Advances in simulation (London, England)最新文献

{"title":"Impact of interprofessional blended learning with low-fidelity simulation on neonatal resuscitation skills among interns: a quasi-experimental study in Tanzania.","authors":"Ambroce Stephen, Angelina A Joho, Vicent Bankanie","doi":"10.1186/s41077-026-00451-w","DOIUrl":"10.1186/s41077-026-00451-w","url":null,"abstract":"<p><strong>Background: </strong>Despite the national rollout of the Helping Babies Breathe (HBB) program, neonatal mortality due to birth asphyxia remains a major challenge in Tanzania. Evidence shows that there is inadequate competence (including knowledge, skills, and attitudes) in newborn resuscitation among medical and nursing interns as they transition into practice. The traditional method of a one-day instructor-led HBB model provides little hands-on practice. Integrating low-fidelity simulation with blended learning may contribute to better transfer of learning and offer a more sustainable model for skills retention.</p><p><strong>Objective: </strong>To evaluate the efficacy of interprofessional low-fidelity simulation with a blended-learning approach among medical and nursing interns' HBB knowledge and skills in Dar es Salaam.</p><p><strong>Methods: </strong>A controlled quasi-experimental design was used with 128 participants. Stratified random sampling by profession was used to select participants for the two groups (64 in the intervention group, 64 in the control group). The intervention group received a 2-h instructor-led online session and two days (16 h total) of hands-on low-fidelity simulation, guided by the HBB 2nd Edition curriculum (which emphasises the Golden Minute, preparation for birth, initial steps including stimulation and warming, bag-mask ventilation, and post-resuscitation care through interactive case-based scenarios and paired practice). The control group received reading materials and continued with their business-as-usual practice. Knowledge (17-item MCQ) and skills (18-item checklist) were assessed at baseline, immediately after intervention, and six weeks post-intervention for both groups. Data were analysed using IBM SPSS version 27, with an independent t-test and a linear mixed model (LMM). β coefficients represent adjusted mean differences from linear mixed models.</p><p><strong>Results: </strong>The groups were similar at baseline. The intervention group showed significant improvements compared with the control group. Knowledge score increased by β = 5.39 immediately post-intervention post-training, and by β = 3.90 in six weeks (both p < 0.001). Skills improved by β = 5.36 immediately and β = 3.47 at six weeks (both p < 0.001).</p><p><strong>Conclusion: </strong>Low-fidelity simulation with blended learning significantly improved HBB knowledge and skills among interns, with effects sustained at six weeks. This approach is practical and scalable for strengthening newborn resuscitation capacity in resource-limited settings.</p><p><strong>Trial registration: </strong>Trial registered to Pan African Trial Registry with Reg no PACTR202512785351089.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance using a visuo-haptic surgical simulator is affected by age.","authors":"Mara Coduri, Chiara Saporetti, Michele Minuto, Maura Casadio, Serena Ricci","doi":"10.1186/s41077-026-00442-x","DOIUrl":"10.1186/s41077-026-00442-x","url":null,"abstract":"<p><strong>Background: </strong>Surgeons need to master many manual skills, which potentially decrease with age. Yet, there is no standardized approach to objectively assess how aging affects basic surgical performance and skills training. In this context, simulation offers a promising solution, being widely used to train and test novice clinicians. This study aims to evaluate the impact of age on performance using a visuo-haptic surgical simulator.</p><p><strong>Methods: </strong>A total of 39 participants were divided in two groups: 20 young (20-40 years) and 19 older adults (50-70 years). All participants completed multiple repetitions of three basic surgical tasks using a custom visuo-haptic simulator: incision, an adapted version of the needle threading task, and suturing. Performance metrics such as errors, trajectory, and task duration were compared between groups and across repetitions.</p><p><strong>Results: </strong>Younger participants outperformed older ones in all tasks. Specifically, they cut more tissue, made fewer errors in the dexterity task, and sutured faster. Both groups partially improved with practice, although older subjects improved less than younger ones.</p><p><strong>Conclusions: </strong>Altogether these results suggest that age significantly affects performance in basic surgical tasks; moreover, older subjects might benefit from periodic training sessions to maintain their skills. In this regard, visuo-haptic simulation can serve as an effective training and evaluation tool to assess and counteract the effects of aging on surgical ability.