Enhancing adult-gerontology primary care nurse practitioner students' self-confidence and self-efficacy in the clinical setting through a simulation activity

ABSTRACT

New graduate nurse practitioners often encounter a significant gap between theoretical classroom learning and the realities of clinical practice, with many experiencing challenges in translating didactic knowledge into hands-on patient care. This pilot project explored the effect of a standardized patient simulation-based experience on Doctor of Nursing Practice adult-gerontology primary care nurse practitioner students' self-confidence, self-efficacy, and clinical performance within a primary care setting. Eleven students completed a quasi-experimental pretest and posttest study, including focused standardized patient simulation-based experience participation and reflective review. Statistically significant improvements were seen in 14 of 23 measures on the National League for Nursing-Student Satisfaction and Self-Confidence in Learning Scale, specifically regarding geriatric patient assessment, diagnostic reasoning, physical examination, care planning, and resource awareness. Students' reflective narratives reinforced these findings, citing increased confidence in clinical skills and highlighting areas for further growth. Although some aspects, such as stress management and advocacy for care plans, did not improve, simulation provided meaningful opportunities for skill development and transition preparation. Immediate debriefing and video reflection were noted as valuable for learning and anxiety reduction. These findings suggest that focused simulation can foster self-efficacy and competence in new nurse practitioners and should be broadly considered in graduate nursing education. Further research across diverse populations and institutions is recommended to strengthen the case for widespread simulation integration in nurse practitioner programs.