Purpose: This study aimed to develop a program using the Room of Errors (ROE) technique to enhance the patient nursing student’s safety competencies and determine the effectiveness of simulation-based education. Methods: We conducted a methodological study using the ADDIE model for program development (Molenda, 2003). During the ROE activities, students identified errors that threatened patient safety. The program's effectiveness was evaluated in the implementation phase by measuring students' confidence in patient safety using a one-group pretest-posttest design. Results: Participants' satisfaction with the ROE program was 4.90 ± 0.36 on a 5-point Likert scale. The pre- and post-ROE program patient safety confidence scores (H-PEPSS) were statistically significant, increasing from 3.62 ± 0.54 to 4.19 ± 0.60. Participants' subjective evaluations were generally positive, indicating increased insight, confidence, and vigilance in error prevention. Conclusion: Based on this study’s significant findings, it would be beneficial to encourage students and healthcare providers to utilize ROE programs to enhance patient safety competencies.

Purpose: Improving students’ self-confidence is an important strategy in simulation learning. This study aimed to identify the factors influencing students’ self-confidence in simulation learning based on the Jeffries Simulation Framework. Method: A cross-sectional survey was conducted with 140 senior nursing students’ at a university, and data were collected through self-reported questionnaires. Data on students’ self-confidence were collected for student/ facilitator factors (satisfaction on major, overall grade average, and facilitator satisfaction), educational practice factors (active learning, collaboration, diverse ways of learning and educational goals), and simulation design characteristics factors (objectives/information, support, problem solving, feedback, and fidelity). Data were analyzed using an independent t-test, one-way ANOVA, Pearson’s correlation, and hierarchical multiple regression analysis. Results: The regression model had an adjusted R2 of .61, indicating that education goal, active learning, facilitator satisfaction, and fidelity were significant predictors of students’ self-confidence in simulation learning. Conclusion: To increase students' self-confidence with simulation learning strategies, it is necessary to design lessons that include educational goals, active learning, improved student satisfaction with the facilitator and fidelity based on the Jeffries Simulation Framework.

Purpose: This study examined the influence of nursing students’ competencies in assessment, communication, clinical judgment, and patient safety on evidence-based practice (EBP) competency through simulation training. Methods: Data were collected from in December 11 in 2023 to January 30 in 2024, using a self-report questionnaire. The final participants were 230 nursing students in two universities. Multiple regression, t-test, ANOVA were used for data analysis. Results: The competencies of nursing students who participated in simulation training significantly influenced their EBP competency. The most influential factor on nursing students’ competency of EBP was Clinical Judgment, followed by Communication. Assessment and Patient safety competencies did not have a statistically significant impact on EBP competency. Conclusion: It is crucial for nurses to implement EBP to provide high-quality nursing and advance nursing as a science. However, since EBP competency is difficult to acquire in a short period, education on EBP is necessary from nursing school. Simulation training is considered an effective means to enhance nursing students' competency in EBP. Our study suggests incorporating elements that strengthen competencies in clinical judgment and communication when establishing a simulationbased training program to enhance the EBP competency of nursing students.

Virtual reality (VR) simulation in nursing education, especially in the teaching of VR simulations just prior to clinical practice, has the potential to enhance the effectiveness of clinical practice and better prepare nursing students for patient care. The aim of this study was to evaluate the effect of a preclinical VR simulation education program on the development of critical thinking, self-efficacy, problem-solving ability, and perceived clinical competency among undergraduate nursing students. The study was conducted between May and June 2021 using a pretest-posttest design with a control group. A total of 42 nursing students were recruited through convenience sampling from two separate classes. The intervention group participated in VR simulation education, while the control group engaged in lecture-based education, before beginning clinical practice. Assessments were conducted before preclinical education and after completing clinical practice using structured questionnaires. The data was analyzed using chi-square tests, independent t-tests, and ANCOVA. The findings indicated that the intervention group had a significantly higher score in perceived clinical competency compared to the control group (F = 5.25, p = 0.029) after controlling for pretest scores. However, there were no statistically significant differences in critical thinking, self-efficacy, or problem-solving abilities between the two groups. These findings suggest that preclinical VR simulation education is partially effective in preparing nursing students for their clinical practice, underscoring the need for a balanced educational approach that integrates VR with clinical practice to develop a full spectrum of nursing skills and knowledge.

