Look before you leap: lessons learned when introducing clinical simulation.

Before investing in a human patient simulator, we designed a preliminary study that examined student responses to a laboratory exercise that used lower-fidelity simulation. Our purpose was to compare beginning-level, baccalaureate nursing students' self-reported assessment in the domains of confidence, ability, stress, and critical thinking before and after they participated in the simulation. Results showed statistically significant improvement in all domains for skills in urinary catheterization, intravenous and nasogastric medication administration, and sterile dressing change.