Date of Award

Summer 7-31-2026

Document Type

Dissertation

Degree Name

Doctor of Nursing (ND)

First Advisor

Dr. Peggy Bergeron

Abstract

Background: The average turnover rate among newly graduated nurses (NGNs) in the United States is 25-30% within their first year, with increased rates in high-stress units like obstetrics and critical care. Many risk factors contribute to the high turnover rate of NGNs, but one modifiable factor is feelings of self-efficacy. Studies have shown that simulation training can increase self-efficacy in obstetric emergencies. This study was conducted to explore feelings of self-efficacy among NGNs working in the labor and delivery unit after a rapid cycle deliberate practice (RCDP) simulation of an OB emergency.

Methods: The study used a descriptive qualitative research design. Seven NGNs on the labor and delivery unit of an urban hospital in Alabama participated in RCDP simulation of an OB emergency. Post simulation, three focus groups were conducted to gather data about the participants’ feelings of self-efficacy and confidence. Thematic analysis was then used to identify, analyze, and report data from the collected focus group data.

Results: All seven participants reported an increase in self-efficacy for OB emergency situations after the use of the RCDP simulation. Five themes emerged from the data analysis: feelings of confidence, skill and expertise level, feedback, repetition, and prepared for the future.

Conclusion: This study supports the implementation of the RCDP simulation method to increase self-efficacy in NGNs in the labor and delivery unit. The repetition and feedback used during RCDP were instrumental to the participants’ feelings of increased confidence in their skills, improved knowledge, and the increase in their OB emergency awareness. Increased self-efficacy in OB emergencies could increase the retention rate of NGNs on the labor and delivery unit.

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