This study aimed to explore nursing students' experience of learning cardiopulmonary resuscitation (CPR) in a web-based virtual simulation (vSim) through analysis of the reflection journals. Method: From June to July 2020, data were collected from 48 fourth-year nursing students who performed the simulation by reviewing prompt feedback on their CPR performance. The contents of the reflection journals were analyzed using NVivo qualitative data analysis software. Results: Nursing students experienced unfamiliarity with the English-based virtual environment as well as psychological pressure and anxiety about emergencies. Incorrect interventions were identified in the following order of frequency: violation of defibrillator guidelines, missing fundamental nursing care, error in applying an electrocardiogram monitor, inadequate initial response to cardiac arrest, insufficient chest compression, and inadequate ventilation. Lastly, the participants learned the importance of embodied knowledge, for knowing and acting accurately and reacting immediately, and their attitudes as nurses, such as responsibility, calmness, and attentiveness. Learning strategies included memory retention through repetition, real-time feedback analysis, pre-learning, and imagining action sequences in advance. The level of achievement, time required, CPR quality, and confidence improved with behavior-modification strategies developed through self-reflection. Conclusion: Educational interventions that are based on understanding accurate algorithms can strengthen selfawareness of mistakes to improve efficient imparting of CPR education.

We aimed to develop and analyze the effectiveness of a “Room of Errors” simulation program for educating nursing students in patient safety management. Methods: This study used a quasi-experimental method (two group, before and after evaluation) and enrolled 35 nursing students as the participants. Data were collected using a self-reported questionnaire and analyzed through descriptive statistics and the independent t-test and Mann-Whitney U test using SPSS/WIN Statistics version 25.0. Results: After completing the “Room of Errors” simulation program, the participants’ score of intention and confidence in performance for patient safety management in the experimental group were significantly higher than those in the control group. Conclusion: A “Room of Errors” simulation education program for nursing students effectively increased the intention and confidence in performance of nursing students in patient safety management.

An “online respiratory infectious disease nursing simulation course” was developed to strengthen the nursing competency in respiratory infectious disease. Methods: In this methodological study, an “online respiratory infectious disease nursing simulation course” was developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model and evaluated using a one-group pre-post quasi-experimental design to ascertain the respiratory infectious disease knowledge, performance confidence, and clinical performance of 37 nursing students. Results: The online course comprised 17 sessions categorized as follows: seven theory, five at-home laboratory training, two case study, and three simulation sessions. All the nursing students engaged in the course successfully fulfilled its requirements by attending all 17 sessions and passing the clinical performance examination. The knowledge, confidence, and clinical performance (t=-6.60, -10.62, and –6.36, respectively; p<.001 for all) pertaining to respiratory infectious disease significantly increased among participants after the concluding simulation session, compared with their pre-scores obtained prior to the course participation. Conclusion: The “online respiratory infectious disease nursing simulation course” significantly improved the nursing knowledge, performance confidence, and clinical performance ability of nursing students in managing respiratory infectious diseases.

This study aimed to investigate the impact of implementing team-based learning (TBL) in postpartum nursing simulation practical education for nursing college students. Methods: The study design was a non-equivalent control group pretest-posttest quasi-experimental design. 128 nursing students divided into two groups: 61 in the experiment group and 67 in the control group. During the winter break in January 2023, students participating in simulation practicals were assigned to the control group, while students participating in simulation practicals during the regular semester (April 2023) were assigned to the experimental group, to prevent crossontamination between the groups due to experimental treatment. Both groups completed selfdministered questionnaires to assess self-directed learning abilities, collaborative self-efficacy, academic achievement, and learning satisfaction. Results: The experimental group showed significantly better compared to the control group, the experimental group showed higher levels of academic achievement and learning satisfaction. Conclusion: It was evident that TBL applied to postpartum nursing simulation practical education is a pedagogical teaching strategy that enhances academic achievement and learning satisfaction. It is necessary to develop and apply team-based simulation practical education not only for challenging obstetric cases but also for labor and delivery nursing, antepartum nursing, and other related areas in clinical practice.

The purpose of this study was to identify the factors related to the problem-solving ability of nursing students who experienced simulation training. Methods: A descriptive survey study was performed using a structured questionnaires consisting of a learning flow state scale, nursing student’s anxiety and self-confidence with clinical decision making scale, simulation design scale, and problem-solving ability scale. Data were collected from 154 nursing students in five nursing schools located in D city and G province. Data were analyzed by frequencies, independent t-test, one-way ANOVA, Pearson correlation coefficient, and stepwise multiple regression with IBM SPSS Statistics 19.0. Results: The significant factors associated to the problem-solving ability of nursing students who experienced simulation training were simulation design characteristics (β=.34, p<.001), learning flow (β=.25, p=.001), and self-confidence with clinical decision making (β=.23, p=.001). These factors explained 46.5% of problem-solving ability. Conclusion: To improve the problem-solving ability of nursing students, the simulation module should be designed with high fidelity.

