Date of Award


Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Philosophy (PhD)


College of Graduate Studies

First Advisor

Teresa Atz

Second Advisor

Cynthia Foronda

Third Advisor

Shannon Phillips

Fourth Advisor

Susan D. Newman


There is a paucity of research examining the relationship of participant demographic characteristics to outcomes in clinical simulation, specifically in nursing education. This is primarily because research in simulation has included a homogenous sample, in terms of the race of nursing students and manikins. In addition, there is very little research directly or indirectly examining the minority nursing students’ perceived barriers and facilitators to current simulation practices. This dissertation study aims to explore the racially diverse nursing students’ self-efficacy, satisfaction, and perceptions of participating in a simulation experience using racially diverse manikins. The first manuscript, through thematic analysis of focus group discussions, explores the baccalaureate minority nursing students’ perceptions of high-fidelity simulation. The second manuscript identifies, through an integrative review, the clinical experiences including facilitators and perceived barriers of minority students in undergraduate nursing programs. Finally, the third manuscript is a mixed methods feasibility study to explore a racially diverse sample of baccalaureate nursing students’ self-efficacy, satisfaction, and perceptions using racially diverse manikins. This dissertation creates a foundation for future development of nursing theory, research, and intervention development to ensure that current simulation practices are inclusive for diverse groups of nursing students.


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