Nurse Education Today最新文献

{"title":"The relationship between gender role attitudes and career choices among nursing students: A cross-sectional study","authors":"Ayla Güllü ,&nbsp;Nihal Aloğlu","doi":"10.1016/j.nedt.2025.106841","DOIUrl":"10.1016/j.nedt.2025.106841","url":null,"abstract":"<div><h3>Aim</h3><div>The healthcare sector is one of the domains where inequalities stemming from gender roles and expectations are most pronounced. For nurses, gender awareness is crucial in fostering meaningful connections with patients and plays a vital role in enhancing the quality of healthcare services. This study aims to explore the relationship between gender role attitudes and career choices among the new generation of nursing students.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted with a sample of 332 nursing students. Data were collected using the Gender Role Attitudes Scale (GRAS) and the Vocational Choices in Entering Nursing Scale (VCENS). Data analysis included <em>t</em>-tests, ANOVA, post-hoc Benferroni tests, spearman correlation analysis and linear regression analysis.</div></div><div><h3>Results</h3><div>77.1 % of the students were female (<em>n</em> = 256), 64.5 % chose the profession voluntarily, and 53.9 % selected nursing due to its ease of employment. The female students scored significantly higher on the GRAS compared to the male students. Those who voluntarily chose the profession had significantly higher VCENS total scores and ‘Vocational Congruency’ subscale scores. However, no significant relationship was found between gender role attitudes and career choice in nursing students.</div></div><div><h3>Conclusion</h3><div>Educational programs can be designed to promote gender equality awareness among students. Public awareness campaigns can highlight the importance and value of nursing while emphasizing that it is not a gender-specific profession.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"154 ","pages":"Article 106841"},"PeriodicalIF":4.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling learning styles and strategies of nursing students: A cluster analysis study","authors":"Hui Ge ,&nbsp;Tingting Feng ,&nbsp;Huiling Hu ,&nbsp;Jiashuai Li ,&nbsp;Xue Wu","doi":"10.1016/j.nedt.2025.106840","DOIUrl":"10.1016/j.nedt.2025.106840","url":null,"abstract":"<div><h3>Background</h3><div>A learner profile, as a method for presenting students' core characteristics and behaviors, has been widely recognized in personalized education, yet it remains underexplored in the context of diversified nursing teaching modes. Nursing requires the application of theoretical knowledge of the curriculum to clinical practice procedures, demanding that nursing students not only absorb information but also transform, integrate, and critically apply it in dynamic, real-world settings. Investigating nursing students' learning style preferences and behavioral strategies is critical for understanding how to adapt teaching methods to meet varied learning needs, thereby enhancing teaching quality and improving student learning outcomes.</div></div><div><h3>Aim</h3><div>To explore a nursing learner profile by analyzing learning styles and strategies, providing insights for integrating diversified teaching modes with personalized learning.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted among 303 nursing students from two public universities. Data collection included sociodemographic information, learning styles, and learning strategies. Clustering ensemble analysis, including voting and consensus matrix methods, was performed to identify a learner profile.</div></div><div><h3>Results</h3><div>A total of 241 valid questionnaires were analyzed, with the majority of participants being female (80.08 %) and an average age of 20.8 ± 1.79. Most students considered blended online and offline teaching (65.56 %) and scenario-based simulation teaching (28.22 %) to be the most effective teaching modes. Six distinct learner clusters were identified, each exhibiting differences in background characteristics, learning styles, and learning strategies: intuitive efficient learners (cluster 1), efficient uncertain learners (cluster 2), intrinsic-driven global learners (cluster 3), reflective independent learners (cluster 4), verbal logical learners (cluster 5), and extrinsic-driven inefficient learners (cluster 6).</div></div><div><h3>Conclusion</h3><div>This study highlights the diversity of nursing learners and the need for personalized teaching approaches. A nursing learner profile provides a foundation for designing tailored instructional strategies and addressing individual differences in nursing education.