The effect of multiple simulation exposures on nursing students’ critical thinking in first direct patient care practice

Abstract

Background

This study explored the effect of multiple simulation exposures on critical thinking in first-year nursing students before and after two weeks of initial direct patient care practice.

Methods

A quasi-experimental pretest–post-test design was used with first-year associate degree nursing students (n = 39) who were assigned to one of two study groups. Group 1 participated in two simulation exposures; Group 2 participated in four simulation exposures. Critical thinking was measured using the Health Sciences Reasoning Test both before the simulation exposures and after two weeks of first direct patient care practice. Statistical analyses included paired t-tests, independent t-tests, and two-way mixed ANOVA.

Results

Two simulation exposures significantly improved critical thinking (p = .043). Four exposures showed improvement, though not statistically significant (p = .106). No significant differences were found between exposure groups over time (p = .604).

Conclusions

Multiple simulation exposures may enhance critical thinking before direct patient care practice, with two exposures yielding statistically significant results. However, these findings should be interpreted within the context of the study design, in which simulation was integrated with, rather than isolated from, subsequent clinical practice. Overall, critical thinking scores increased from pretest to posttest, supporting the integration of simulation into early clinical education.