Purpose: Since the COVID-19 pandemic, virtual simulation practice has been increasingly activated as an alternative to clinical practice in nursing colleges. This study aimed to provide basic data by confirming changes in self-efficacy and nursing knowledge in the virtual simulations of nursing students, and identifying virtual presence, virtual patient learning system evaluation (VPLSE), and practical satisfaction. Methods: This was a single-group pre-post quasi-experimental study. The subjects were 28 third-grade nursing students. Results: Self-efficacy and nursing knowledge increased significantly (p<.001). Virtual presence had a significant positive correlation with VPLSE) (p=.002) and practice satisfaction (p=.011). There was also a significant positive correlation between virtual simulation learning evaluation and practice satisfaction (p<.001). Conclusion: Based on these results, virtual simulation practice can be used with clinical practice as an educational method to improve nursing students' self-efficacy and nursing knowledge in nursing education. Virtual presence was confirmed as a significant variable to improve practice satisfaction and VPLSE. It is necessary to develop a virtual simulation program that can improve virtual presence through collaboration with virtual reality technology experts.

Purpose: This study aimed to explore the meaning of simulation practice after experiencing virtual simulation for nursing students with clinical practice experience. We attempted to determine a nursing simulation strategy as an alternative to the clinical practice in the COVID-19 pandemic. Methods: The participants were seven nursing students who experienced clinical practice and completed alternative virtual simulation practice in the COVID-19 pandemic. The data were collected through in-depth interviews and analysed using the phenomenological methodology. The key question was “what is the meaning and nature of child health nursing practice using virtual simulation in the COVID-19 pandemic?” Results: The significant statements were categorized into 14 themes, 7 theme clusters, and 2 categories. The categories extracted were “a sense of difference between virtual and reality” and “experience systematic learning transfer.” Conclusion: Practical education through nursing simulation is important for students to experience a systematic and efficient learning. Additionally, simulation educators should produce various efforts to help students achieve the learning outcomes, such as scenarios, class environments, and instructor preparation, to reduce their sense of separation from practice.

Purpose: This study was conducted to confirm the effects of self-directed practice using augmented reality simulation on nursing students' confidence in nursing skills, ability to apply them, and satisfaction with self-study. Method: This was a quasi-experimental study with a non-synchronized pretest/posttest nonequivalent control group design. The study participants were 58 second-grade nursing students (29 in the experimental group and 29 in the control group) from Y city. The questionnaire was used to evaluate the confidence in nursing skills (16 questions), performance ability (23 questions), and satisfaction with self-practice (17 questions). The experimental group intervention was an autonomous practice using augmented reality simulation, and the control intervention was an autonomous practice using video-based interventions. The collected data were analyzed by t-test, x2-test, and ANCOVA (Analysis of Covariance) using the SPSS 25.0 program. Results: The experimental group outperformed the control group in terms of nursing skill confidence (F=25.79, p<.001), nursing skill performance ability (F=67.10, p<.001), and self-study satisfaction (F=14.10, p=.001). Conclusion: Self-directed practice using augmented reality simulation was confirmed to be an effective method to increase confidence, ability and practice satisfaction in nursing skills.

Purpose: This study is examined the effects of simulation practice education with problem-based learning methods on nursing students' learning attitudes, learning satisfaction, critical thinking disposition, and problem-solving ability. Method: A quasi-experiment single group pretest-posttest design was adopted. Simulation education was conducted by utilizing problem-based learning methods to teach the following topics to nursing students enrolled in 4th grade in S city: respiratory, circulatory, and nervous system. The experiment was conducted for 12 weeks, from September to December, 2019. Paired t-test and Pearson product-moment correlation coefficient were used to analyze the collected data. Results: Learning attitude and problem-solving ability showed significant differences in the experiment. Among the sub-areas of problem-solving ability, there were significant differences in the following: problem recognition (p<.001), information gathering (p<.001), confident thinking disposition (p<.001), acceptance to carry out an adventure (p<.001), evaluation (p=.027), and feedback (p<.001). In addition, learning attitude showed significant positive correlations with learning satisfaction, critical thinking disposition, and problem-solving ability. Conclusion: The findings of this study suggest that, it is necessary to develop a variety of iterative studies and simulation scenarios to confirm the effectiveness of simulation training.

