improvement initiative included: Will a high fidelity simulation session improve critical thinking skills for registered nurses hired within the last three years, at the ICFMR? And, will the introduction of simulation learning to develop critical thinking skills, decrease the number of respiratory emergencies at the ICFMR that require hospitalization? Purpose
The purpose of this quality improvement initiative was to provide education (a respiratory emergency workshop and simulation session) on emergency scenarios for newly hired nurses at the ICFMR to determine the relationship simulation learning had on developing critical thinking skills. Goal
This project had two goals. The first goal was to evaluate if novice nurses could enhance critical thinking skills to manage respiratory emergencies in an effective manner by attending a high fidelity simulation workshop. The second goal was to decrease the number of individuals hospitalized at the ICFMR secondary to respiratory emergencies. Objectives
The objectives for this project included: 1) Increase nurses critical thinking acquisition measured by the California Critical Thinking Disposition Inventory (CCTDI) questionnaire after an educational workshop and simulation session on managing respiratory emergencies. 2) Conduct a simulation session for nurses to effectively manage respiratory emergencies in a risk-free safe environment. 3) Provide individual feedback for nurses through debriefing sessions to evaluate performance. Plan
Education was provided with a workshop on emergency care followed by a high fidelity simulation session. A pre and post questionnaire, the CCTDI, was administered to evaluate the development of critical thinking skills. IRB approval was obtained from the Mendota Mental Health Institute and Regis University. A local college provided access to the high fidelity simulation lab. Outcomes and Results
Twenty novice nurses attended the didactic emergency care workshop followed by a high fidelity simulation session. Results from a paired samples t- test suggested that overall there was no statistical difference between critical thinking skill development and simulation learning. However, anecdotal comments suggested a positive practice outcome after the workshop and simulation. Further study is recommended.

Date of Award

Fall 2015

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

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