Pub Date : 2026-02-01DOI: 10.1016/j.ecns.2025.101899
Jiyoung Kim RN, ANP, PhD, Yeji Kim RN, Hyunji Park RN, Jiyeong Won RN, Jiwon Yun RN, Yuran Lee RN
Background
Recognizing situations that threaten patient safety and predicting potential risks are essential in nursing practice. This study aimed to evaluate the error detection rates and effects of safety-centered simulation education using a 360-degree video Room of Errors (ROE) on attitudes toward patient safety, confidence in performance, immersion, and learning satisfaction. Educational experiences were also explored qualitatively.
Methods
A concurrent mixed-methods design was employed. A total of 34 third- and fourth-year nursing students participated in Korea. A 360-degree video ROE simulation of perioperative patient safety management was developed and implemented. Attitudes toward patient safety, performance confidence, immersion, and learning satisfaction were measured and analyzed using SPSS/WIN 29.0. Experience was examined using qualitative content analysis.
Results
Students detected errors more frequently in the physical environment and patient identification but less often in medication administration. Scores for attitudes toward patient safety and performance confidence significantly improved postintervention (p < .001). Qualitative findings highlighted positive themes such as “emotional responses to the learning experience”, “structural and pedagogical benefits”, and “transformative outcomes of learning”, alongside a theme of “perceived weaknesses and suggestions”.
Conclusions
Safety-centered simulation education using 360-degree video can improve nursing students’ attitudes toward patient safety and confidence in performance, thus supporting the transfer of learning to clinical practice.
{"title":"Safety-centered simulation education using the 360-degree video room of errors: A mixed-methods study","authors":"Jiyoung Kim RN, ANP, PhD, Yeji Kim RN, Hyunji Park RN, Jiyeong Won RN, Jiwon Yun RN, Yuran Lee RN","doi":"10.1016/j.ecns.2025.101899","DOIUrl":"10.1016/j.ecns.2025.101899","url":null,"abstract":"<div><h3>Background</h3><div>Recognizing situations that threaten patient safety and predicting potential risks are essential in nursing practice. This study aimed to evaluate the error detection rates and effects of safety-centered simulation education using a 360-degree video Room of Errors (ROE) on attitudes toward patient safety, confidence in performance, immersion, and learning satisfaction. Educational experiences were also explored qualitatively.</div></div><div><h3>Methods</h3><div>A concurrent mixed-methods design was employed. A total of 34 third- and fourth-year nursing students participated in Korea. A 360-degree video ROE simulation of perioperative patient safety management was developed and implemented. Attitudes toward patient safety, performance confidence, immersion, and learning satisfaction were measured and analyzed using SPSS/WIN 29.0. Experience was examined using qualitative content analysis.</div></div><div><h3>Results</h3><div>Students detected errors more frequently in the physical environment and patient identification but less often in medication administration. Scores for attitudes toward patient safety and performance confidence significantly improved postintervention (<em>p</em> < .001). Qualitative findings highlighted positive themes such as “emotional responses to the learning experience”, “structural and pedagogical benefits”, and “transformative outcomes of learning”, alongside a theme of “perceived weaknesses and suggestions”.</div></div><div><h3>Conclusions</h3><div>Safety-centered simulation education using 360-degree video can improve nursing students’ attitudes toward patient safety and confidence in performance, thus supporting the transfer of learning to clinical practice.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"111 ","pages":"Article 101899"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-31DOI: 10.1016/j.ecns.2025.101901
Malou Van Geloven RN, BSc , W.M. Walima RN, BSc , E. Hagenbeek RN, MSc , W.A. Bouwes MD, PhD , J. Tyerman RN, PhD , Elisabeth Vera Habes RN, MSc
Background
The increasing diversity of patient populations calls for greater attention to intercultural communication in nursing education.
