Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Kenneth Phillips

Committee Members

Lora Beebe, Ralph Brockett, Tami Wyatt


The problem investigated in this study was the lack of empirical evidence available regarding the effectiveness of electronic interactive simulation (EIS) for developing critical thinking disposition and clinical judgment skills in the senior baccalaureate nursing student.

The aim of this study was to identify an effective method of experiential learning simulation that may be independently accessed by the learner with a goal of enhancing critical thinking disposition and clinical judgment skills of senior baccalaureate student nurses (BSN).

The purpose of this experimental study was to compare the effects of EIS to traditional paper case studies on the critical thinking disposition and clinical judgment skills, measured by accuracy and efficiency of situational decision making, of senior nursing students enrolled in baccalaureate nursing programs in the United States.

One hundred and seventeen senior nursing students completed the randomized control study by using either the EIS or paper case study learning intervention. Repeated measures ANOVA and nonparametric tests were used to test the hypotheses that senior BSN who participate in EIS of real-life clinical scenarios over a period of two weeks will experience significant increases in clinical judgment and critical thinking disposition compared to students who receive traditional paper case study simulation.

Results showed that participants who used EIS over a two-week period increased their scores for critical thinking disposition overall and on three of the subscales. Results also indicated a positive trend, greater than the comparison group, on the remaining subscales. It is noted that many scores for the Case Study group actually decreased, suggesting that this method had a stifling effect on the development of critical thinking disposition. Retention and application of learned information was apparent for both groups, however, there was a trend for a greater change in the EIS group compared to the Case Study group. Additional research is needed to explore the effectiveness of this emerging pedagogy to add to what is known about the effects of experiential learning in the healthcare professions.

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