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening simulation design and cultural safe practice: end-user evaluation of the quality simulation assurance framework.","authors":"Melanie Barlow, Yoriko Kikkawa, Colleen Ryan, Terri Downer, Robyn Dickie, Chanchal Kurup, Kerry Reid-Searl, Aimee Lamb, Alexandra Wordworth, Natasha Eaton, Leeanne Heaton, Stephen Guinea","doi":"10.1186/s41077-026-00454-7","DOIUrl":"10.1186/s41077-026-00454-7","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based learning is a core component of health professional education, yet designing simulations that are culturally responsive, educationally robust, and locally relevant remains challenging. Existing international standards reflect the cultural contexts in which they were developed and provide limited guidance for adapting simulation design for Australia and Aotearoa New Zealand, including effective inclusion of Australian First Nations and New Zealand Māori perspectives. The Quality Simulation Assurance Framework (QSAFe) was developed to address this gap and support culturally safe, high-quality simulation design. This study explored two research questions: (1) How do participants evaluate the applicability of the framework, including its relevance and feasibility, to their simulation practice? and (2) How does the framework support users in their design and delivery of quality simulation, including perceived helpfulness, value, and educative impact?</p><p><strong>Methods: </strong>A pilot evaluation was conducted across five tertiary institutions. Twenty-six educators used the framework to benchmark an existing simulation-based learning activity, and four participated in semi-structured interviews. Quantitative data were analysed using descriptive statistics. Qualitative data were examined using reflexive thematic analysis to explore perceptions of applicability and educative value.</p><p><strong>Results: </strong>Participants reported that the framework and supporting materials were broadly applicable to their simulation practice. Most participants rated their experience positively and indicated an intention to use the framework in future design or documentation. Four themes described the framework's perceived value: usability, promoting best practice, supporting reflection on design, and encouraging consistent learner experience. Although the consultation and co-design element of the framework received the lowest quantitative relevance rating, findings showed this element to be least understood, particularly in relation to cultural safety and Australian First Nations and New Zealand Māori inclusion. Participants suggested improvements such as a brief orientation, video walkthroughs, and an online version with embedded guidance. Limitations included a small sample, incomplete survey responses, and challenges recruiting interview participants.</p><p><strong>Conclusions: </strong>The Quality Simulation Assurance Framework appears feasible, useful, and educative, supporting more consistent and culturally responsive simulation design. Further refinement should focus on strengthening guidance for co-design with Australian First Nations and New Zealand Māori and enhancing usability.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI integration in healthcare simulation debriefing: support or substitute?","authors":"Lucy Stocks, Marc Place, Victoria Brazil, Ranjev Kainth, Belinda Lowe, Ibraaheem Khan, Prashant Kumar","doi":"10.1186/s41077-026-00448-5","DOIUrl":"10.1186/s41077-026-00448-5","url":null,"abstract":"<p><p>Debriefing is widely recognised as a central mechanism for learning within healthcare simulation, enabling learners to reflect on clinical actions, decision-making, and team interactions. However, high-quality debriefing is resource-intensive, dependent on facilitator expertise, and increasingly challenged by the growing complexity and volume of data generated during modern simulation activities. Artificial intelligence (AI) offers emerging opportunities to augment aspects of debriefing by analysing performance data, structuring reflective dialogue, and supporting learning environments. This article explores the emerging role of AI within debriefing. Drawing on the current literature, we describe four modes of AI being integrated into debriefing practice: metric-based AI tutors, large language model-assisted debriefing tools, conversational chatbot debriefers and hybrid integrated AI systems. For each mode, we examine their underlying mechanisms, current applications, and current contributions to, and limitations within, debriefing. Using these four modes as a scaffold, we offer practical guidance for simulation practitioners considering the integration of AI tools within their own practice, including considerations related to faculty AI literacy, educational alignment, governance, and implementation. While the empirical evidence base is evolving, AI-driven approaches offer new ways of supporting facilitators in augmenting reflective practice. When implemented thoughtfully and with appropriate human oversight, the integration of AI into debriefing portends a new era supporting reflective learning within healthcare simulation.