LAUSR

Abstract Background Undergraduate nursing students experience anxiety during simulation. Excessive anxiety can impair learning and performance. Method Nursing students (N = 96) from first and final semesters of a program participated in an exploratory, sequential, mixed-methods study to identify and rank anxiety sources from simulation components occurring in preparation, prebrief, implementation, and debriefing. Results Participants experienced high normal levels of anxiety that did not change across the curriculum. Having the title or role of primary nurse caused the highest level of anxiety, followed by concern about making a mistake. Conclusion Results provide understanding of sources of anxiety during simulation and support use of the INACSL Standards of Best Practice: SimulationSM (2016). Recommendations to mitigate anxiety are identified, which may lead to enhanced learning in this setting.