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"154 ","pages":"Article 106840"},"PeriodicalIF":4.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging self-confidence and learning flow: The role of psychological safety in high-fidelity simulation education","authors":"Soon-Hee Lee ,&nbsp;In-Suk Yang","doi":"10.1016/j.nedt.2025.106837","DOIUrl":"10.1016/j.nedt.2025.106837","url":null,"abstract":"<div><h3>Background</h3><div>Self-confidence, psychological safety, and learning flow are key factors in high-fidelity simulation (HFS) education. While their individual effects on learning outcomes have been explored, the mediating role of psychological safety in the relationship between self-confidence and learning flow remains unclear.</div></div><div><h3>Objectives</h3><div>This study examines whether psychological safety mediates the relationship between self-confidence and learning flow in nursing students undergoing HFS education.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional study was conducted with 149 nursing students from three South Korean universities. Data were collected via a web-based survey, and mediation analysis was performed using Baron and Kenny's method, with significance confirmed by the Sobel test.</div></div><div><h3>Results</h3><div>Self-confidence was positively correlated with psychological safety (<em>r</em> = 0.265, <em>p</em> = .001) and learning flow (<em>r</em> = 0.523, <em>p</em> &lt; .001). Psychological safety also showed a significant positive correlation with learning flow (<em>r</em> = 0.395, p &lt; .001). Mediation analysis confirmed that psychological safety partially mediated the effect of self-confidence on learning flow (Sobel test: Z = 1.977, <em>p</em> = .048). The effect size of the mediation effect was small but meaningful (κ² = 0.026), indicating that psychological safety plays a significant role in enhancing the relationship between self-confidence and learning flow.</div></div><div><h3>Conclusion</h3><div>Psychological safety enhances the positive impact of self-confidence on learning flow. Nursing educators should foster psychologically safe learning environments to maximize students' engagement and learning outcomes in HFS education.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"154 ","pages":"Article 106837"},"PeriodicalIF":4.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postgraduate nursing students' motivation for learning: A mixed-method study exploring changes in academic motivation","authors":"Hanne Maria Bingen ,&nbsp;Camilla Olaussen ,&nbsp;Irene Rød ,&nbsp;Hilde Sundfær ,&nbsp;Marianne Trygg Solberg","doi":"10.1016/j.nedt.2025.106834","DOIUrl":"10.1016/j.nedt.2025.106834","url":null,"abstract":"<div><h3>Background</h3><div>Promoting and maintaining academic motivation throughout higher education is predicted to positively influence students' academic success. According to the Self-Determination Theory, motivation foster student engagement and optimal learning. Research on the academic motivation of postgraduate nursing students is limited, and no studies have explored academic motivation over time among advanced practice nursing students.</div></div><div><h3>Aim</h3><div>The aim of this study was to explore levels of academic motivation and student engagement among advanced practice nursing students in critical care through the first semester of their master's program.</div></div><div><h3>Design</h3><div>A convergent mixed methods design.</div></div><div><h3>Methods</h3><div>Study participants were advanced practice nursing students at a university college. Quantitative data was collected through a longitudinal survey-based method using the Academic Motivation Scale (<em>n</em> = 17). Qualitative data were obtained through professional essays (<em>n</em> = 9) and reflection notes (<em>n</em> = 3). Data was analyzed separately and compared for complementary findings.</div></div><div><h3>Results</h3><div>Questionnaire: A significant decline in the self-determination index, intrinsic motivation, and the most autonomous form of extrinsic motivation was observed. Qualitative findings: Study demands experienced as barriers to <em>autonomy</em>; prioritizes what appears meaningful for clinical nurses. Encouraged by professional clinical <em>competence</em> but missing learning challenges that support competence achievement. Missing learning together and <em>relating</em> to peers.