본 연구의 목적은 시뮬레이션기반 실습교육이 간호대학생들의 고용가능성, 진로탐색행동 및 진로결정 자기효능감에 미치는 효과를 확인하고자 시도되었다. 비동등성 대조군 전후설계를 적용한 유사실험 설계로 J지역 소재 3학년 학생을 편의표집하여 총 120명의 간호대학생들로, 실험군 60명, 대조군 60명이 연구에 참여하였다. 실험군은 6주간 실험에 참여하였다. 연구결과, 시뮬레이션기반 실습교육은 간호대학생의 고용가능성(t=-2.31, p=.023), 진로탐색행동(t=-3.05, p=.003)을 유의하게 증가시켰으나, 진로결정자 기효능감(t=-.87, p=.387)은 통계적으로 유의한 차이가 없었다. 결론적으로 시뮬레이션기반 실습교육은 간호대학생들의 교육에 유용하므로 강화해야 할 것이다.

Purpose: The purpose of this study is to provide basic data for developing strategies to improve the learning effect of simulation by analyzing the reflective journaling after the simulation based learning on the nursing of patients with upper gastrointestinal (UGI) bleeding. Method: From September 19–29, 2016, we conducted a simulation of UGI bleeding patient nursing with fourth-year students in the nursing department of University B in City A, and analyzed the data using content analysis. Results: In this study, reflective journaling can be an effective educational method to strengthen nursing competence, such as the self-reflection of nursing students, evidence-based nursing practice, teamwork, and communication ability. Conclusion: Reflective journaling after practice in simulation-based education is an important process in training critical thinking, situational judgment, and reflection of nursing practice content, and needs to be extended to both on-campus practice and clinical practice.

Purpose: This study was tried to identify the effects of simulation practice education on the clinical competence, critical thinking disposition and self-confidence of nursing process in new graduated nurses. Methods: This study was one group pre-post test design, participants are 50 new graduated nurses with less than 3 month of working experience. The simulation practice education applied the first semester of the third grade, over 15 weeks with 1 credit per 2 hours per week by two instructors with four scenarios. Data were analyzed by descriptive statistics, paired t-test, Pearson’s correlation coefficients using the SPSS WIN 21.0 program. Result: There was a significant difference simulation practice education on the clinical competence and critical thinking disposition in the new graduated nurses. There was a correlation between clinical competence and critical thinking disposition. Conclusion: New nurses' capacity can be strengthened by applying simulation practice education that improve the clinical performance by enhance the critical thinking Disposition.

Purpose: This study aimed to clarify the effects of simulation-based practice using a standardized patient on nursing students’ problem-solving capacity, self-efficacy for therapeutic communications, and confidence in clinical performance. Methods: We adopted a one-group pretest–posttest experimental design. We examined changes in the students’ problem-solving capacity, self-efficacy for therapeutic communications, and confidence in clinical performance before and after simulation-based practice and after clinical practicum. Results: The scores for problem-solving capacity increased from 159.28 before simulation-based practice to 263.02 after it and 161.99 after clinical practicum, but there was no statistical significance(p=.775, p=.339). The scores for self-efficacy for therapeutic communications rose with statistical significance from 120.78 before simulation-based practice to 126.30 after it (p= .017), but fell to 120.52 after clinical practicum. The scores for confidence in clinical performance increased with statistical significance from 54.98 before simulation-based practice to 59.42 after it (p=.008) and 58.50 after clinical practicum (p<.001). Conclusion: We confirmed that simulation-based practice with a standardized patient offers students hands-on experience of a clinical situation and, thereby, enhances their problem-solving capacity, self-efficacy for therapeutic communications, and confidence in clinical performance.

Purpose: The aim of this study was to examine the effect of repeated simulation and role rotation in a cardiac arrest simulation on learning immersion, learning confidence, and simulation satisfaction. Methods: This study was the descriptive survey and 199 nursing students completed a cardiac arrest simulation-based education program developed by the researcher. Participants repeated the simulation 3 times. Data were analyzed using time series, ANOVA, t-test with SPSS 21.0 program. Results: Over than 2 times was effective frequency of repetition of simulation. There were no differences in learning immersion, learning confidence and satisfaction after simulation due to rotation. Additionally, there were no differences in satisfaction after simulation. However, participants in the lead nursing role in simulation had less learning immersion and learning confidence compared to those not in the lead role. Conclusion: The results indicate that repeted use of the cardiac arrest simulation improved clinical practice; however, role rotation did not impact learning immersion or learning confidence. Even though there was no effect of role rotation, the results did indicate that experience as a leader in simulation is associated with less learning immersion and confidence. These results suggest the need to carefully debrief the lead nursing student. Further, in order to prevent nursing instructor burn-out and encourage participation of students in learning, future work should examine increased repetition frequency.

