Clinical Simulation in Nursing最新文献

{"title":"Utilization, application and effectiveness of metaverse in simulation-based nursing education: A systematic review","authors":"Carley Jans RN, MTeach, PhD Candidate ,&nbsp;Cherie Lucas PhD, BPharm ,&nbsp;Tracy Levett-Jones RN, PhD","doi":"10.1016/j.ecns.2025.101807","DOIUrl":"10.1016/j.ecns.2025.101807","url":null,"abstract":"<div><h3>Background</h3><div>The Metaverse is an emerging technological innovation with potential applications for healthcare education.</div></div><div><h3>Aim</h3><div>The objective of this systematic review was to evaluate the utilization, application, and effectiveness of the Metaverse in simulation-based nursing education.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across eight electronic databases, yielding 32 studies that met the inclusion criteria. The studies, conducted between 2016 and 2023, were predominantly quantitative, with some employing mixed methods and qualitative approaches.</div></div><div><h3>Findings</h3><div>The review identified two main themes: learning outcomes and learner experiences. Learning outcomes included knowledge acquisition, clinical skill development, self-efficacy, confidence, and motivation. Use of Metaverse components, particularly virtual reality (VR), generally improved knowledge and technical skill acquisition, especially in areas such as infection control and neonatal resuscitation. Gains in nontechnical skills, including problem-solving and critical thinking, were also observed. However, evidence on motivation and confidence was mixed, with some studies reporting significant improvements and others finding no difference compared to traditional teaching methods. Learner experiences encompassed satisfaction, presence and immersion, usability, acceptability, and anxiety reduction. Learner satisfaction was consistently high, with VR perceived as visually appealing, interactive, and conducive to engaging learning environments. VR also enhanced presence and immersion, creating realistic and interactive simulations. Usability was typically rated as good, though challenges such as cybersickness were noted. Overall, participants viewed Metaverse technologies positively for their ability to create immersive, enjoyable, and effective learning experiences.</div></div><div><h3>Conclusions</h3><div>This review highlights the potential of the Metaverse in nursing education, particularly for enhancing learning outcomes and learner experiences. However, the lack of studies on the full application of the Metaverse, including social connectedness, suggests the need for further research to explore its comprehensive role in simulation-based learning.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101807"},"PeriodicalIF":2.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221774","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":"Effectiveness of chatbot iCAN on reporting of child and adolescent abuse and neglect among emergency nurses: A pilot study","authors":"Li-Cheng Kao RN, MSN ,&nbsp;Su-Fen Cheng RN, PhD ,&nbsp;Wei-Chuan Chang MPH ,&nbsp;Pei-Fang Lai MD, PhD ,&nbsp;Mei-Lin Hsieh RN, MSN","doi":"10.1016/j.ecns.2025.101827","DOIUrl":"10.1016/j.ecns.2025.101827","url":null,"abstract":"<div><h3>Background</h3><div>Child and adolescent abuse and neglect (CAN) can lead to long-term trauma. These experiences can also contribute to cycles of family violence. Emergency nurses frequently encounter suspected cases, making it essential to strengthen their recognition and reporting competencies. This study examined the effectiveness of chatbot-facilitated education in improving CAN-related knowledge, attitudes, and reporting intention.</div></div><div><h3>Methods</h3><div>A two-group repeated-measures design was used with 32 emergency nurses recruited through purposive sampling. Both groups received CAN education; the experimental group additionally interacted with a chatbot named iCAN. Assessments were conducted at pre-test, post-test (week 1), and follow-up test (week 4).</div></div><div><h3>Results</h3><div>The experimental group showed significantly greater improvement in CAN knowledge and reporting intention (<em>p</em> &lt; .001) compared to the control group. While reporting attitudes improved in the experimental group and declined in the control group, between-group differences were not statistically significant (<em>p</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>Chatbot-facilitated education significantly enhanced emergency nurses’ CAN knowledge and intention to report. Optimizing chatbot design may further support nurses in identifying and reporting suspected cases.