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From prototype to national standard: a governance framework for scaling simulation-based bronchoscopy training.","authors":"Michal Pirozynski, Jack Jakimowicz","doi":"10.1186/s41077-026-00452-9","DOIUrl":"10.1186/s41077-026-00452-9","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based education can improve procedural training, but national adoption depends on governance, scalability, quality assurance, and alignment with postgraduate certification requirements. This Advancing Simulation Practice report describes how bronchoscopy simulation developed from a pilot educational initiative into a mandatory national component of postgraduate pulmonary medicine training.</p><p><strong>Main body: </strong>We present a practice-based implementation account of a national reform in procedural training, using bronchoscopy as the index procedure. Rather than testing an effectiveness hypothesis, we examine programme design, governance, scale-up, instructor development, quality assurance, and regulatory embedding. The Consolidated Framework for Implementation Research and the RE-AIM framework were used to structure reflection on implementation determinants and programme outcomes, rather than as prospectively applied measurement instruments. The national simulation programme trained 402 physicians across procedural specialties, supported by 85 nationally certified instructors, and delivered 184 structured training cycles comprising 5,999 instructional hours. The bronchoscopy component enrolled 186 pulmonary specialty trainees, of whom 185 completed the course; 46 instructors were certified to deliver bronchoscopy training. Post-course evaluations showed high perceived relevance and increased self-reported confidence, which are interpreted as acceptability and early implementation indicators rather than evidence of clinical competence. Following national evaluation, bronchoscopy simulation was incorporated in 2024 as a mandatory component of postgraduate specialisation training in pulmonary diseases. Scale-up was supported by national-level European Union structural funding for health workforce development and simulation infrastructure, including POWER project POWR.04.03.00-00-0291/16, in which bronchoscopy formed one component of broader endoscopic simulation capacity.</p><p><strong>Conclusion: </strong>The main contribution of this programme was the governance pathway that enabled simulation to progress from local innovation to national training policy. Sustainable implementation depended on staged scale-up, explicit curriculum design, instructor certification, common standard operating procedures, external quality assurance, distributed simulation-centre capacity, and alignment with regulatory postgraduate training requirements. Future evaluation should examine clinical transfer, workplace performance, and patient-safety outcomes.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13470932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authentic roles matter: how in situ simulation influences fidelity, psychological safety, and learning transfer.","authors":"Kenneth Boe Krarup, Alexandra Claire McKenzie, Ayham Al-Masri, Lotte Abildgren","doi":"10.1186/s41077-026-00449-4","DOIUrl":"10.1186/s41077-026-00449-4","url":null,"abstract":"<p><strong>Background: </strong>In situ simulation (ISS) enables healthcare teams to test systems, identify safety threats, and strengthen interprofessional practice. Compared with off-site simulation (OSS), ISS may promote greater fidelity and transfer of learning. Cross-training, where participants adopt roles outside their profession, is widely used in healthcare education but remains controversial, with little evidence on how participants perceive its impact.</p><p><strong>Methods: </strong>We conducted a qualitative study in a Danish teaching hospital intensive care unit, using ethnographic observations, field notes, and semi-structured interviews. Sixteen interviews with physicians and nurses, supported by audio recordings of debriefings, were thematically analysed using a phenomenological-hermeneutic approach with consensus coding.</p><p><strong>Results: </strong>Four themes were identified: fidelity, psychological safety, transfer, and cross-training. Participants described fidelity as multidimensional, including environmental, team, scenario, time, and resource aspects. ISS was perceived as more realistic and immersive than OSS, supporting deeper engagement and learning. PS was enhanced by familiarity with colleagues and environment, limited observation, and absence of cross-training. Facilitator competence at facilitating politely and creating room for all participants to speak up strongly influenced PS. ISS was viewed as promoting greater transfer of technical and social-cognitive skills to clinical practice, with some learning leading to organisational change. Cross-training was met with mixed reactions. Most participants, especially junior staff, preferred training in authentic roles, citing negative effects on PS and learning. More experienced clinicians occasionally valued cross-training for its reflective potential, though often only in less advanced roles.