Date Awarded


Document Type


Degree Name

Doctor of Education (Ed.D.)




The purpose of this research was to determine if selected problem-solving skills of freshmen nursing students in an associate-degree nursing program could be enhanced by an instructional strategy that combined simulated patient encounters with two types of feedback obtained from experienced nurses. The skills were: (1) the detection, encoding, and retrieval of cues and (2) the generation of tentative problem formulations. Six videotaped simulations of nurse-patient encounters were shown to a group of experienced nurses, who were asked to write tentative problem formulations with relevant cues and summarizing assessments of the situations. Data of the nurses' information processing activities while performing the simulation exercises were additionally collected and analyzed. The results of this analysis were used to develop an instructional package that was tested on a sample of freshmen nursing students.;The sample was randomly assigned to three groups: two treatment groups and a posttest-only control group. The following were hypothesized: (1) that the selected problem-solving skills of the treatment groups would be significantly improved by the instructional strategy, and (2) that the skills would be more greatly enhanced in the treatment group which received outcome and process feedback from the experienced nurses than in the treatment group which received outcome feedback only.;The results of the analysis of covariance supported the first hypothesis but not the second hypothesis. It was found that the mean of the group receiving outcome feedback was significantly higher than the control group, but that there was no difference in the means of the control group and the treatment group which received both outcome and process feedback.;Limitations of the study were related to the samples used; i.e., the number of experienced nurses was small and the sample of students was drawn from an existing nursing program. Implications for future research included: (1) other applications and modifications of the components of the instructional strategy; (2) variation of the types of simulation; (3) further research into problem-solving processes and outcomes of experienced nurses.



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