This multisite study examined the impact of multiple-patient simulation experiences on the development of nursing students' patient safety competencies in the final semester of their baccalaureate or associate degree nursing program. It extends the Jeffries Simulation Model by investigating how the student factors of tolerance for ambiguity and self-reported grade point average (GPA), in addition to age, relate to the outcomes of simulation. The study showed that students' safety competencies improved significantly from the first to the second simulation. Student age, GPA, and tolerance of ambiguity were not significantly correlated to the students' demonstration of patient safety competencies. The findings of this study contribute to the science of nursing education by providing evidence for nursing educators related to the impact of multiple-patient simulations on improving and documenting students' patient safety competencies before their entry into the workforce.
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