</p><p><strong>Conclusion: </strong>In situ simulation promotes learning by aligning fidelity, psychological safety, and transfer within participants' authentic clinical roles and environments. Cross-training was frequently perceived as undermining both learning and psychological safety, particularly among less experienced staff, suggesting a misalignment between role substitution and learners' developmental needs. Careful scenario design emphasising authentic roles, realistic fidelity, and skilled facilitation may optimise simulation learning outcome, Cross-training should be applied selectively, with explicit attention to learners' experience levels, role authenticity, and potential impacts on psychological safety.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Into the light: the rise of shadowbox simulation to illuminate decision-making.","authors":"Victoria Ruth Tallentire, Lachlan Dick, Robert Hart, Thalia Monro-Somerville, Benjamin Clarke, Russell Allan","doi":"10.1186/s41077-026-00450-x","DOIUrl":"10.1186/s41077-026-00450-x","url":null,"abstract":"<p><strong>Background: </strong>Shadowbox simulation is an educational approach that utilises the ShadowBox method, originally developed in high-stakes fields such as firefighting and the military, adapted for healthcare education. Grounded in cognitive transformation theory and drawing heavily on naturalistic decision-making, shadowbox simulation makes expert reasoning visible and accessible, enabling learners to compare their decision-making with that of experts and develop complex cognitive and behavioural skills.</p><p><strong>Main body: </strong>Early applications of shadowbox simulation in healthcare have demonstrated feasibility across diverse contexts. Building on these foundations, we describe the implementation of a hybrid shadowbox simulation format within Scotland's national Internal Medicine Training program. This model combines video vignettes of expert practice, structured decision-points, group discussion and procedural practice, all supported by expert facilitation. Evaluation across more than 40 sessions shows that learners value the safe learning environment, the opportunity to embrace uncertainty and explore multiple perspectives, and the balance of reflective discussion with procedural refreshers. Feedback indicates that the format may foster deeper engagement, greater knowledge retention, and broader participation compared with traditional immersive simulation, while requiring fewer resources. By synthesising evidence from outside healthcare, reviewing recent adaptations, and presenting the principles and outcomes of national implementation, this article positions shadowbox simulation as a theory-informed, resource-efficient, and scalable method that advances simulation practice.</p><p><strong>Conclusion: </strong>We argue that shadowbox simulation offers particular promise for developing non-technical or behavioural skills, supporting reflective learning, and widening access to simulation-based education. Future potential applications extending to leadership, delegation, and induction training across healthcare professions are discussed.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Meeting a human, not a medical condition\": a qualitative study of simulated patients' perceptions of forming a therapeutic alliance with psychiatrists.","authors":"Sydney Potts, Mona Gupta, Nadia Daly","doi":"10.1186/s41077-026-00446-7","DOIUrl":"10.1186/s41077-026-00446-7","url":null,"abstract":"<p><strong>Objective: </strong>Increasingly in psychiatric and psychotherapeutic training, simulated patients (SPs) participate in the teaching and evaluation of clinical skills and knowledge. Despite their widespread involvement, doubt remains as to whether a genuine therapeutic alliance can be established with SPs. Further, little is known about the SP's perspective on alliance formation which is an important gap given the correlation between patient perception of alliance and therapeutic success.</p><p><strong>Methods: </strong>We interviewed three simulated patients about their perception of the bond formed during role plays of standard full-length psychiatric diagnostic assessments. Each SP played their role multiple times yielding sixteen unique interactions and therefore sixteen interviews. SPs watched a complete video recording of each of their role plays. After watching each role play, they rated their interaction with the psychiatrists using the bond subscale of the Working Alliance Inventory (WAI). Following the ratings, each SP was interviewed about the bond formation in each interaction.</p><p><strong>Results: </strong>Despite the simulation, SPs were able to form bonds with psychiatrists across full-length diagnostic assessments. Feeling respected by the psychiatrist, both in the psychiatrist's attempt to understand the problem and in their approaches to finding solutions facilitated bond formation. However, SPs had different preferences as to how respect should be conveyed. When it went well and when it went wrong, bond formation was affected by the same factors in the simulations as is the case in real practice.</p><p><strong>Conclusions: </strong>Our results suggest that from the point of view of SPs, a therapeutic alliance as reflected by bond formation can be established between psychiatrists and SPs in the context of full-length diagnostic assessments. These findings would be strengthened through replication involving comparison of both the SP and the psychiatrist perspectives.