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Updated: Feb 25, 2026

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Published on: April 23, 2014
Back to Reality: The Use of the Presence Questionnaire for Measurement of Fidelity in Simulation
Background And Purpose:
Simulation fidelity includes three aspects: physical, conceptual, and psychological. This study reports on strengths and limitations of the Presence Questionnaire (PQ) for measurement of fidelity in human patient simulation.
Methods:
This nonexperimental correlational study includes a convenience sample of 83 undergraduate nursing students who participated in an emergency simulation and completed the PQ. Analysis of variance (ANOVA) on the 7-item PQ Realism subscale between groups who did or did not experience simulation equipment malfunction measured the PQ's sensitivity to this challenge to fidelity.
Results:
Students (n = 23) experiencing simulation equipment malfunction scored significantly lower on the PQ Realism subscale than students (n = 58) not experiencing equipment malfunction.
Conclusions:
The modified PQ Realism subscale is a valid measure of physical fidelity in nursing simulation and may advance the study and development of simulation for researchers and nursing educators.

