The purpose of this explanatory sequential mixed methods study was threefold. First, this study compared the effects of two different simulation-based instructional strategies on athletic trainers’ clinical competence in performing cardiovascular screening with cardiac auscultations. Second, this study identified the athletic trainers’ perceptions of learning through simulation-based instructional strategies. Third, this study attempted to identify and offer instructional recommendations based on the outcomes.

The quantitative phase analyzed cognitive and diagnostic reasoning knowledge and history-taking and clinical skills specific to cardiovascular screenings with cardiac auscultations as it was taught to athletic trainers (ATs) at a continuing professional education (CPE) course. The quantitative results found that high-fidelity and low-fidelity simulation-based instructional strategies significantly increased cognitive and diagnostic reasoning knowledge and history-taking and clinical skill from pre-test to post-test assessment on all dependent variables. When comparing the two fidelity types to each other, the analysis found that the participants in the high-fidelity simulation group gained significantly more skill when compared to the low-fidelity group.

In the qualitative analysis of this study, three themes emerged specific to the perceptions of the athletic trainers’ experiences as they learn through simulation-based instructional strategies. The first theme that emerged was a clear indication that participants’ exhibited positive perceptions of learning through simulation-based instructional strategies. The second theme that emerged was that the high-fidelity simulation experience during the pre-assessment and post-assessment raised an awareness of the deficit of knowledge and skills in performing a comprehensive cardiovascular screening with cardiac auscultations. Lastly, the third theme that emerged was specific to the perceived limitations in the effectiveness of low-fidelity simulation and the perceived strengths in the effectiveness of high-fidelity simulation.

A few instructional recommendations emerged from this dissertation study. Simulation-based instructional strategies are an ideal teaching method to utilize during continuing professional education courses with athletic trainers. Specifically, this study identified that both, high-fidelity and low-fidelity simulation, are effective in teaching cardiovascular screening with cardiac auscultations. Additionally, the participants perceived influences of a pre-test on the identification of their knowledge and skills deficit suggests that there are benefits of utilizing an authentic simulation pre-test as part of CPE courses.