The purpose of this comparative research study was to demonstrate the effect of simulation activities on critical thinking and self-confidence in an electrocardiogram nursing course.


The treatment group received weekly simulation exposure in addition to lecture (500 minutes combined total), and the control group received weekly lecture (400 minutes total didactic instruction).


Critical thinking and self-confidence measures showed no significant differences between the groups, except when controlled by semester level. The second-semester senior students scored significantly higher in both critical thinking and self-confidence measures. A pre- and postsimulation measure of self-confidence demonstrated statistically significant improvement following simulation.


Higher critical thinking scores were significantly related to higher self-confidence ratings, as was student employment on a telemetry unit.