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 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.

본 연구는 팀 기반 시뮬레이션실습에서 교수평가, 동료평가와 자기평가의 점수를 확인하 며, 평가주체별로 점수를 어떻게 주는 경향이 있는지 알아보고 그 관계를 파악하는 것을 목적으로 한다. 이를 위해 ‘성인간호학실습(4)’를 수강한 간호대학생 중 연구 참여에 동의한 135명을 대상으로 학생들이 제출한 동료평가지와 자기평가지의 점수와 교수자 점수를 통계 적으로 분석하였다. 연구결과, 평가주체별 점수는 자기평가, 동료평가, 교수평가 순이었고, 자기평가에서 음의 왜도가 크고 첨도가 높아 스스로에게 높은 점수를 주는 경향이 있음과 집중된 평가 경향을 보이는 것으로 나타났다. 반면에 교수평가는 상대적으로 고르게 분포 된 평가를 하는 것으로 나타났다. 평가주체별 점수간 관계는 동료평가와 교수평가간에 정 적 상관관계가 있었다. 결론적으로, 팀 활동에서의 다면평가는 단일 평가자가 평가할 때 발 생하는 평가자 오류에서 상대적으로 자유롭지만, 단순히 평가자의 수를 늘리는 것만으로는 평가 결과의 신뢰성을 보장할 수 없기 때문에 맹목적으로 신뢰해서는 안 된다. 본 연구는 팀 기반 시뮬레이션실습에서 다면평가를 위한 구체적인 기준을 마련하고, 평가의 신뢰도와 타당도를 제고하기 위한 자료로 활용될 수 있을 것이다.

Purpose: This study aimed to evaluate the effectiveness of low-fidelity simulation and actual human practice on the learning outcomes of a peripheral intravenous injection program for nursing students. Methods: Seventy-two third-year nursing students from a university in Seoul were included and divided into two groups; 38 and 34 in the low-fidelity simulation and human practice groups, respectively. The program was conducted from June 19–20, 2024. Data were analyzed using frequency, percentage, mean, standard deviation, χ²-test, independent t-test, and ANCOVA. Results: Both groups showed significant improvements in venipuncture performance, communication skills, empathy, academic performance, and self-efficacy. However, there were no statistically significant differences in these outcomes between both groups. Additionally, post-program learning satisfaction was similarly high in both groups. Conclusion: Low-fidelity simulation is as effective as actual human practice in achieving comparable learning outcomes in a peripheral intravenous injection program for nursing students. With appropriate instructional design, low-fidelity simulation can be a viable alternative to human practice, providing flexibility and accessibility in nursing education. This study underscores the importance of incorporating additional educational modules that enhance emotional and social skills, such as communication and empathy, tailored to the characteristics of individual learners.

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.

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.