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-confidence and anxiety in clinical decision-making among nursing students during high-fidelity simulation training: a longitudinal study.","authors":"Geert Van de Weyer, Filip Haegdorens, Senne Vleminckx, Deborah Hilderson, Erik Franck","doi":"10.1186/s41077-026-00445-8","DOIUrl":"10.1186/s41077-026-00445-8","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision-making is a core nursing competency that develops progressively through education and practice. However, nursing students frequently report reduced self-confidence and increased anxiety when required to make clinical decisions. High-fidelity simulation (HFS) provides a safe, realistic environment to practice clinical decision-making and may influence these psychological determinants. Longitudinal studies on how repeated exposure to HFS affects anxiety and self-confidence across an entire nursing curriculum remain limited.</p><p><strong>Methods: </strong>A four-year longitudinal study examined changes in nursing students' self-confidence and anxiety in clinical decision-making during repeated annual exposure to HFS within a single cohort. A total of 143 students completed pre- and post-intervention questionnaires using the Nursing Anxiety and Self-Confidence with Clinical Decision-Making-High-Fidelity Simulation scale (NASC-CDM-HFS). Linear mixed-effects models with random intercepts for participants examined year-by-year changes in self-confidence and anxiety, adjusted for age and prior healthcare experience. The anxiety models were further adjusted for baseline self-confidence levels.</p><p><strong>Results: </strong>Pre-intervention self-confidence increased naturally across the program, whereas pre-intervention anxiety declined, indicating growing familiarity with clinical practice. After participating in HFS, significant improvements were observed during the first year. Self-confidence increased (b = 6.64, 95% CI [4.17, 9.11]) and anxiety decreased (b = -2.90, 95% CI [-5.27, -0.68]). In subsequent years (Y2-Y4), HFS produced no additional statistically significant effects.</p><p><strong>Conclusion: </strong>High-fidelity simulation enhancess self-confidence and reduces anxiety during clinical decision-making among novice nursing students. However, significant effects were only found during the first training year. This suggests that the psychological impact of HFS is strongest when students are exposed to simulationtraining for a first time. To repeat these psychological benefits throughout the curriculum, simulation activities should be progressively adapted in complexity, integrated more frequently, and aligned with students' advancing clinical competencies.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, usability, and preliminary knowledge outcomes of a virtual-reality fire-safety training for undergraduate nursing students: a quasi-experimental study.","authors":"Fatma Magdi Ibrahim, Ibrahim Al Faouri, Eman Abdelaziz Rashad Dabou","doi":"10.1186/s41077-026-00440-z","DOIUrl":"10.1186/s41077-026-00440-z","url":null,"abstract":"<p><strong>Background: </strong>In‑hospital fires are rare but high‑risk events, and nurses must be able to recognize hazards and initiate first‑response actions. This study compared a virtual‑reality (VR) fire‑safety training group with a time‑matched lecture group (covering the same learning objectives) and assessed system usability in the VR group among nursing students.</p><p><strong>Methods: </strong>We conducted a quasi-experimental study among undergraduate nursing students at RAK Medical and Health Sciences University, Ras Al Khaimah (RAK), United Arab Emirates. Two pre-existing timetable-based student groups, created by the university registrar during routine scheduling, were assigned as clusters to either the VR training group or a time-matched lecture group covering the same learning objectives. A researcher-developed 12-item fire-safety knowledge test (total score 0-12; 1 point per item) was administered before and after the session. Usability of the VR system was measured with the 10-item System Usability Scale (SUS; 0-100). Analyses included paired t-tests, chi-square tests, and analysis of covariance controlling for baseline knowledge (alpha = 0.05).</p><p><strong>Results: </strong>N = 130 students (VR group, n = 65; lecture group, n = 65) completed the study. Knowledge improved from 5.8 ± 1.2 to 9.3 ± 1.0 in the VR group (p < 0.001) and from 5.7 ± 1.3 to 7.8 ± 1.5 in the lecture group (p < 0.01). At post-test, 89% in the VR group vs. 62% in the lecture group achieved \"good\" knowledge (≥ 9/12; p = 0.002). ANCOVA indicated a significant between-group difference in post-test knowledge after adjustment for baseline (pre-test) knowledge, favoring the VR group. The VR system showed high usability (SUS = 84.6/100).</p><p><strong>Conclusion: </strong>Preparing nursing students to respond effectively to in-hospital fires is essential. In this pilot study, VR fire-safety training produced larger immediate knowledge gains than the time-matched lecture group and was rated highly usable, supporting its integration as a supplementary educational strategy.</p>","PeriodicalId":72108,"journal":{"name":"Advances in simulation (London, England)","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}