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101827"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221848","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":"Structured Prebrief for Clinical Judgment in Nursing Simulation: A Quasi-Experimental Study","authors":"Elizabeth Parker EdD, RN, CNE, CHSE ,&nbsp;Jane K. Dickinson RN, PhD, CDCES, FAAN ,&nbsp;Cynthia Crews DNP, RN, CNE, CHSE ,&nbsp;Elizabeth Zirkle MSN, RN, FNP-C","doi":"10.1016/j.ecns.2025.101826","DOIUrl":"10.1016/j.ecns.2025.101826","url":null,"abstract":"<div><h3>Background</h3><div>The literature on simulation prebriefing is limited. This study explored the impact of structured prebriefing on nursing students’ clinical judgment and self-perceived patient care ability.</div></div><div><h3>Methods</h3><div>A quasi-experimental design compared standard (control) and structured (intervention) prebriefing in 55 undergraduate nursing students. Outcome measurements the Laseter Clinical Judgment Rubric (LCJR) and the Perceptions to Care in Acute Situations (PCAS).</div></div><div><h3>Results</h3><div>Both groups showed improvement in mean scores on PCAS, with no significant difference in LCJR scores between groups.</div></div><div><h3>Conclusion</h3><div>Structured prebriefing did not yield statistically significant improvements. This study's limitations, including a relatively small sample, a rise in student attrition rate, the use of one site, and one-time exposure to the intervention, highlight the need for further research to determine the impact of structured prebriefing on clinical judgment and development of a prebriefing model.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101826"},"PeriodicalIF":2.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119863","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":"Challenged, informed, and connected: Nursing students’ insights following Opioid Use Disorder simulation debriefing","authors":"Monika S. Schuler PhD, FNP, BC ,&nbsp;Mary K. McCurry PhD, RNBC, ANP, ACNP ,&nbsp;Jennifer Dunbar Viveiros PhD, RN, CNE ,&nbsp;Mirinda Tyo PhD, RN, TCRN ,&nbsp;Shannon Avery-Desmarais PhD, RN, AGNP-C ,&nbsp;Danielle DeGonge PhD, RN, OCN","doi":"10.1016/j.ecns.2025.101820","DOIUrl":"10.1016/j.ecns.2025.101820","url":null,"abstract":"<div><h3>Background</h3><div>Negative attitudes toward individuals with opioid use disorder (OUD) are common among healthcare providers, including nursing students. While simulation education can reduce stigma, evidence-based simulations incorporating diverse perspectives of individuals with OUD, including LGBTQ+ individuals, rural residents, older adults, and those experiencing human trafficking, are needed.</div></div><div><h3>Methods</h3><div>This qualitative descriptive study explored the impact of six high-fidelity simulations, co-created with input from the recovery community, on 60 nursing students’ attitudes toward caring for diverse individuals with OUD. Simulation debriefings were analyzed for evolving perspectives.</div></div><div><h3>Results</h3><div>Initial reflections revealed themes of “Limited knowledge of OUD” and “Out of my comfort zone.” Postdebriefing themes included “recognizing stigma,” “treating the person—not the disorder,” “importance of caring behavior,” and “building connections.” Beyond attitudinal shifts, debriefings elicited personal reflection with some students connecting the simulations to family or friend OUD experiences with new meaningfulness. Trauma informed debriefings helped students process emotions triggered by these reflections.</div></div><div><h3>Conclusion</h3><div>Community-informed simulations are transformative in nursing education. By addressing knowledge gaps, challenging biases, and fostering empathy, they promote stigma-free, person-centered OUD care.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101820"},"PeriodicalIF":2.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098497","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":"Psychological safety mediates the relationship between climate of silence and team learning in simulation debriefing","authors":"Hyang Eun Yoo MSN ,&nbsp;Young Sook Roh PhD","doi":"10.1016/j.ecns.2025.101821","DOIUrl":"10.1016/j.ecns.2025.101821","url":null,"abstract":"<div><h3>Background</h3><div>This web-based cross-sectional study examined whether psychological safety mediates the relationship between climate of silence and team learning during debriefings among nursing students.</div></div><div><h3>Methods</h3><div>This cross-sectional descriptive study included 200 Korean nursing students who completed a web-based questionnaire. Mediation analysis using the percentile bootstrap method was performed.