Date of Award

Summer 7-31-2026

Document Type

Thesis

Degree Name

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Department

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First Advisor

Dr. Laura Williams

Abstract

Background: Simulation is a core teaching strategy in nursing education, yet student anxiety may negatively impact learning outcomes. Psychological safety has been identified as a critical factor in effective simulation-based student learning.

Purpose: The purpose of this project was to examine whether an enhanced simulation prebrief improved perceived psychological safety among second-semester associate degree nursing students during a high-fidelity pediatric asthma scenario at a rural community college in Alabama.

Methods: A quasi-experimental one-group pretest–posttest design evaluated changes in psychological safety following a structured, evidence-based prebrief grounded in the International Nursing Association for Clinical Simulation and Learning (INACSL) Healthcare Simulation Standards of Best Practice and the National League for Nursing (NLN) Jeffries Simulation Theory. Participants completed Dr. Amy Edmondson's Psychological Safety Index (PSI) before an earlier course simulation. Baseline results guided development of an enhanced prebrief delivered immediately before the pediatric asthma simulation. Participants completed the PSI again afterward. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test.

Results: All PSI items showed improvement from prebrief to debrief. Students indicated a significantly increased willingness to take risks during simulation (Z = -2.274, p = .023).

Conclusion: The enhanced prebrief improved students’ perceived psychological safety, with the greatest impact on the area of risk-taking. These findings support the use of structured, student-informed prebriefing to strengthen engagement, communication, and overall readiness in simulation-based nursing education.

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