Clinical Simulation in Nursing最新文献

{"title":"Determinants of psychological safety in simulation-based learning among health professions students: A cross-sectional study","authors":"Samira Ahmed Alsenany PhD, MSN in Community Nursing, BSc in Nursing Sciences, RN ,&nbsp;Aseelah Abdullah Alnazawi ,&nbsp;Ohoud Alnazawi PhD, MSN in Community Nursing, BSc in Nursing Sciences, RN ,&nbsp;Ahmed Abdelwahab Ibrahim El-Sayed PhD, MSN in Nursing Administration, BSc in Nursing Sciences, RN","doi":"10.1016/j.ecns.2026.101905","DOIUrl":"10.1016/j.ecns.2026.101905","url":null,"abstract":"<div><h3>Background</h3><div>Simulation-based learning is an essential strategy in health professions education that allows learners to develop clinical competence in a controlled and supportive environment. Psychological safety—students’ perceptions that they can express ideas, ask questions, and make mistakes without fear of embarrassment—is critical to maximizing learning outcomes. However, limited research has examined psychological safety across different health disciplines.</div></div><div><h3>Aim</h3><div>This study aimed to assess the level of psychological safety among health professions students engaged in simulation-based learning and to explore factors influencing it, including gender, academic discipline, and frequency of simulation exposure.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 210 final-year students enrolled in the medicine, nursing, and applied medical sciences programs at a governmental university in Saudi Arabia. Data were collected using the Psychological Safety in High-Fidelity Simulation Scale, adapted for multidisciplinary use. Descriptive and inferential statistics were performed using SPSS version 20, with significance set at <em>p</em> &lt; .05.</div></div><div><h3>Results</h3><div>Most participants reported moderate to high psychological safety levels. Nursing students demonstrated higher psychological safety scores than medical students (<em>p</em> = .02), while female students scored lower than males (<em>p</em> = .03). Frequent exposure to simulation was significantly associated with increased psychological safety (OR = 2.3, <em>p</em> = .01).</div></div><div><h3>Conclusion</h3><div>Psychological safety is a key component of effective simulation-based education. Enhancing faculty support, implementing structured debriefing, and ensuring frequent simulation opportunities can foster psychologically safe learning environments. Targeted strategies addressing gender and disciplinary disparities are essential to promote inclusive, high-quality learning experiences in health professions education.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101905"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an acute myocardial infarction simulation on nursing students’ clinical judgment: Integrating faculty- and self-assessments","authors":"Hwa Sun Kim PhD, RN","doi":"10.1016/j.ecns.2025.101895","DOIUrl":"10.1016/j.ecns.2025.101895","url":null,"abstract":"<div><h3>Background</h3><div>Simulation-based education offers a safe and effective approach for developing clinical judgment in high-risk contexts, such as acute myocardial infarction (AMI).</div></div><div><h3>Objective</h3><div>To examine the effects of a hybrid AMI simulation on nursing students’ clinical judgment and perceived learning using both faculty- and self-assessed measures.</div></div><div><h3>Methods</h3><div>A single-group pre–post study was conducted with 92 matched fourth-year nursing students (from a cohort of 103). Instruments included the faculty-rated Lasater Clinical Judgment Rubric (LCJR), the self-rated Simulation-based Clinical Judgment Rubric (SP-CJR), and the Simulation Effectiveness Tool-Modified (SET-M). Paired-sample t-tests, 95% confidence intervals, effect sizes (Cohen’s dz), and Pearson correlations were computed.</div></div><div><h3>Results</h3><div>Students’ SP-CJR scores increased significantly from 77.27 to 86.96 (t[91] = 7.50, <em>p</em> &lt; .001, dz = 0.78), and SET-M scores improved from 4.24 to 4.54 (t[91] = 4.72, <em>p</em> &lt; .001, dz = 0.49). Faculty LCJR scores averaged 3.14 (SD = 0.36) across domains. Positive correlations were found between faculty and student ratings (r = 0.21-0.27).