Purpose: This study examined the effectiveness of an integrated nursing simulation practicum in enhancing readiness for practice and self-confidence in clinical decision-making among nursing students. Methods: A quasi-experimental design with a nonequivalent control group and preand post-test measurements was employed. The participants were 51 fourth-year nursing students enrolled in a simulation practicum. The integrated simulation program comprised six scenarios covering adults, women’s health, and pediatric nursing, totaling 30 instructional hours. Data were analyzed using SPSS version 26.0, with paired and independent t-tests, Fisher’s exact test, and the Mann-Whitney U test. Results: The experimental group showed significant improvements in readiness for practice (t=-3.55, p=.002) and self-confidence in clinical decision-making (t=-7.40, p<.001) compared to pre-intervention scores. A statistically significant difference in readiness for practice was observed between the experimental and control groups (p=.048). However, the difference in self-confidence in clinical decision-making between the groups was not statistically significant. Conclusion: Nursing education should equip nursing students to effectively transition into clinical practice as new graduate nurses. The integrated simulation practicum can be considered an effective strategy for enhancing nursing students’ readiness for practice.

Purpose: This mixed-methods study developed an infant nursing simulation practice program for nursing students and analyzed its effects on nursing knowledge, critical thinking disposition, clinical competence, and learning satisfaction through quantitative research. The study also qualitatively explored student’s experiences through focus group interviews. Methods: A mixed-methods design was employed incorporating a nonequivalent one-group pretest-posttest design(N=62) and focus group interviews(n=11). Participants were nursing students who applied for simulation training at a university between March and June, 2024. Quantitative data were analyzed using descriptive statistics and paired t-test, while qualitative data were analyzed through thematic analysis. Results: Quantitative findings revealed that participation in the infant care simulation program, result in significant inprovements in nursing knowledge (t=-3.60, p<.001) and clinical competence(t=-2.95, p=.004). However no significant improvement critical thinking disposition was observed. Qualitative analysis revealed three themes: ‘performing nursing care for infants’, ‘experiencing real situations and repeated practice’, and ‘reflection on nursing performance and disappointment with the set contents’. Conclusion: The infant nursing simulation training effectively enhanced nursing knowledge and clinical competence, providing a positive learning experience for nursing students. Further development and evaluation of simulation training across various subjects are recommended to confirm its broader educational effectiveness.

Purpose: This study investigated the mediating effect of simulation confidence on the relationship between simulation immersion and clinical reasoning among nursing students. Methods: A total of 166 participants who had completed adult nursing courses and participated in simulation training were included. Results: Participants reported high satisfaction with their majors, practicums, and college life. The average immersion score was 3.71 out of 5, indicating a moderately high level of engagement. No significant differences in clinical reasoning were found based on demographic factors; however, satisfaction with one’s major, practicum, and college life showed significant associations with clinical reasoning. Simulation immersion, confidence, and clinical reasoning were all positively correlated. PROCESS Macro Model 4 revealed that both the direct and indirect effects of simulation immersion on clinical reasoning through confidence were statistically significant, even after controlling for satisfaction-related covariates. Conclusion: These findings suggest that simulation immersion is a key factor in enhancing clinical reasoning and is partly mediated by increased confidence. Therefore, simulation-based education should therefore incorporate strategies that promote learner immersion and self-efficacy in order to optimize cognitive learning outcomes.

This study aimed to develop a simulation-based scenario for pediatric nursing based on Kawasaki disease and to evaluate its impact on nursing students' knowledge, critical thinking disposition, self-efficacy, stress levels, and clinical performance. Methods: The scenario template was developed using the ADDIE model based on the National League for Nursing/Jeffries Simulation Framework. A quasi-experimental, single-group pretest-posttest was used. The study was conducted between March 3 and April 18, 2025, with 64 fourth-year nursing students. Self-report questionnaires were used to assess knowledge, critical thinking disposition, and selfefficacy. Stress was measured using physiological indicators, and clinical performance after the simulation was independently evaluated by both the instructor and researcher. Results: The scenario template required approximately six hours, and the simulation scenario operated for 20 minutes. Evaluation of the simulation`s effectiveness showed significant improvements in knowledge of Kawasaki disease (t=-6.96, p<.001), critical thinking disposition (t=-4.08, p<.001). The average clinical performance score was 64.81±6.61 out of a total of 86 points. Conclusion: The simulation-based learning method using the developed Kawasaki pediatric nursing scenario template was shown to be effective in enhancing clinical performance among nursing students. It may serve as a valuable educational tool for pediatric nursing education and future simulation-based training programs.