</div></div><div><h3>Conclusions</h3><div>Even though postgraduate students maintain motivation through the first semester, there seems to be a shift from autonomous to more controlled motivation. A desire for higher clinical competence sustains motivation, and the change in academic motivation relates to experiences of the education's less adequate relevance to clinical practice, insufficient time to perform learning activities, and lack of support. To address this, we recommend clarifying the clinical relevance of learning activities, allocating sufficient study time, and providing opportunities for peer, clinical preceptor, and educator support.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"154 ","pages":"Article 106834"},"PeriodicalIF":4.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding and addressing whiteness in health assessment: Nursing education","authors":"Nadia Prendergast ,&nbsp;Jennifer Lapum ,&nbsp;Juilett Saunders Hill ,&nbsp;Michelle Hughes ,&nbsp;Leinic Chung-Lee ,&nbsp;Priscilla Boakye ,&nbsp;Raquel Lashley","doi":"10.1016/j.nedt.2025.106830","DOIUrl":"10.1016/j.nedt.2025.106830","url":null,"abstract":"","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"153 ","pages":"Article 106830"},"PeriodicalIF":3.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of cultural competence training given based on the peer education method on the cultural competence levels of nursing students: A randomized controlled trial","authors":"Cennet Çiriş Yildiz ,&nbsp;Fatime Algur ,&nbsp;Fatma Kuzu ,&nbsp;Sümeyye Aydin","doi":"10.1016/j.nedt.2025.106832","DOIUrl":"10.1016/j.nedt.2025.106832","url":null,"abstract":"<div><h3>Aim</h3><div>The purpose of this study is to determine the effects of cultural competence training provided based on the peer education model on the cultural competence levels of nursing students.</div></div><div><h3>Design</h3><div>This study had a randomized controlled pretest-posttest design with intervention and control groups.</div></div><div><h3>Method</h3><div>The sample consisted of third- and fourth-year nursing students (intervention group: 75; control group: 78) studying at two non-profit universities in Istanbul.</div></div><div><h3>Results</h3><div>There was a significant difference among the cultural knowledge levels of the intervention group in the pretest, first follow-up, and second follow-up measurements (<em>p</em> &lt; 0.05). The cultural competence levels of the participants in the intervention group also differed significantly among the pretest, first follow-up, and second follow-up measurements (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Cultural competence training not only allows nursing students to improve their cultural competence but also helps them understand patients from different cultures better and provide higher-quality patient care.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"153 ","pages":"Article 106832"},"PeriodicalIF":3.6,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of interprofessional simulation-based experiences in fostering the development of health professional students' professional identity: A scoping review","authors":"Kelly Squires ,&nbsp;Belinda Judd ,&nbsp;Tayne Ryall ,&nbsp;Christie van Diggele ,&nbsp;Kellie Britt ,&nbsp;Pauletta Irwin","doi":"10.1016/j.nedt.2025.106828","DOIUrl":"10.1016/j.nedt.2025.106828","url":null,"abstract":"<div><h3>Introduction</h3><div>Interprofessional education aims to prepare future health professionals for collaborative practice by developing essential skills in communication and teamwork. Simulation-based experiences are a popular teaching method in interprofessional education, providing students with safe and supportive learning environments that authentically replicate clinical practice. Developing a strong professional identity is crucial in health professional students, as it fosters a sense of belonging and helps define roles and boundaries within healthcare teams. This scoping review aims to synthesise the literature to explore the impact of interprofessional simulation-based experiences on the development of health professional students' professional identity.</div></div><div><h3>Methods</h3><div>Following Arksey and O'Malley's methodological framework, 22 studies were included in the review.</div></div><div><h3>Findings</h3><div>Findings demonstrated interprofessional simulation positively impacted professional identity development by helping students to understand their roles within the healthcare team and recognise the value of their profession. However, stereotypes, power imbalances and lack of role clarity can hinder professional identity development.</div></div><div><h3>Conclusion</h3><div>When designing effective interprofessional simulation-based experiences for professional identity development, it is important to ensure students understand their professional roles, scenarios being used are inclusive of all professions involved, there is adequate preparation and debriefing opportunities and stereotypes and hierarchy are addressed. Future research should focus on exploring the long-term impact of interprofessional simulation experiences on professional identity development.