Objective and Method
This qualitative study explores the experiences of Dutch and Tanzanian nursing students during a joint CAN-Sim virtual simulation on metabolic syndrome in Tanzania. Eight students participated in interviews and participant observation. Data were thematically analysed.
Results
Six themes emerged: group dynamic, differences in norms, perceived relations, communication styles, learning value and recommendations.
Conclusion
The differences posed communication challenges, but a positive group dynamic helped overcome barriers. Participants experienced this process as a valuable learning opportunity that enhanced their cultural competence.
{"title":"Exploring intercultural communication in the development of nursing simulation: A Dutch-Tanzanian CAN-Sim collaboration on metabolic syndrome","authors":"Malou Van Geloven RN, BSc , W.M. Walima RN, BSc , E. Hagenbeek RN, MSc , W.A. Bouwes MD, PhD , J. Tyerman RN, PhD , Elisabeth Vera Habes RN, MSc","doi":"10.1016/j.ecns.2025.101901","DOIUrl":"10.1016/j.ecns.2025.101901","url":null,"abstract":"<div><h3>Background</h3><div>The increasing diversity of patient populations calls for greater attention to intercultural communication in nursing education.</div></div><div><h3>Objective and Method</h3><div>This qualitative study explores the experiences of Dutch and Tanzanian nursing students during a joint CAN-Sim virtual simulation on metabolic syndrome in Tanzania. Eight students participated in interviews and participant observation. Data were thematically analysed.</div></div><div><h3>Results</h3><div>Six themes emerged: group dynamic, differences in norms, perceived relations, communication styles, learning value and recommendations.</div></div><div><h3>Conclusion</h3><div>The differences posed communication challenges, but a positive group dynamic helped overcome barriers. Participants experienced this process as a valuable learning opportunity that enhanced their cultural competence.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101901"},"PeriodicalIF":2.5,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1016/j.ecns.2026.101905
Samira Ahmed Alsenany PhD, MSN in Community Nursing, BSc in Nursing Sciences, RN , Aseelah Abdullah Alnazawi , Ohoud Alnazawi PhD, MSN in Community Nursing, BSc in Nursing Sciences, RN , Ahmed Abdelwahab Ibrahim El-Sayed PhD, MSN in Nursing Administration, BSc in Nursing Sciences, RN
Background
Simulation-based learning is an essential strategy in health professions education that allows learners to develop clinical competence in a controlled and supportive environment. Psychological safety—students’ perceptions that they can express ideas, ask questions, and make mistakes without fear of embarrassment—is critical to maximizing learning outcomes. However, limited research has examined psychological safety across different health disciplines.
Aim
This study aimed to assess the level of psychological safety among health professions students engaged in simulation-based learning and to explore factors influencing it, including gender, academic discipline, and frequency of simulation exposure.
Methods
A cross-sectional survey was conducted among 210 final-year students enrolled in the medicine, nursing, and applied medical sciences programs at a governmental university in Saudi Arabia. Data were collected using the Psychological Safety in High-Fidelity Simulation Scale, adapted for multidisciplinary use. Descriptive and inferential statistics were performed using SPSS version 20, with significance set at p < .05.
Results
Most participants reported moderate to high psychological safety levels. Nursing students demonstrated higher psychological safety scores than medical students (p = .02), while female students scored lower than males (p = .03). Frequent exposure to simulation was significantly associated with increased psychological safety (OR = 2.3, p = .01).
Conclusion
Psychological safety is a key component of effective simulation-based education. Enhancing faculty support, implementing structured debriefing, and ensuring frequent simulation opportunities can foster psychologically safe learning environments. Targeted strategies addressing gender and disciplinary disparities are essential to promote inclusive, high-quality learning experiences in health professions education.
