Date of Paper/Work


Type of Paper/Work

Systems Change Project

Degree Name

Doctor of Nursing Practice



First Advisor

Matthew Byrne


Obstetric complications can be anticipated based on certain risk factors before they become emergent such as maternal post-partum hemorrhage. The challenge for smaller hospitals is that there is a low incidence rate of obstetrical emergencies for nurses to develop and maintain competency in providing care. A component to providing competent care is the possession of the non-clinical skill of Situational Awareness (SA). High-fidelity simulation technology has generated opportunities to create realistic simulations during which nurses can develop components that promote SA (confidence, knowledge, and critical thinking ability) without endangering real patients.

Patients deserve safe and quality care from practitioners regardless of prior training; therefore, there is a need to examine how simulation is an effective way to train all nurses for complex and rare patient situations. The purpose of this system change project was to review and analyze the literature as well as evaluate participant data related to the effect of high-fidelity simulation education on a nurse’s situational awareness.

Ten novice obstetric nurses from Mayo Clinic Health System – Franciscan Healthcare participated in the simulation study at Viterbo University’s Simulation Learning Center. SA was measured as a latent variable and evaluated on whether participants improved their knowledge levels, confidence levels, and showed evidence of clinical decision making following the simulation. The Confidence and Knowledge surveys were evaluated separately by a t-test to determine statistical significance. The Clinical Decision Making ability was assessed by the researcher based on whether the participants met pre-set benchmarks within the simulation.

The results from the study showed evidence that there were participants that increased their knowledge level, confidence level and demonstrated critical thinking but not all three Impact of High Fidelity Simulation components together. Overall the data revealed a trend towards the participants increasing the components of SA and therefore a trend toward increasing their SA. Anecdotal comments from the participants were also collected.

Critical to increasing and maintaining the nursing workforce is the successful training of nurses in the work setting. Increasing specialized training and dedicating educational resources for nurses may help produce a staff with more competent nurses. This SCP does provide support for the use of high fidelity simulation education to develop SA for critical experiences in the acute care setting.