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"153 ","pages":"Article 106828"},"PeriodicalIF":3.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the peer mentoring journey: Experiences of peer mentors in an undergraduate nursing programme","authors":"Siriwan Lim ,&nbsp;Gwynevere Yan Tong Lim ,&nbsp;Cherlyn Yan Ling Chong ,&nbsp;Evelyn Kit Yee Ho ,&nbsp;Yanhong Dong","doi":"10.1016/j.nedt.2025.106829","DOIUrl":"10.1016/j.nedt.2025.106829","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Higher education institutions recognise the importance of peer mentoring in preparing nursing students to transition from academia into clinical practice. However, there is limited literature from Singapore and culturally comparable Southeast Asian contexts that explores peer mentors' embodied perceptions, as most existing research has predominantly centered on Western setting. Given Singapore's unique multicultural context that differs greatly from the West, it is crucial to investigate peer mentors' experiences in local peer mentoring programmes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Aims&lt;/h3&gt;&lt;div&gt;To explore peer mentors' experiences and understand their perceptions of peer mentoring in an undergraduate nursing baccalaureate programme in Singapore.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study utilised a descriptive qualitative design, collecting data from November 2019 to January 2020. Fifty, second to fourth-year nursing students from a peer mentoring programme in a tertiary institution were recruited using convenience sampling. Face-to-face focused group discussions guided by a semi-structured interview guide were audio-recorded and transcribed verbatim. Written reflections were collected and thematic analysis was utilised. Ethical approval was obtained for the research.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Four overarching themes and sixteen subthemes emerged. The themes were: (1) Self-Discovery: From Vulnerability to Empowerment; (2) Synergistic Growth: Enhancing Clinical Skills and Professional Identity; (3) Fostering Connections: Supporting Growth and Community; and (4) Navigating the Mentoring Landscape: Attitudes, Challenges, and Suggestions. Peer mentors experienced personal and professional growth together with mentees through mentoring interactions and self-reflection. Mentors reported transformative mentoring experiences when they were able to build meaningful connections with their mentees and were motivated intrinsically to strengthen the peer mentoring culture within the nursing faculty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study provides insights into the experiences and perceptions of peer mentors in a Singapore undergraduate nursing programme, which aligned with results from existing global studies, despite its diverse and multicultural context. To overcome the challenges experienced by the mentors, support from the faculty, such as the provision of resources and mentor-mentee matching, is essential.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Implications&lt;/h3&gt;&lt;div&gt;Peer mentoring in undergraduate nursing programmes is crucial for effective mentoring. Institutions should adopt formal mentor-mentee matching to foster meaningful connections. Investigating how mentors integrate their guidance post-graduation can shed light on its positive impact on patient-centred nursing care. Future research should focus on diverse populations and employ longitudinal studies for insights into mentoring evolution and its lasting impacts.&lt;/div&gt;&lt;/div","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"154 ","pages":"Article 106829"},"PeriodicalIF":4.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma-informed pedagogy in nursing: A participatory action research exploration of individual and system approaches for increasing resilience","authors":"Robin Evans-Agnew ,&nbsp;Karalynn LaValley ,&nbsp;Tiffany Smith Fromm","doi":"10.1016/j.nedt.2025.106827","DOIUrl":"10.1016/j.nedt.2025.106827","url":null,"abstract":"<div><h3>Background</h3><div>Trauma is an important cause of nurse burnout. Nursing students often have prior, current, and intersectional experiences of trauma in their lives. Students experience vicarious trauma through clinical and classroom instruction. Despite this, there is little explicit guidance for developing trauma-informed practices in nursing education.