The purpose of this study was to develop a nursing education program using Web-based simulation for the care of patients with intracranial pressure. An additional aim was to verify the effectiveness of nursing knowledge, problem-solving competency, a critical thinking disposition, and the expectation of learning transfer. Methods: This was an experimental study using repeated measures with a nonequivalent control group. The participants were senior nursing students, randomly assigned to experimental (n=30) and control (n=30) groups. The experimental group participated in a nursing education program that included Web-based lectures, pre-briefing, Web-based simulation, and debriefing, whereas the control group’s program included only Web-based lectures. Results: A significant difference was found between the experimental and control groups in problem-solving competency (F=5.84, p=.005), critical thinking disposition (F=4.25, p=.021), and the expectation of learning transfer (t=2.30, p<.025). Also, a significant interaction between time and group was found in problem-solving competency and critical thinking disposition. Conclusion: The results of this study showed that the education program using Web-based simulation positively affected nursing students’ problem-solving competency, critical thinking disposition, and the expectation of learning transfer. Therefore, this program can be considered a valuable aid in educating nursing students.

본 연구의 목적은 시뮬레이션 실습 교육에서 임상수행능력에 대한 명확한 개념의 속성을 규명 하고 이를 조직화하여 임상수행능력에 대한 이론적 근거를 마련하기 위해 시도되었다. 연구 방법으로는 Walker And Avant의 개념분석 방법을 사용하였다. KISS, KMbase, DBpia, RISS, PubMed, CINAHL, Medline의 데이터베이스에서 보건의료인 교육을 위한 시뮬레이션 교육이 권고된 시점인 2000년부터 2023 년 4월까지 보고된 논문을 수집하였다. 연구 결과 임상수행능력의 속성은 (1) 지식, 판단, 기술의 종합적인 능력, (2) 의료 환경 변화에 능숙히 대처하는 능력, (3) 간호 대상자의 요구에 적절하게 대응하여 간호 역할 을 수행하는 능력이다. 본 연구는 시뮬레이션 실습 교육에서 임상수행능력에 대한 연구가 활발한 상황에서 간호학적 관점의 중요성을 인식하고, 개념분석을 한 연구로서 의의가 있다. 본 연구에서 나타난 시뮬레이 션 실습 교육에서 임상수행능력 속성을 포함한 훈련 프로그램 및 도구를 개발하고 이를 활용하여 프로그램 의 효과를 측정하는 것이 필요할 것으로 사료된다.

Purpose: This study aimed to explore nursing simulation training needs and the educational environment of instructors. Method: This study was conducted according to the inductive method of qualitative content analysis. An online focus group interview was conducted with six instructors with experience operating a nursing simulation. Data were collected in July 2021. Results: First, “nursing simulation practice operations” required simulation design elements, practical operations, and curriculum integration. Second, the “educational environment” showed a lack of human and physical resources, and there was a need for standard education reflecting the domestic nursing education environment. Third, for “instructor competencies”, the facilitator role, step-by-step education for strengthening instructor competencies, and cooperation with clinical experts were derived. Fourth, it was found that “learner competencies” should meet the nursing professionals’ needs; self-directed learning competency and unique human competency should also be strengthened. Conclusion: This study is meaningful because it seeks to understand the instructor’s needs for nursing simulation training and the educational environment. Moreover, it identifies considerations for instructor and learner competencies in the nursing simulation operator training programs.

Purpose: This study aimed to develop a faculty development program for nursing simulation on perceived knowledge, confidence, and competence, and then evaluate its effects. Method: A one-group pretest–posttest design was used. The eight-hour program covered simulation education theory, scenario design and development, simulation design and operation using patient simulators and standardized patients, debriefing, curriculum integration, simulation evaluation, and faculty development. Thirty-eight participants completed a self-administered questionnaire. Data were collected in August 2021. The study used paired t-tests to analyze differences in perceived knowledge, confidence, and competence before and after the application of the program. Results: The participants were generally satisfied with this program. The results indicated that knowledge, confidence, and competence for nursing simulation significantly improved. Conclusion: The faculty development program positively affected simulation instructors’ knowledge, skill, and attitude. Therefore, this validated and standardized training program can be used for training simulation faculty members at universities and institutions. It can not only reduce the cost and effort required for faculty development at each university but also ultimately contribute to the spread of nursing simulation.