</div></div><div><h3>Conclusion</h3><div>A theory-guided hybrid simulation design incorporating standardized patients and high-fidelity manikins was associated with significant pre–post improvements in students’ self-rated clinical judgment and perceived learning, while faculty ratings indicated accomplished levels of observed judgment. Triangulated assessment using LCJR, SP-CJR, and SET-M supports the feasibility of multisource evaluation in simulation-based nursing education and highlights the importance of interpreting self-reported gains alongside faculty ratings.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101895"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a standardized patient program: Sharing insights on the early steps taken","authors":"Nurul Alimah Abdul Nasir PhD, MMedEd ,&nbsp;Nur Amalia Alani Che Baharum MMedEd ,&nbsp;Mohamad Faizal Othman MSc ,&nbsp;Mohd Fazrul Mokhtar DrEmMed, FHEA","doi":"10.1016/j.ecns.2026.101906","DOIUrl":"10.1016/j.ecns.2026.101906","url":null,"abstract":"<div><div>Standardized Patients (SPs) play pivotal role in health professional education by offering realistic and safe environment for students to practice basic and noninvasive clinical skills. However, developing a sustainable SP program, particularly in early-phase settings poses unique challenges. This article describes the steps in establishing SP program at the Faculty of Medicine, Universiti Teknologi MARA, Malaysia, highlighting key strategies, challenges encountered, and lessons learnt. The program was initiated during COVID-19 pandemic to compensate for reduced clinical exposure. Key initiatives included development of an SP guidelines, establishing centralized SP database, and implementation of training workshops for educators and SPs. Feedback was collected to support continuous quality improvement. Around 40 SPs and 15 educators have been trained. Feedback from participants consistently emphasized the value and relevance of the training. Key challenges included difficulty in SP recruitment and retention, and lack of trained administrative personnel. Collaborative efforts with Faculty offering acting courses and structured guidelines helped mitigate these issues. The establishment of an SP program requires careful planning, interprofessional collaboration, and continuous refinement.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101906"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reinforcing prenatal content using an immersive room in family nurse practitioner education","authors":"Kara Elena Schrader DNP, FNP-C ,&nbsp;Kristin Castine DNP, ANP-BC ,&nbsp;Emily McIntire PhD, RN, CHSE ,&nbsp;Anna Schroeder MSN, APRN, AGCNS-BC ,&nbsp;Andrew Greger MA","doi":"10.1016/j.ecns.2026.101910","DOIUrl":"10.1016/j.ecns.2026.101910","url":null,"abstract":"<div><div>Family nurse practitioner students often face limited access to obstetrics-gynecology clinical placements, resulting in reduced prenatal care experience and confidence. To address this gap, and enhance the current curriculum, the nurse practitioner faculty implemented an immersive interactive game-based simulation experience using the Echo Healthcare Immersive Interactive System. This simulation replicates a 28-week prenatal visit and integrates game-based learning, escape room elements, and team-based clinical decision-making. Postevent surveys indicate improved student confidence and preparedness for direct prenatal care.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101910"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of simulation-based training provided to nurses in the hospital environment on child neglect and abuse: Quasi-experimental research","authors":"Yağmur Şancı PhD, RN ,&nbsp;Canan Genç MSc, RN ,&nbsp;Rukiye Kökkız MSc, RN","doi":"10.1016/j.ecns.2026.101903","DOIUrl":"10.1016/j.ecns.2026.101903","url":null,"abstract":"<div><h3>Background</h3><div>Child neglect and abuse are major public health concerns, and nurses play a critical role in early recognition. Simulation-based training is a promising method to strengthen knowledge and preparedness.</div></div><div><h3>Methods</h3><div>This quasi-experimental pretest-posttest study was conducted with 20 nurses working in a pediatric emergency unit of a state hospital between March and April 2024. Data were collected using a socio-demographic form and the “Scale for Determining the Knowledge Level of Nurses and Midwives in Diagnosing the Symptoms and Risks of Child Abuse and Neglect.” Nurses participated in simulation-based training with a structured scenario, followed by debriefing and posttest.