Equivalence Testing of Traditional and Simulated Clinical Experiences: Undergraduate Nursing Students' Knowledge Acquisition

Although simulated clinical experience is being used increasingly in nursing education, vital evidence related to knowledge acquisition associated with simulated clinical experience does not exist. This intervention study used a 2x2 crossover design and equivalence testing to explore the effects of simulated clinical experiences on undergraduate students' (n = 74) knowledge acquisition in a fundamentals of nursing course. Following random assignment, students participated in laboratory-based simulated clinical experiences with high-fidelity human patient simulators and traditional clinical experiences and completed knowledge pretests and posttests. Analysis identified significant knowledge gain associated with both simulated and traditional clinical experiences, with the groups' knowledge scores being statistically significantly equivalent. A priori equivalence bounds around the difference between the groups were set at 5 points. Simulated clinical experience was found to be as effective as traditional clinical experience in promoting students' knowledge acquisition.