</div></div><div><h3>Results</h3><div>Climate of silence and psychological safety significantly predicted team learning. Psychological safety mediated the relationship between climate of silence and team learning among nursing students.</div></div><div><h3>Conclusions</h3><div>Nurse educators should develop and implement targeted strategies to optimize climate of silence and psychological safety, which are critical predictors of team learning.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"108 ","pages":"Article 101821"},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098505","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 beef tongue and virtual reality in episiotomy training on self-efficacy and anxiety in midwifery students: Randomized controlled trial","authors":"Yasemin Hamlaci Baskaya PhD ,&nbsp;Büşra Yolcu MSc ,&nbsp;Zeliha Demir Kaymak PhD ,&nbsp;Serefraz Akyaman PhD ,&nbsp;Zekiye Turan PhD ,&nbsp;Gülüzar Çit PhD","doi":"10.1016/j.ecns.2025.101817","DOIUrl":"10.1016/j.ecns.2025.101817","url":null,"abstract":"<div><h3>Background</h3><div>The application and repair of an episiotomy is a skill that midwifery students must acquire. The type and realism of training methods may influence students' anxiety levels and self-efficacy.</div></div><div><h3>Aim</h3><div>This study was conducted to evaluate the effects of practice training provided with Beef tongue and virtual reality simulation on students' episiotomy self-efficacy and anxiety levels.</div></div><div><h3>Method</h3><div>This randomized controlled trial was registered at ClinicalTrials.gov (NCT06711198) and conducted with 95 midwifery students. Participants were allocated to one of three groups—beef tongue simulation (<em>n</em> = 31), virtual reality simulation (<em>n</em> = 32), or a mixed group combining both methods (<em>n</em> = 32)—using block randomization with sealed envelopes, performed by an independent person to ensure balanced group sizes. No blinding was used due to the nature of the interventions. Data were collected using the Student Identification Form, State-Trait Anxiety Inventory, and Episiotomy Self-Efficacy Scale. The study received no external funding.</div></div><div><h3>Results</h3><div>All training methods significantly improved episiotomy self-efficacy (<em>p</em> &lt; .05), with the greatest improvement in the mixed group. Training also reduced state anxiety (<em>p</em> &lt; .05), with the largest decrease in the beef tongue group, while VR had the least effect on anxiety reduction.</div></div><div><h3>Conclusion</h3><div>A holistic approach to episiotomy training is essential for skill development. Integrating VR simulations with haptic materials can enhance students' learning by reducing anxiety and improving self-efficacy.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"107 ","pages":"Article 101817"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060591","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":"“Let’s go on safari”: Development of a visually enhanced mental simulation for healthcare team collaboration","authors":"Jennifer Dale-Tam RN, MSN, CNCC(c), CCSNE, CHSE-A","doi":"10.1016/j.ecns.2025.101814","DOIUrl":"10.1016/j.ecns.2025.101814","url":null,"abstract":"<div><div>Healthcare team training traditionally relies on medically complex simulations, which may not always emphasize collaboration skills. Visually Enhanced Mental Simulations (VEMS) emerged during the COVID-19 pandemic as an alternative. A non-medical VEMS, Let’s Go on Safari, was refined through three Plan-Do-Study-Act cycles via participant feedback and peer review. Interprofessional participants expressed high satisfaction, and simulation facilitator peers affirmed its potential value in fostering teamwork. The Safari VEMS provides a low-stakes, low-resource approach with the possibility of breaking down silos and enhancing healthcare team collaboration, offering an innovative modality for skill development beyond traditional medical-based simulations.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"107 ","pages":"Article 101814"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060592","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 breastfeeding counseling education model developed in metaverse on breastfeeding counseling skills, knowledge and empathy level","authors":"Sinem Ceylan PhD ,&nbsp;Gulten Guvenc PhD","doi":"10.1016/j.ecns.2025.101810","DOIUrl":"10.1016/j.ecns.2025.101810","url":null,"abstract":"<div><h3>Background</h3><div>Researchers developed a training environment within the metaverse to facilitate breastfeeding counselling practices.