</div></div><div><h3>Results</h3><div>Knowledge scores significantly increased after training, particularly in recognizing physical and behavioral symptoms of abuse. However, improvements were limited in identifying children at higher risk of neglect and abuse.</div></div><div><h3>Conclusion</h3><div>Simulation-based training enhances nurses’ knowledge of child abuse recognition and should be integrated into nursing education and in-service programs to improve clinical preparedness.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101903"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing breastfeeding knowledge, assessment skills and self-efficacy in nursing students: A comparison of traditional, assessment-simulation-animation-based and mixed simulation-based education","authors":"Ching-Hsueh Yeh PhD, RN ,&nbsp;Ya-Ping Yang PhD, RN","doi":"10.1016/j.ecns.2026.101908","DOIUrl":"10.1016/j.ecns.2026.101908","url":null,"abstract":"<div><h3>Background</h3><div>Nursing students often possess adequate knowledge but struggle to apply it in clinical practice, highlighting the need for improved educational approaches.</div></div><div><h3>Aim</h3><div>To compare the effects of traditional, assessment-simulation-animation-based (ASA-based), and mixed simulation-based education on breastfeeding knowledge, assessment skills, and self-efficacy.</div></div><div><h3>Methods</h3><div>A three-group prepost quasi-experimental design was conducted with 179 nursing students in Taiwan. Comparison group (CG) received traditional education; Experimental Group I (EG-I) received ASA-based videos with pamphlets; and Experimental Group II (EG-II) received mixed simulation-based education combining ASA-based videos and scenario-based interactive training, evaluated through a team-based OSCE (objective structured clinical examination).</div></div><div><h3>Results</h3><div>All groups demonstrated improvements in knowledge and self-efficacy, as well as satisfactory objective structured clinical examination (OSCE) performance in postpartum and breastfeeding assessments. Post hoc analysis revealed that EG-II achieved significantly higher scores than EG-I in breastfeeding knowledge and assessment skills, and surpassed comparison group (CG) in knowledge and self-efficacy.</div></div><div><h3>Conclusion</h3><div>The scenario-based interactive training created a stronger impression, enhanced realism, increased students' confidence, and encouraged a clinical approach with a firm grasp. Mixed simulation-based education is recommended for nursing curricula and new nurse training.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101908"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147400922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-based quality improvement initiative to enhance identification and management of in-hospital strokes","authors":"Erin Wasylyk DNP, CRNA ,&nbsp;Virginia C. Simmons DNP, CRNA, CHSE-A, ANEF, FAANA, FAAN ,&nbsp;Sarah Rollison DNP, CRNA, CNE, CHSE ,&nbsp;Jessica Szydlowski DNP, CRNA, CHSE ,&nbsp;Nicole Petsas Blodgett PhD, RN, CHSE-A, ANEF","doi":"10.1016/j.ecns.2025.101898","DOIUrl":"10.1016/j.ecns.2025.101898","url":null,"abstract":"<div><h3>Background</h3><div>In-hospital strokes are associated with delayed recognition and poorer outcomes.</div></div><div><h3>Methods</h3><div>A pre-post quality improvement project evaluated didactic education and simulation-based training for inpatient stroke recognition among cardiothoracic ICU nurses (n = 31). Outcomes included knowledge scores, simulation performance, and time to complete critical stroke-response actions.</div></div><div><h3>Results</h3><div>Mean knowledge scores increased from (<em>M</em> = 86.77% to 93.87%, <em>p</em> &lt; .001), and performance improved recognition and task management (<em>p</em> &lt; .001). Total mean task completion time decreased from 144.35 to 105.29 seconds (<em>p</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Simulation-based training significantly improved nurses’ knowledge, performance, and efficiency in managing in-hospital stroke events.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101898"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of 3D virtual cadaver simulation on confidence, achievement, and satisfaction among first-year nursing students: A randomized controlled trial","authors":"Hyeongyeong Yoon PhD, RN","doi":"10.1016/j.ecns.2025.101902","DOIUrl":"10.1016/j.ecns.2025.101902","url":null,"abstract":"<div><h3>Background</h3><div>Anatomy is a core subject in nursing education, yet its complexity often challenges first-year students. Visualization-based approaches, such as 3D virtual cadaver simulation, may enhance learning outcomes.