基于模拟的学习是卫生专业教育的一项基本策略，它使学习者能够在受控和支持性的环境中发展临床能力。心理安全——学生认为他们可以表达自己的想法，提出问题，犯错误，而不用担心尴尬——是最大化学习成果的关键。然而，对不同健康学科的心理安全进行了有限的研究。目的评价卫生专业学生模拟学习的心理安全水平，探讨性别、学科、模拟接触频率等因素对心理安全的影响。方法对沙特阿拉伯一所公立大学医学、护理和应用医学专业的210名应届学生进行横断面调查。数据收集使用心理安全高保真模拟量表，适应多学科使用。描述性统计和推理统计采用SPSS version 20，显著性设置为p <； 0.05。结果大多数参与者报告了中等到高度的心理安全水平。护生心理安全得分高于医学生（p = 0.02），女学生心理安全得分低于男学生（p = 0.03）。频繁接触模拟与心理安全感增加显著相关（OR = 2.3, p = 0.01）。结论心理安全是实施有效模拟教育的重要组成部分。加强教师支持，实施结构化的汇报，并确保频繁的模拟机会可以营造心理安全的学习环境。解决性别和学科差异的有针对性战略对于促进卫生专业教育中包容的高质量学习体验至关重要。
{"title":"Determinants of psychological safety in simulation-based learning among health professions students: A cross-sectional study","authors":"Samira Ahmed Alsenany PhD, MSN in Community Nursing, BSc in Nursing Sciences, RN , Aseelah Abdullah Alnazawi , Ohoud Alnazawi PhD, MSN in Community Nursing, BSc in Nursing Sciences, RN , Ahmed Abdelwahab Ibrahim El-Sayed PhD, MSN in Nursing Administration, BSc in Nursing Sciences, RN","doi":"10.1016/j.ecns.2026.101905","DOIUrl":"10.1016/j.ecns.2026.101905","url":null,"abstract":"<div><h3>Background</h3><div>Simulation-based learning is an essential strategy in health professions education that allows learners to develop clinical competence in a controlled and supportive environment. Psychological safety—students’ perceptions that they can express ideas, ask questions, and make mistakes without fear of embarrassment—is critical to maximizing learning outcomes. However, limited research has examined psychological safety across different health disciplines.</div></div><div><h3>Aim</h3><div>This study aimed to assess the level of psychological safety among health professions students engaged in simulation-based learning and to explore factors influencing it, including gender, academic discipline, and frequency of simulation exposure.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 210 final-year students enrolled in the medicine, nursing, and applied medical sciences programs at a governmental university in Saudi Arabia. Data were collected using the Psychological Safety in High-Fidelity Simulation Scale, adapted for multidisciplinary use. Descriptive and inferential statistics were performed using SPSS version 20, with significance set at <em>p</em> < .05.</div></div><div><h3>Results</h3><div>Most participants reported moderate to high psychological safety levels. Nursing students demonstrated higher psychological safety scores than medical students (<em>p</em> = .02), while female students scored lower than males (<em>p</em> = .03). Frequent exposure to simulation was significantly associated with increased psychological safety (OR = 2.3, <em>p</em> = .01).</div></div><div><h3>Conclusion</h3><div>Psychological safety is a key component of effective simulation-based education. Enhancing faculty support, implementing structured debriefing, and ensuring frequent simulation opportunities can foster psychologically safe learning environments. Targeted strategies addressing gender and disciplinary disparities are essential to promote inclusive, high-quality learning experiences in health professions education.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101905"},"PeriodicalIF":2.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1016/j.ecns.2025.101895
Hwa Sun Kim PhD, RN
Background
Simulation-based education offers a safe and effective approach for developing clinical judgment in high-risk contexts, such as acute myocardial infarction (AMI).
Objective
To examine the effects of a hybrid AMI simulation on nursing students’ clinical judgment and perceived learning using both faculty- and self-assessed measures.
Methods
A single-group pre–post study was conducted with 92 matched fourth-year nursing students (from a cohort of 103). Instruments included the faculty-rated Lasater Clinical Judgment Rubric (LCJR), the self-rated Simulation-based Clinical Judgment Rubric (SP-CJR), and the Simulation Effectiveness Tool-Modified (SET-M). Paired-sample t-tests, 95% confidence intervals, effect sizes (Cohen’s dz), and Pearson correlations were computed.