</div></div><div><h3>Method</h3><div>In this randomised controlled trial, theoretical breastfeeding education was compared with LactaVerse—a breastfeeding counseling training environment within the metaverse, designed using Unity as two rooms: a hospital room and a room where lactation physiology is examined. A total of 111 nursing students (intervention: 55, control: 56) who volunteered and met the inclusion criteria participated in the study. Students' breastfeeding knowledge levels, counselling skills, and empathy skills were measured.</div></div><div><h3>Findings</h3><div>LactaVerse was found to be effective in increasing nursing students' breastfeeding knowledge and counselling skills, as well as in enhancing emotional empathy skills.</div></div><div><h3>Conclusion</h3><div>It is recommended that LactaVerse be used in nursing education and integrated into different educational fields to create virtual nursing laboratories.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"107 ","pages":"Article 101810"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060524","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":"Implementation and evaluation of a mass casualty incident simulation for emergency nurse practitioner students","authors":"W. Travis McCall PhD, APRN, CCP,&nbsp;Eric S. Hall MSN, RN, NI-BC, CSSWB","doi":"10.1016/j.ecns.2025.101808","DOIUrl":"10.1016/j.ecns.2025.101808","url":null,"abstract":"<div><h3>Background</h3><div>Competencies and knowledge of practice standards identify that advanced practice nurse education should include the delivery of care to patients affected by disaster events and public health emergencies.</div></div><div><h3>Methods</h3><div>A mass casualty incident simulation utilizing high-fidelity manikins, low-fidelity manikins, and standardized patients was implemented to benefit the education and preparation of emergency nurse practitioner students.</div></div><div><h3>Results</h3><div>Learners provided positive quantitative and qualitative feedback about the simulation and debriefing activities.</div></div><div><h3>Conclusion</h3><div>The simulation was determined to be valuable in the education of emergency nurse practitioner students. The inclusion of a grounding exercise and a discussion of the identification and use of mental health resources following such events were beneficial for learners.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"107 ","pages":"Article 101808"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050095","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":"Understanding interprofessional co-debriefing practices within large scale ward-based simulation","authors":"Melanie Barlow RN, PhD, BN ,&nbsp;Robyn Dickie ,&nbsp;Alycia Jacob ,&nbsp;Shari Maver ,&nbsp;Nick Flynn ,&nbsp;Alison Blunt ,&nbsp;Susan Darzins ,&nbsp;Hugh Davies ,&nbsp;Michelle Smith-Tamaray ,&nbsp;Elisabeth Jacob","doi":"10.1016/j.ecns.2025.101809","DOIUrl":"10.1016/j.ecns.2025.101809","url":null,"abstract":"<div><h3>Background</h3><div>Despite growing use of interprofessional simulation in healthcare education, there is a lack of published frameworks to guide structured, co-facilitated debriefing between professions. This study explored how nursing and allied health facilitators engage in interprofessional co-debriefing within a large-scale, ward-based simulation program involving over 2000 health students.</div></div><div><h3>Methods</h3><div>Twelve interprofessional co-debriefings were observed and assessed using the debriefing assessment for simulation in healthcare (DASH) tool, with both rater (observer) and instructor (debriefer) versions. Mean debriefing assessment for simulation in healthcare (DASH) scores were compared across five core elements. Qualitative data from instructor short-answer responses and observer field notes were also analysed.</div></div><div><h3>Results</h3><div>Raters consistently scored debriefings higher than instructors, except where debriefers lacked formal training. Three key themes emerged: the interplay between co-facilitation and debriefing structure, uncertainty impedes curiosity and, ``phew, my students are chatty.''</div></div><div><h3>Conclusion</h3><div>This study is among the first to directly examine real-world interprofessional co-debriefing practices. It highlights the critical need for structured guidance in co-debriefing, identifies challenges unique to interprofessional facilitation, and provides practical insights to support the development of future interprofessional debriefing frameworks.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"107 ","pages":"Article 101809"},"PeriodicalIF":2.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050094","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}