Purpose: This study aimed to understand the meanings and nature of the lived experience of participating in integrated simulation practice of standardized patients with complex problems. Methods: The hermeneutic phenomenological human science approach developed by van Manen was adopted in-depth interviews and observations were conducted with 6 standardized patients’ and recorded with their consent. The data were collected over two months, from March 1, to April 30, 2016. The statements were analyzed and revealed five essential themes of the standardized patients with complex problems. Results: The essential themes of outcomes consisted of <Conflict between the virtual and real world>, <Inadequate and surprise nursing interventions>, <Limitations of the standardized patient role>, <Identified with the standardized patient>, and <Rewarding patient role>. Conclusion: The standardized patients who participated in this study had difficulty in carrying out the role of the patient, and they said that the nursing students felt that they were rewarding because they were helpful.

Purpose: The purpose of this study was to compare the effectiveness of debriefing with video and oral debriefing alone by undergraduate nursing students in the nursing educational simulation setting. Methods: Nursing students participating in experiment were 168. Data was collected for each group after the simulation including debriefing. Result: Experimental group who experienced simulation debriefing with video and control group had differences in clinical practice items according to characteristics. Experimental group who experienced simulation debriefing with video had significantly higher debriefing satisfaction than control group who didn't experience that. Conclusion: This study found that simulation debriefing with video was effective educational method to promote debriefing satisfaction. It is needed to find the relation between clinical practice and debriefing satisfaction.

Purpose: This study was to identify relationship between instructor and learner's evaluation in the simulation-based maternity nursing. Methods: The simulation-based nursing education program was taken by 112 fourth year nursing students. 30 item clinical practice competency evaluation tool has been developed for instructor. And 30 item clinical practice competency scale(self reported form) was used for students. Result: The critical items of the simulation-based maternity nursing were suggested in this study. Mean score for clinical practice competency are as follows: student's evaluation 4.0(on a 5-point scale), instructor's evaluation 76.7(on a total 90-point). There was a positive correlation between instructor and learner's evaluation score. Conclusion: These findings will be useful guideline in development direction of qualitative simulation-based nursing education program.

Purpose: This study was tried to identify the effects of problem-based learning integrated with simulation education on the critical thinking disposition, problem-solving process and self-confidence of nursing process in nursing students. Methods: This study was one group pre-post test design, participants are 47 senior nursing students. We developed the simulation practice by applying problem based learning taking 2 hours per session, once per week for 15 weeks. Data were analyzed by descriptive statistics, paired t-test, Pearson’s correlation coefficients using the SPSS WIN 18.0 program. Result: There was a significant difference simulation practice by applying problem based learning on the critical thinking disposition, problem-solving process and self-confidence of nursing process of nursing students. There was a correlation between each other variables. Conclusion: Therefore, suggest that the repeated studies to verify the effects of simulation practice by applying problem based learning.

Purpose: This study sheds light on the learning experiences of simulation-based education in nursing, through a comparative analysis with clinical practice experiences. Methods: Participants were six nursing students who underwent simulation-based nursing education. In-depth focused individual interviews were conducted, and themes were extracted from the data through content analysis. Results: Two essential themes were extracted: 1) shift from being an observer to being active participants and 2) shift from unidimensional to multi-dimensional problem solving. Conclusion: These results indicate that simulation-based education was effective in enhancing learning attitude and problem-solving skills. These results can also guide nurse educators regarding the conditions under which simulation environments are more effective

Purpose: The purpose of this study is to analyze the level of satisfaction and clinical competence on simulation-based practice in woman’s hospital and to figure out the factors that level of satisfaction affect to clinical competence. Method The subjects in the experimental group were 93 students who did simulation-based practice and subjects in the control group were 70 students who practiced in woman’s hospital. Data was analyzed using ex post factor experimentation during second semester in 2013. Results: There was statistically no significant difference between the two groups, but positive correlation between the main variables. The most significant affecting factors to clinical competence in experimental group were satisfaction of contents and duration(R2=.24). The most significant affecting factors to clinical competence in control group were satisfaction of evaluation and practice stressor (R2=.32). Conclusion Since there was no difference between the two groups, once the difficult part in clinical practice of maternity nursing is practiced repeatedly, student’s competence can be improved. Hence the continual study was required.