</div></div><div><h3>Objective</h3><div>Our purpose was to explore practices in trauma-informed pedagogy for nurse resilience. Our specific aims were to 1) assess faculty and students on teaching and learning resilience, 2) explore practices in trauma-informed pedagogy, and 3) disseminate promising practices to nurse educators.</div></div><div><h3>Design</h3><div>We implemented a one-year participatory action research approach in a community of practice with faculty (n = 7) from clinical, diploma, and baccalaureate programs in our region.</div></div><div><h3>Methods</h3><div>We conducted focus groups with students (n = 5) and faculty (n = 7) to initiate an action research phase of observation, reflection, and action cycles implementing practices in our own classrooms, and periodically disseminating context-specific findings to faculty in the region.</div></div><div><h3>Results</h3><div>Focus group themes included trauma, fostering resilience, power-relations, human connections, and modeling trauma-informed practice. Our community of practice held 20 cycle sessions over 12 months and disseminated a toolkit for educators, an op-ed on faculty burnout, and a regional roundtable of 13 colleges of nursing. We identified regionally specific strategies for addressing power relations between academic, healthcare, nursing and governmental regulatory institutions.</div></div><div><h3>Conclusion</h3><div>Faculty action for advancing nursing resilience must engage with the complex, systemic, and intersectional sources of trauma that are grounded in the communities and institutions they serve.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"153 ","pages":"Article 106827"},"PeriodicalIF":3.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring nursing students' experiences with virtual patient-based health assessment simulation program: A qualitative study","authors":"Shinhye Ahn ,&nbsp;Hye Won Jeong","doi":"10.1016/j.nedt.2025.106826","DOIUrl":"10.1016/j.nedt.2025.106826","url":null,"abstract":"<div><h3>Background</h3><div>Health assessment education using virtual patients has emerged as an innovative teaching strategy in nursing education, particularly in response to limited clinical practice opportunities and increased emphasis on patient safety. Despite the growing adoption of virtual patient simulations (VPSs), there is limited understanding of how nursing students experience and learn through this educational approach.</div></div><div><h3>Objective</h3><div>This study aimed to explore nursing students' experiences with the Virtual Patient-Based Health Assessment Simulation Program (VP-HASP) and to understand their learning processes through the lens of Kolb's Experiential Learning Theory.</div></div><div><h3>Design</h3><div>A qualitative study using focus group interviews (FGIs).</div></div><div><h3>Methods</h3><div>Thirty second-year nursing students who completed an 11-week VP-HASP participated in five FGIs. Each week consisted of 2-hour sessions including pre-briefing, VPS, and debriefing. Data were analyzed using qualitative content analysis following Graneheim and Lundman's approach.</div></div><div><h3>Results</h3><div>Five main themes emerged: (1) Development trajectory of system-based clinical reasoning competency, highlighting the progression from initial system adaptation to advanced clinical judgment; (2) Changes in clinical performance ability in temporal context, showing evolution from basic skills to integrated expertise; (3) Psychosocial impact of digital-based practice, revealing both psychological safety in learning and challenges in emotional engagement; (4) Context-specific learning transfer patterns, demonstrating how nursing students applied knowledge across different clinical scenarios; and (5) Practical applicability of virtual patient-based learning, identifying both possibilities and limitations for clinical practice application. Given the qualitative focus of this study, quantitative measures were not investigated.</div></div><div><h3>Conclusions</h3><div>VP-HASP effectively enhanced nursing students' health assessment competencies, clinical reasoning abilities, and integrated thinking skills. While nursing students valued the safe learning environment and opportunities for repeated practice, the system showed limitations in non-verbal communication and emotional engagement. The findings suggest that VPS is an effective educational strategy when implemented with appropriate pedagogical support and recognition of its limitations.</div></div>","PeriodicalId":54704,"journal":{"name":"Nurse Education Today","volume":"153 ","pages":"Article 106826"},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}