Back to Reality: The Use of the Presence Questionnaire for Measurement of Fidelity in Simulation

Background and Purpose: Simulation fidelity includes three aspects: physical, conceptual, and psychological. This study reports on strengths and limitations of the Presence Questionnaire (PQ) for measurement of fidelity in human patient simulation. Methods: This nonexperimental correlational study includes a convenience sample of 83 undergraduate nursing students who participated in an emergency simulation and completed the PQ. Analysis of variance (ANOVA) on the 7-item PQ Realism subscale between groups who did or did not experience simulation equipment malfunction measured the PQ's sensitivity to this challenge to fidelity. Results: Students (n = 23) experiencing simulation equipment malfunction scored significantly lower on the PQ Realism subscale than students (n = 58) not experiencing equipment malfunction. Conclusions: The modified PQ Realism subscale is a valid measure of physical fidelity in nursing simulation and may advance the study and development of simulation for researchers and nursing educators.