Date of Award

Summer 6-25-2018

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Mandi Alonzo

Second Advisor

Dr. Kristi Frisbee

Third Advisor

Dr. Julie Samuels


The purpose of this quantitative research project was to examine the efficacy of pre-simulation progressive muscle relaxation in decreasing the level of anxiety experienced by nursing students during simulation exercises. Simulation is an important teaching strategy in nursing education; it provides an arena in which to practice skills and decision-making without putting real patients in danger of any mistakes. Student anxiety is a challenge of the simulation teaching strategy, because it can make students feel unsuccessful. Decreasing student anxiety will be important as simulation is used more frequently in nursing education. Our study assessed students’ anxiety before simulation and the effect of pre-simulation progressive muscle relaxation on student anxiety and outcomes including student skill performance and student satisfaction with simulation. The data showed students who were involved in PMR had significantly lower state and trait anxiety scores than those who did not experience PMR; students who participated in PMR reported being more satisfied with the simulation experience than those who were not subjected to PMR. Most students were satisfied with PMR, but some were not. PMR should be offered as a method for anxiety reduction for simulations in nursing education; however, students should be encouraged to find the anxiety reduction strategy that works for them, and more research is needed on this topic. Future research should examine the effects of PMR and anxiety on skill performance and possible factors that influence student satisfaction with PMR and other anxiety reduction methods. Further research should include qualitative methods in order to explore student attitudes about PMR and its use in managing simulation related anxiety.