D. Erlam, GSmythe, LWright, V2017-07-112017-07-1120172017Open Journal of Nursing. Vol.07 No.06(2017), Article ID:77155,15 pages. doi: 10.4236/ojn.2017.760512162-53362162-5344https://hdl.handle.net/10292/10649Recent trends in simulation use have necessitated a more considered approach in the use of this teaching/learning tool. The aim of this research is to discover ways to improve simulation as a teaching/learning platform. Action research was used to answer the question, “How can I improve pedagogical practices with undergraduate nurses in simulation?” This study was implemented at a University in Auckland, New Zealand between November 2012 and March 2014. A purposive sample was sought from second and third-year nursing students (n = 161) enrolled in the three-year undergraduate bachelor of nursing program. Methods included focus groups, questionnaires, debriefing sessions, pre- and post-tests, and Lasater clinical judgment rubric analysis. Seven instructional scaffolds emerged which maximized student learning and retention. These scaffolds: 1) helped move students from known into unknown knowledge; 2) provided situated coaching; 3) modeled expected performance; 4) gave opportunity for improvement; 5) reduced confusion; 6) taught effective communication; and 7) promoted new learning through debriefing. These strategies resulted in a simulation experience which improved clinical reasoning in undergraduate nursing students.This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).http://creativecommons.org/licenses/by/4.0/Simulation; Undergraduate Nursing Education; Scaffold; Deteriorating PatientJournal ArticleOpenAccess10.4236/ojn.2017.76051