</div></div><div><h3>Methods</h3><div>A randomized controlled pretest–posttest design was used. The experimental group participated in 2-hour 3D virtual cadaver simulation sessions weekly for five weeks, while the control group received conventional instruction. Academic confidence and perceived academic achievement were measured before and after the intervention, and learning satisfaction was assessed post-intervention.</div></div><div><h3>Results</h3><div>The experimental group showed significantly greater improvements in academic confidence and academic achievement than the control group, as well as higher learning satisfaction.</div></div><div><h3>Conclusion</h3><div>3D virtual cadaver simulation effectively enhanced academic confidence, achievement, and learning satisfaction in nursing students.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101902"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147400921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcribing and coding audiovisual simulation recordings for in-depth analysis","authors":"Carolyn J. Kerns EdD,&nbsp;Heather Cole PhD,&nbsp;Mahalia Barrow EdD,&nbsp;Holly Stokley MSN","doi":"10.1016/j.ecns.2026.101907","DOIUrl":"10.1016/j.ecns.2026.101907","url":null,"abstract":"<div><h3>Introduction</h3><div>Simulation is widely used in nursing education, yet traditional evaluation strategies often capture only observable actions, missing the complexity and context of student learning.</div></div><div><h3>Methods</h3><div>This article presents the Simulation Analysis Method for Recordings (SAMR), a structured research method with a step-by-step guide for transcribing, coding, and analyzing audiovisual simulation and debriefing data. This method integrates actions and verbalizations within a selected conceptual model, such as the Tanner Clinical Judgment Model or others aligned with learning objectives.</div></div><div><h3>Results</h3><div>A structured analytic template supported deductive coding, theme development, and comparison of expected versus observed performance, aligning with evaluation tools such as the Lasater Clinical Judgment Rubric.</div></div><div><h3>Discussion</h3><div>This method is structured and systematic, enabling detailed analysis of simulation performance to inform pedagogy, assess learning, and guide curriculum revision.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101907"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Game-based learning in pediatric nursing: Escape room effects on safety and clinical decision-making","authors":"Andrea M. Peters MS,&nbsp;Jean M. Gambo MSN,&nbsp;Kelly Bates DNP,&nbsp;Rebecca Weston EdD, MSN","doi":"10.1016/j.ecns.2026.101909","DOIUrl":"10.1016/j.ecns.2026.101909","url":null,"abstract":"<div><h3>Background</h3><div>The shift of nursing curricula towards competency-based education requires the development of new learning strategies. The use of game-based learning in nursing education has been shown to improve student performance in numerous domains. This study aimed to assess students’ perceived effectiveness of a structured, medium-fidelity pediatric inpatient safety escape room.</div></div><div><h3>Sample</h3><div>A total of 44 students completed the structured escape room. Immediately after finishing the activity, students completed a survey to determine its perceived impact in several domains.</div></div><div><h3>Methods</h3><div>Immediately after completion of the simulation, students completed a survey of seven items selected from the Simulation Effectiveness Tool-Modified to evaluate their perceptions of the activity’s effectiveness.</div></div><div><h3>Results</h3><div>Participants reported perceived improvement across all items, with mean scores ranging from 2.61 to 2.77 on a 3-point scale, suggesting that students felt the learning experience was beneficial.</div></div><div><h3>Conclusions</h3><div>The escape room had a positive perceived impact on student learning. Escape rooms may serve as a powerful tool to reinforce critical thinking, safety, and teamwork in nursing education.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101909"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}