Purpose: This study aims to examine the characteristics and educational outcomes of immersive virtual reality (VR)-based nursing simulation using the integrative review method developed by Whittemore and Knafl. Methods: Data were collected between December 30, 2023, and January 15, 2024. Studies published in English or Korean were included without restrictions of publication year. Searches were conducted in PubMed, Web of Science, EMBASE, CINAHL, RISS, KISS, DBpia, and KoreaMed using combinations of the keywords “‘nursing”, “student*”, “simulation”, “SIM”, “education”, “VR”, and “Virtual reality” to identify relevant articles. Results: Of the 237 studies identified, 11 were included in the analysis, with most conducted in Korea (n=7). In most studies, scenario-based VR was used; the Oculus platform (n=4), the HTC Vive (n=2), and a mobile HMD (n=1). Six studies incorporated handheld controllers, and three haptic sensors. VR groups showed greater improvements in knowledge, engagement, self-confidence, and skill performance than the control groups. Usability ratings were high for accessibility and realism; however, challenges were observed in device operation, especially without technical support. Reported adverse effects included visual fatigue, headache, dizziness, motion sickness, and discomfort when wearing glasses. Conclusions: Immersive VR simulation offers realistic, customizable learning environments, enhancing nursing education, supporting advanced instructional methods, and improving clinical safety and patient-centered competencies. Ongoing efforts in technological standardization, program development, and curricular integration are recommended.

Purpose: This study aims to develop and evaluate A4, a generative AI agent (Adaptive Aptitude Assessment by AI for Nursing Students), designed to support undergraduate nursing students in matching their personal traits with suitable clinical roles. Method: An exploratory research design was used with 71 nursing students and 65 clinical nurses. Developed using ChatGPT-4, the A4 agent classified nursing roles, identified required personal traits, and generated adaptive test items. Perceived person–job fit was measured via survey, and the data were analyzed using descriptive statistics and independent t-tests. Results: Among students, 80.3% agreed that the A4 results represented their characteristics, compared with 69.2% of nurses. Nursing students had higher perceived aptitude–fit scores (2.99 ± 0.62) than nurses (2.74 ± 0.69), indicating a significant difference (t = 2.19, p = .030). Conclusion: The findings indicate that the generative AI-based adaptive assessment, which incorporated clinical scenarios, was perceived by nursing students and clinical nurses as a tool that represents personal traits. This suggests its potential to support personalized career guidance in nursing education and serve as a supplementary tool for clinical practicum orientation.

Purpose: This study aimed to evaluate the effects of a simulation-based Room of Errors patient safety education program on patient safety-related nursing activities and critical reflection competency of new nurses. Method: A randomized controlled pretest–posttest design was used. A total of 63 new nurses participated, with 32 assigned to the experimental group and 31 to the control group. The experimental group received a team-based simulation intervention, with participants collaboratively identifying and addressing patient safety hazards within Room of Errors scenarios. Results: In the experimental group, patient safety-related nursing activity scores increased significantly after the intervention (t = 2.70, p = .011), while the control group showed no significant change (t = 0.23, p = .816). Additionally, critical reflection competency scores improved significantly in the experimental group (t = 3.66, p < .001), with no significant change observed in the control group (t = -0.53, p = .603). The between-group difference in change scores for critical reflection competency was statistically significant (t = 2.77, p = .007). Conclusion: The simulation-based Room of Errors education program effectively enhanced patient safety-related nursing activities and critical reflection competency among new nurses, suggesting its value as a training method for developing essential competencies in clinical practice.

Purpose: This study aimed to identify the educational needs that should be considered in developing a simulation-based program to enhance patient safety competency among nursing students. Methods: The participants included 38 nursing students and 38 practicing nursing professionals. Data were collected from March 5 to 19, 2025, using a structured self-report questionnaire. The data were analyzed using SPSS 19.0, employing descriptive statistics, paired t-tests, Importance–Performance Analysis (IPA), and Borich’s needs assessment. Results: A significant difference was observed between the current and required levels of educational needs across all items related to developing a simulation-based program to enhance patient safety competencies among nursing students and professionals. According to the results of the IPA and Borich needs assessment, “Clinical reasoning” and “Medication safety” emerged as the highest priority for nursing students and professionals, respectively. Conclusion: These findings are expected to provide foundational evidence for developing a simulation-based program aimed at enhancing patient safety competencies in nursing students.

Purpose: This study examined the effects of a virtual reality (VR)-based self-directed practice program for indwelling catheterization on the practice immersion, performance confidence, and practice satisfaction of nursing students. Methods: A quasi-experimental study employing a non-equivalent control group pretest–posttest design was conducted with 59 nursing students. The experimental group (n = 26) performed VR-based, self-directed practice, while the control group (n = 33) conducted conventional mannequin-based practice. Data were analyzed using generalized estimating equations, independent t-test and the Mann–Whitney U test. Results: A significant group-by-time interaction effect was observed for performance confidence (Waldχ² = 6.88, p = .009), indicating a greater improvement in the experimental group. Practice immersion was significantly higher in the experimental group than in the control group (t = 2.31, p = .025). However, no significant difference was observed in practice satisfaction between the groups (Z = -0.07, p = .944). Conclusion: The VR-based self-directed practice program effectively enhanced performance confidence and practice immersion of nursing students. VR simulation is recommended as a valuable educational strategy to complement conventional mannequin-based practice in self-directed learning environments.