Purpose: This qualitative phenomenological study aims to understand how nursing students interpret their experiences with handover education using concept maps in simulation-based nursing education. Methods: Data were collected from September 18, 2021 to April 6, 2022, through in-depth one-to-one interviews with 11 nursing students. Interviews, which were conducted once or twice, lasted for 30 to 45 minutes per session. The main interview question was “How do you make meaning of your experiences with handover education using concept maps in simulation-based nursing education?” The collected data were analyzed using content analysis. Results: Three categories of were identified: actively engaged with students, addressed the reality of handover education, and there are two sides to handover education. The participants in this study require systematic education on the take-over method and process that can integrate and structure the continuity and thinking necessary for nursing work. Conclusion: Handover education using concept maps in simulation-based methods should be adapted according to the abilities of nursing students and their contextual needs. Future studies using large sample sizes and multiple settings should substantially evaluate the impact of handover education programs using concept maps on clinical outcomes.

Purpose: This study aims to improve nursing students’ competency through evidence-based nursing simulation education. Simulations included blood transfusion care for cancer patients, pneumothorax post-op care, and blood pressure control for hypertension care. Moreover, the study investigated the effects of simulations on anxiety, self-confidence, and student satisfaction with the learning experience. Method: Participants completed a survey on student satisfaction, self-confidence, and anxiety. A prospective, one-group, pre- and post-test design of 135 fourth-grade nursing students was used. A simulation scenario was developed according to the design. It consisted of pre-briefing, practice, serial tests, and debriefing. A simulation of three scenarios comprised blood transfusion care for cancer patients, pneumothorax post-op care, and blood pressure control for hypertension care. Twenty hours of evidence-based nursing simulation practicum consisting of three scenarios dealing with major adult diseases was conducted. Result: Students showed significant improvements over time in self-confidence (t=4.67, p<.001), student satisfaction (t=3.94, p<.001), and anxiety (t=-4.63, p<.001) after the evidence-based nursing simulation. Conclusion: Simulation of evidence-based education may be a useful and effective learning strategy. Nursing educators can design evidence-based simulation programs to improve educational effectiveness.

Purpose: This study reviews trends in the development of nursing simulation evaluation instruments and their characteristics in South Korea. Methods: Published and unpublished studies were analyzed using Korean electronic databases, such as the Research Information Sharing Service, the National Library of Korea, and the Korea Institute of Science and Technology Information. The keywords for the search included “nursing,” “simulation,” “instrument development,” “evaluation,” “validity,” and “reliability.” Results: A total of 16 studies and 17 evaluation instruments from between 2012 and 2022 were included and categorized. The participants included junior or senior undergraduate nursing students. The evaluation was conducted through observation and self-report and classified into cognitive, psychomotor, and affective domains. Only one instrument used for observation was measured for intra-rater reliability. Overall, 35.3% of the instruments integrally evaluated the cognitive, psychomotor, and affective domains, and 23.5% only reported one type of validity. Conclusion: The results indicate that the instruments insufficiently reflect the various learning outcomes of simulation education. Therefore, future research should be conducted to develop simulation evaluation instruments to evaluate integral learning areas according to the learning goals and examine their validity.

Purpose: Room of Errors is a little-known method in Korea, effective for patient safety education. This study aimed to examine nursing students’ recognition of pre-staged medical errors while working as individuals or in a team. Methods: Thirty-four errors for a pre-op care scenario and thirty errors for a post-op care scenario were pre-set in two simulated patient rooms. Fifty-six nursing students randomly participated as individuals or as a team in one of two “Room of Errors” to find as many errors as possible within a certain time. The evaluation of error detection and debriefing occurred immediately following the simulation. Results: “Wrong patient name on wrist band” (77-100%) and “bedside rails down” (91-100%) were the most frequently identified errors by both individuals and teams. Few students found “injection of a drug to which the patient is allergic” (0-9%) and “administration of a contraindicated drug to the patient” (0-7.7%). The performance of students working in a team was much better than those working alone. Conclusion: This study found that “Room of Errors” provided very experiential and practical learning to nursing students in identifying simulated patient threats. The method is also useful for interprofessional patient safety education to develop teamwork and communication.

Purpose: This was a qualitative study using a phenomenological research method. It was conducted to investigate the essential meaning of nursing students’ experiences participating in simulation education with standardized patients. Methods: This study’s research participants included 16 senior employees in the nursing department of two universities. They had experiences participating in simulation education with standardized patients. This study was conducted from June 1 to December 31, 2021, and the data were analyzed using Colaizzi’s (1978) phenomenological method. Results: After analyzing the meaning of simulation experiences with the standardized patients, 101 meaning formations were deduced. From this, 13 theme, 4 theme clusters and 2 categories—effective lesson, tasks to solve. Conclusion: Simulation with standardized patients is a recent approach that has been actively applied in simulation-based learning in nursing colleges. This study conducted qualitative research on students’ experiences with standardized patients and analyzed essential meaning of the experiences. Therefore, it is recommended that simulation education content with standardized patients is developed. This can be achieved by optimizing the advantages of standardized patients with various clinical cases in other subjects besides psychiatry.

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.