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.

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.

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.

본 연구는 국내 해기사 양성 교육기관의 선박조종 시뮬레이터 교육훈련 현황을 분석하고, 국제 기준(STCW 협약, IMO Model Course) 및 국내 법규와의 비교를 통해 표준화의 필요성과 개선 방향을 제시하였다. 분석 결과, 동일한 유형의 시뮬레이터 교육임에도 교 육기관별로 교육시간, 내용, 운영방식에서 큰 차이가 존재하였으며, 이는 해기인의 역량 균질성 확보에 부정적 영향을 미칠 수 있음을 확 인하였다. STCW 협약과 IMO Model Course는 시뮬레이터 교육의 목표, 최소 교육시간, 시나리오 구성, 평가 방법 등을 명확히 규정하고 있 으나, 국내 지정교육기관 기준은 교육시간 및 운영·평가 절차를 구체적으로 명시하지 않아 표준화가 미흡하다. 이에 본 연구는 ECDIS·Radar/ARPA·리더십 및 팀워크 등 핵심 시뮬레이터 교육에 대해 국제 기준에 부합하는 최소 교육시간 확보와 표준 시나리오 개발을 제안하며, 교수자 자격은 IMO Model Course 6.10 요건을 충족하도록 관리할 것을 권고한다. 이러한 표준 운영안은 교육 품질의 일관성을 보장하고, 상황인식·위기대응·의사결정 등 복합 역량을 강화하여 국제 해사안전 기준 준수와 해운산업의 경쟁력 제고에 기여할 수 있을 것이다.

Purpose This study aimed to develop and evaluate a simulation-based autotransfusion device training program to enhance the clinical performance, performance confidence, and educational satisfaction of post-anesthesia care unit (PACU) nurses. Methods: A single-group pretestposttest study was conducted with 30 PACU nurses. The program, based on the ADDIE model, included orientation, simulation training, and debriefing. Data were collected using validated tools before and after the program and analyzed using the Wilcoxon signed-rank test. Results: Clinical performance improved from a median of 30.00 to 43.00 (Z =−4.78, p < .001). Performance confidence increased from 31.00 to 47.50 (Z =−4.71, p < .001), while educational satisfaction rose from 26.00 to 40.00 (Z =−4.73, p < .001). Conclusions: The simulation-based program effectively enhanced the clinical performance, performance confidence, and education satisfaction of PACU nurses. These findings underscore the value of simulation-based training for enhancing nurses’ competence in using complex, high-risk medical devices.

Purpose: This study evaluated the impact of a nursing simulation learning module for caring for patients with chronic obstructive pulmonary disease (COPD) on nursing knowledge, clinical competence, team psychological safety, and learning satisfaction among nursing students. Methods: A non-equivalent control-group pretest–posttest quasi-experimental design was used with 36 students (18 per group) assigned to either a simulation group or a lecture group. Data collected from June 8 to July 13, 2024, were analyzed using SPSS 27.0. Results: Nursing knowledge showed no significant between-group difference (F=1.32, p=.260) but improved over time (F=8.24, p=.007). Clinical competence showed a significant group-by-time interaction (F=58.33, p<.001). Team psychological safety (t=2.70, p=.012) and learning satisfaction (t=2.27, p=.030) were higher in the simulation group. Conclusion: These findings provide foundational data for developing simulation-based educational strategies in nursing curricula. The module may also be applied to the training of novice nurses in clinical settings, thereby contributing to enhanced nursing education and improved clinical practice.

Purpose: This study aimed to develop and evaluate a simulation-based nursing education program for respiratory emergencies in critically ill, extremely low birth weight infants (ELBWIs). Methods: A single-arm quasi-experimental study was conducted with 32 neonatal intensive care unit (NICU) nurses. The program was developed systematically using the ADDIE model, incorporating needs assessment, real-case scenario development, and pilot testing. Data were collected before and after the intervention and were analyzed using paired and independent t-tests, as well as a one-way analysis of variance (ANOVA) with Scheffé post-hoc tests. Results: The results showed statistically significant improvements in participants’ problemsolving ability (t = -3.49, p = .001), clinical performance confidence (t = -4.64, p < .001), and overall clinical performance competency (t = -13.79, p < .001) following the training. The clinical relevance and feasibility of the program were supported by pilot testing and positive evaluations of the practicality and educational usefulness of the simulation scenarios. Conclusion: These findings suggest that the simulation-based program was effective in enhancing NICU nurses’ clinical competence in managing respiratory emergencies in ELBWIs and can be used as a practical alternative to traditional on-the-job training.

STCW 협약 A-VI에 의거, 승선 필수 증서를 발급받기 위해 소화 과정 최저 훈련 이수를 거치게 되는 공간이 수소화 훈련장 이다. 선박 화재의 상황과 유사한 장소에서 발생한 화재 진압 훈련을 위한 실습 장소의 특성상, 재실자의 안전을 보장할 수 있는 운영 을 위해 안전성을 수치화하여 평가하고 기준을 수립하는 연구의 필요성이 대두되었다. 화재 안전 평가를 위해 FDS를 기반으로 한 Pyrosim을 활용하여 제연설비 유무에 따른 Case를 설정, vector의 분석을 통한 연기 유동 및 열기에 대한 평가를 수행하였다. 피난 안전 평가는 Pathfinder를 통해 허용 피난시간, 총 피난시간을 수치화된 결과로 해석, 비교하여 안전성을 분석하였다. 각 Case에 대한 안전성 을 평가함으로 제연설비별 기능의 적정성을 수치, 시각적으로 나타내었으며, 현재 운영 상태는 안전성이 양호한 것으로 평가하였다. 집 진설비가 정지한 비상상황은 각 피난시간과 111.2초의 여유시간으로 나타내어 수소화 훈련장의 비상상황에 대한 피난시간의 기준으로 활용할 것을 제시하였다.

