Associations of stress, self-esteem, and collective efficacy with flow in simulation among nursing students: A descriptive cross-sectional study.

BACKGROUND: Simulation-based learning was developed to enable nursing and medical students to obtain clinical experience in a safe and controlled environment. The extent to which students concentrate in simulation situations can influence their educational outcomes. However, there are no studies yet on the factors that influence flow in simulation practice. Understanding which factors influence flow might help in achieving better simulation-based learning outcomes.

OBJECTIVES: The purpose of this study was to identify the factors related to flow in simulation practice, including stress, self-esteem, and collective efficacy.

DESIGN: This was a descriptive cross-sectional study.

SETTING: A university in South Korea during the 2015 academic year.

PARTICIPANTS: This study was conducted with 84 senior nursing students. Their average age was 23 years old and >90% were female.

METHODS: The stress, self-esteem, and collective efficacy of senior nursing students were measured before simulation practice, while flow in simulation practice was measured after simulation.

RESULTS: Flow during simulation practice was positively correlated with self-esteem and collective efficacy, but negatively correlated with stress. Furthermore, only collective efficacy was a significant predictor of flow during simulation.

CONCLUSIONS: Nursing education must be oriented to help emphasize collective efficacy to improve students' outcomes from simulation-based learning.