Purpose: This study examined the effects of simulation-mixed maternity nursing practicum on learning attitude, learning satisfaction and clinical practice performance in nursing students. Methods: One group, pre-post design, was utilized with 64 students. The simulation-mixed maternity nursing practicum consisted of intrapartum and postpartum care. Results: The learning attitude and learning satisfaction scores in maternity nursing care showed a significant change in the post-test (t=-5.92, p <.001, t=-7.35, p <.001) and enhanced clinical practice performance. Conclusion: The simulation-mixed maternity nursing practicum was useful in improving the learning attitude and learning satisfaction and clinical practice performance for maternity nursing practicum in nursing students. In conclusion, We recommend for simulation-mixed maternity nursing practicum to increase clinical practice performance of the students.

Purpose: The purpose of this study was to identify the differences in learning flow and problem solving ability by simulation-based fundamentals of nursing practice program depending on the level of self-efficacy of nursing students. Methods: This study was a one group pre-post design. This study involved 254 second grade nursing students at T university in D city. Data were collected from October 28th to November 29th in 2013. Data were analyzed with frequency, percentage, descriptive statistics, paired t-test, ANOVA and post hoc test with using IBM SPSS WIN version 18.0. Results: There was a statistically significant increase in learning flow(F=14.328, p <.001) and problem solving ability(F=4.315, p=.014). There were significant differences on 11.12 score of learning flow and 7.20 score of problem solving ability with answer ‘Low’ by the level of self-efficacy. Conclusion: The result showed that the simulation-based fundamentals of nursing practice program improve learning flow and problem solving ability of low self-efficacy students. Therefore, it is an effective learning method.

Purpose: The study was undertaken to evaluate the reliability and validity of hypoglycemia clinical judgment rubric which developed for investigation nursing student’s clinical judgement competency on hypoglycemia simulation practice. Methods: The study was a methodological study with 59 nursing students from Y University participating. Fifty video files were used to analyze nursing student’s clinical judgment competency. Rubric was consisted with 11 questions having 4 phases (beginning, developing, accomplished, and exemplary) and composed with 4 sub-categories (noticing, interpreting, responding and evaluation/reflecting). Results: The value of inter-rater reliability was r=.92 (p<.001) and Kendall tau b=.79 (p<.001). The value of intra-rater reliability was r=.92 (p<.001) and r=.99 (p<.001). Cronbach's α was .93 as internal consistency reliability. Construct validity by factor analysis, 3 factors were extracted and it explained 80.9% of the variance in clinical judgment competency. The value of competency of hypoglycemia clinical judgment was 2.47 (±.42). Conclusion: The hypoglycemia clinical judgment rubric can be used for assessing clinical judgment competency on simulation practice. Also, it can be applied for evaluation a clinical judgment as a nursing program outcome of nursing students.

Purpose: The purpose of this study was to investigate the effect of debriefing learning using peer feedback after blood transfusion nursing simulation practice. Methods: This study is a mixed method research to investigate the effect of debriefing using peer feedback on learning. The subjects of this study were third-year nursing students, and 23 of them were allocated to the control group and 19 to the experimental group. The experimental treatment was performed for about three hours, and the debriefing using peer feedback was not performed with the control group. The effect of the debriefing was measured in terms of the knowledge, attitude, and confidence in the performance with regard to blood transfusion nursing. The qualitative data about cognitive learning experience during the debriefing were analyzed. The quantitative data were analyzed by a t-test, a x² test, and a paired t-test by using IBM Statistics SPSS 19.0 software. Results: The results showed that the knowledge was significantly increased in both the control group and the experimental group (paired t=-6.411, p<.001; paired t=-5.759, p<.001), that the attitude toward the blood transfusion nursing was not significantly changed in both groups (paired t=-0.639, p=.530; paired t=-0.631, p=.536), and that the confidence in the performance was significantly increased in both groups (paired t=-5.124, p<.001; paired t=-4.747, p<.001). The qualitative data analysis of the cognitive learning experience during the debriefing showed that the content was divided into four subjects: “My errors are clearly seen as I reflect on myself,” “I can understand how to say and perform,” “I could make the knowledge my own by reviewing what I have done,” and “I could have see the big picture of nursing skills.” Conclusion:. The results of this study showed that the debriefing using peer feedback after the simulation had the learning effects of repeated learning and experiential learning of specific nursing skill, indicating that it is a useful education tool in nursing education.