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: The global emphasis on preventing and systematically managing acute cardiac arrest necessitates improved education in cardiovascular emergencies. This study aims to provide foundational data on the effectiveness of simulation-based cardiovascular emergency management education, applying the think-aloud method for nurses. Method: A one-group pre-posttest experimental design was used from July 29 to August 15, 2022. Twenty-eight nurses participated in this study. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test with SPSS/WIN 25.0. Results: The educational intervention showed statistically significant improvements in outcomes: knowledge of cardiovascular emergency management (Z=-4.24, p<.001), confidence in cardiovascular emergency management (Z=-4.63, p<.001), clinical reasoning competence (Z=-4.16, p<.001), and self-efficacy for group work (Z=-3.47, p=.001), and selfregulation for group work (Z=-2.29, p=.022). Conclusion: This study indicates that the use of the think-aloud method in simulation-based learning can effectively enhance cardiovascular emergency management training by reducing learners’ cognitive load. Cardiovascular emergency management competencies can be strengthened through the development of diverse educational strategies and the expansion of training support.

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.

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.

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.

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: 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.

Most fishing vessels are less than 100 m in length (LBP), which is not mandatory for the IMO standards for ship maneuverability. Therefore, research on estimating the maneuverability of fishing vessel hull shapes are somewhat lacking compared to that of merchant ship hull shapes, and at the design stage, the numerical simulation method developed for merchant ships are applied without modification to estimate the maneuverability. Since this can cause estimation errors, the authors have derived a modified empirical formula that can improve the accuracy of estimating the maneuverability of fishing vessels in a previous study. In this study, using the modified empirical formula, the IMO maneuverability evaluation items, the turning motion test and Z-test simulations were performed on the fisheries training vessel BAEK-KYUNG and compared with the sea trial test result to verify the validity of the modified empirical formula. In conclusion, the modified empirical formula was able to estimate quantitatively and qualitatively similar to the result of the sea trial test. Such a study on estimating the maneuverability of fishing vessels will be a good indicator for fishing vessel operators and will help them analyze marine accidents.

Purpose: This study attempted to enhance the nurses’ safety competence in administering medications by using simulation training focused on high-alert medication. Method: A total of 30 nurses from 14 teams participated in the simulation training using a high-fidelity patient simulator. Medication administration performance and built-in error recovery was observed using a medication administration safety assessment checklist. Medication safety knowledge and confidence were measured before and after simulation training. Data were analyzed using descriptive statistics and a paired t-test. Results: There were numerous variations in safe medication administration. The safety behavior by oral prescription was insufficient compared to that by routine medication prescription. Following simulation training, knowledge of medication safety increased significantly, but confidence did not. Conclusion: Nurse educators may consider simulation to be an effective strategy for enhancing nurses’ medication safety competence.

Purpose: The purpose of this study was to explore and analyze the education experiences of nursing graduate students in training simulation educators. Methods: Data were collected using a focus group method with a total of 13 nursing graduate students who ever participated in simulation education for nursing college students. Results: Four theme clusters and 15 sub-themes were emerged through qualitative content analysis. The core theme was “Flapping wings as a novice simulation educator”. The four theme clusters include ‘Confronting myself where expectations and worries coexist’, ‘Experience a new world untrained in the hospital’, ‘Limitation of simulation hard to reach the reality’, ‘Way to become an expert in simulation education’. Conclusion: Nursing graduate students found that the experiences of novice learners as a simulation educator was rewarding and helpful in increasing their self-confidence prior to being placed in an educational setting. Creating a simulation experience for college students could be a daunting task for educators in nursing. Therefore, continued and sustainable efforts are mandated by developing the curriculum for training simulation educators.

Purpose: This study aims to understand and describe in-depth the meaning of evidence-based simulation training education experience of nursing students. Method: This is a qualitative study employing a phenomenological approach. Data were collected from eight seniors in Changshin university in Changwon, from November to December, 2019. The analysis was based on the method proposed by Giorgi. Results: A total of 4 components and 12 sub-components were derived from the analysis. The evidence-based simulation training education experience of nursing students was found to be “burdening Because of the new teaching method,” “immersive,” “an experience of a new field of learning,” and “improving the nursing capacity.” Conclusion: Conclusion: Although the simulation training education burdened participants because of new teaching methods, it is expected to contribute to overcoming the limitations of educational effects in clinical practice and enhance practical clinical performance. Evidence-based simulation training education provides an opportunity to decide rationally by considering the best scientific evidence, clinical expertise, patient values and preferences, and available resources. In the furture, improvement in evidencebased nursing practice is expected.