Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Karen Wyche, PhD; Patricia Davis, DNP


Background: Simulation based education offers safe, reflective learning opportunities. However, data had not been obtained of nursing students’ perceptions of teamwork performed during Virtual Hospital (VH), a multiple patient simulation.

Objectives: This evaluation gap was addressed using the Agency for Healthcare Research and Quality’s (AHRQ) TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ). The validated survey measures self-reported perceptions of teamwork in communication, mutual support, and situational awareness on a Likert scale from 1 to 5 (AHRQ, 2014).

Methods: A pre-and post, one group design was used to measure perceptions of teamwork. Twenty participants were recruited from students, enrolled in a second-degree undergraduate nursing program, scheduled to complete VH in ten predetermined clinical teams. Participants, dispersed among six of the teams, used the T-TPQ to rate perceptions of their teamwork before and after VH. Aggregated pre- and post-VH T-TPQ responses were compared for differences in total and subscale scores. These results were compared to faculty assessments of team communication using the traditional VH evaluation tool.

Results: Nonparametric analysis indicated significant differences between pre- and post-VH TTPQ total scores (p = 0.031), between pre- and post-VH communication subscale scores (p = 0.034), but no difference between scores for pre- and post-VH mutual support or situational awareness subscales (p = 0.059). Faculty evaluations reported three of six teams met communication expectations.

Conclusions: Overall, students perceived VH as an opportunity to practice and assess teamwork, and particularly communication, with a validated, self-report questionnaire (T-TPQ). These findings reinforced its integration in the learning environment.

Open Access




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