1. This action-based research study used a descriptive triangulation process, which included quantitative and qualitative methods to analyze nursing students’ perceptions of learning using home health simulation in a community health course for a BSN nursing program. The simulation included a home health simulation with a high-fidelity mannequin. The study was performed at a private, proprietary 36-month baccalaureate (pre-licensure) nursing program. The research study was introduced to students in the community health course during the Spring and Summer quarters of 2013. The data collection in this study includes measurements from pre- and post-survey questionnaires, observations during the simulation process, and focus group interviews related to the home health simulation experience and the home health nursing role. The instruments focused on the Quality Safety and Education in Nursing (QSEN) competencies of patient-centered care, safety, teamwork/collaboration, and quality improvement. The Mann Whitney U test was completed on the June and August cohorts to identify any statistically significant differences between the groups’ experience. Thematic coding was analyzed from the focus group interviews to identity patterns in student learning in the home health nursing role and setting. The conclusion is that the implementation of home health simulation can enhance student learning and better prepare them for the required competencies of a graduate nurse.. Implementation and Evaluation of Home Health Simulation to Improve Pre-licensure Bachelor of Science Nursing Students’ Learning: An Action Research Study Kathryn Kollowa Ed.D MSN RN Platt College Aurora, Colorado Introduction Methods Results Abstract Data Analysis 1 c. What are the results when comparing two cohort of students who are participating in the home health simulation that show improved student perceptions of learning as a whole? Comparing June and August cohorts with: Pre/Post online survey results: see 1 a. statistical analysis results Observation tool results: Comparison of observed cohort simulation performance Conclusion Final Results Action-based research study --Descriptive triangulation process Quantitative methods Pre and post survey Observation (field notes on group simulations) Qualitative method Focus group interviews (Grounded Theory approach ) Quantitative Pre and post surveys 11 questions/Likert scale 1-5 Analysis Measures of central tendency Nonparametric Mann-Whitney U test due to small sample size Software used (SPSS 22) p< 0.05/95% CI Quantitative Observation tool 11 questions/Likert scale 1-5 Observation Questionnaire Frequency (%) of Likert scale ratings for each simulation group within each cohort Focused group interviews 12 open-ended guided reflection questions facilitated by Researcher digitally recorded & transcribed verbatim Qualitative Focus group interviews Axial Thematic Coding Dedoose software Codes & themes analyzed until saturation 1 a. What statistically significant differences are there with nursing students’ perceptions of learning after completing a home health care simulation? Pre and post survey results: June Cohort: Competency (p=0.008) Teamwork Education (p=0.009) Value of Home Health Simulation (p=0.005) August Cohort: No statistical significance (p=0.04) noted 1 b. What patterns of responses will be identified with the focus groups related to their perceptions of the home health learning experience? Focused group interview results: June & August cohorts 3 themes Theme 1: Awareness of the value of learning through the home health simulation experience Theme 2: Knowledge deficit of the home health nursing role Theme 3: Home health care is in an unfamiliar setting By 2030, the population in America over age 65 is expected to increase from 31 to 71.5 million representing 19.6% of the population (Centers for Disease Control and Prevention [CDC], 2003). This equates to nearly one out of every five people being an older adult, and this segment of the population will have doubled since the year 2000. With the changing demographics, an expected shift of health care delivery will result in the need for increased home healthcare. A significant issue will be ensuring that nurses are properly trained to provide high quality home health care for individuals age 65 and older. Pre-licensure Baccalaureate Nursing programs need to incorporate quality community health learning experiences that include opportunities for the unique area of home health care delivery. Context: Setting was a small, private, proprietary college with a 36 mo BSN pre-licensure nursing program in a Midwestern state Accredited by the Commission on Collegiate Nursing Education (CCNE) Senior year students enrolled in community health course Practical application learning: clinical setting Alternative learning: Home health simulation The students’ perception of the home health learning experience justifies a recommendation of a system-wide change for this nursing program, with implementation of home health simulation in the course curriculum of community health. This improvement process may help students be better prepared to meet their nursing competencies of QSEN for quality and safe patient care as graduate nurses. STRENGTHS (Likert scale 2 or above) June and August Cohorts Patient care 100% Communication Education Patient centered care Teamwork: 100% Professionalism WEAKNESSES (Likert scale 3 or below) Organizational skills June 80% and August 50% 1. What is the impact of the BSN student perceptions of learning with the use of home health simulation? Enhanced learning Recognized the value Recognized lack of knowledge Identified challenges unique to care in home health setting. Recognized their own limited critical thinking & decision-making skills in this unfamiliar home health nursing role Student perceptions of learning: Valued high fidelity home health simulation experience “Prepares you” Recommendations: System change. The outcomes reveal overall positive results of the students’ perceptions of learning in home health simulation.