Results
Students’ SP-CJR scores increased significantly from 77.27 to 86.96 (t[91] = 7.50, p < .001, dz = 0.78), and SET-M scores improved from 4.24 to 4.54 (t[91] = 4.72, p < .001, dz = 0.49). Faculty LCJR scores averaged 3.14 (SD = 0.36) across domains. Positive correlations were found between faculty and student ratings (r = 0.21-0.27).
Conclusion
A theory-guided hybrid simulation design incorporating standardized patients and high-fidelity manikins was associated with significant pre–post improvements in students’ self-rated clinical judgment and perceived learning, while faculty ratings indicated accomplished levels of observed judgment. Triangulated assessment using LCJR, SP-CJR, and SET-M supports the feasibility of multisource evaluation in simulation-based nursing education and highlights the importance of interpreting self-reported gains alongside faculty ratings.
{"title":"Effects of an acute myocardial infarction simulation on nursing students’ clinical judgment: Integrating faculty- and self-assessments","authors":"Hwa Sun Kim PhD, RN","doi":"10.1016/j.ecns.2025.101895","DOIUrl":"10.1016/j.ecns.2025.101895","url":null,"abstract":"<div><h3>Background</h3><div>Simulation-based education offers a safe and effective approach for developing clinical judgment in high-risk contexts, such as acute myocardial infarction (AMI).</div></div><div><h3>Objective</h3><div>To examine the effects of a hybrid AMI simulation on nursing students’ clinical judgment and perceived learning using both faculty- and self-assessed measures.</div></div><div><h3>Methods</h3><div>A single-group pre–post study was conducted with 92 matched fourth-year nursing students (from a cohort of 103). Instruments included the faculty-rated Lasater Clinical Judgment Rubric (LCJR), the self-rated Simulation-based Clinical Judgment Rubric (SP-CJR), and the Simulation Effectiveness Tool-Modified (SET-M). Paired-sample t-tests, 95% confidence intervals, effect sizes (Cohen’s dz), and Pearson correlations were computed.</div></div><div><h3>Results</h3><div>Students’ SP-CJR scores increased significantly from 77.27 to 86.96 (t[91] = 7.50, <em>p</em> < .001, dz = 0.78), and SET-M scores improved from 4.24 to 4.54 (t[91] = 4.72, <em>p</em> < .001, dz = 0.49). Faculty LCJR scores averaged 3.14 (SD = 0.36) across domains. Positive correlations were found between faculty and student ratings (r = 0.21-0.27).</div></div><div><h3>Conclusion</h3><div>A theory-guided hybrid simulation design incorporating standardized patients and high-fidelity manikins was associated with significant pre–post improvements in students’ self-rated clinical judgment and perceived learning, while faculty ratings indicated accomplished levels of observed judgment. Triangulated assessment using LCJR, SP-CJR, and SET-M supports the feasibility of multisource evaluation in simulation-based nursing education and highlights the importance of interpreting self-reported gains alongside faculty ratings.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101895"},"PeriodicalIF":2.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1016/j.ecns.2026.101904
Regina C. Kulacz MSN RN CHSE CHSOS, Amanda Lamberti MSN RN CHSE CHSOS, Pamela Forte DNP MSN RN CNE, Kimberly Lacey DNSc, MSN, RN, CNE, CNL
Simulation is widely used in nursing education; however, its application in graduate nurse educator programs remains limited. This pilot explored the use of a novel multistudent, multipatient simulation in which nurse educator students assumed the role of clinical faculty. Designed in accordance with the Healthcare Simulation Standards of Best PracticeTM, this simulation focused on clinical facilitation, time management, and feedback. Participants (n = 2) reported increased confidence and insight into clinical teaching responsibilities following the encounter. This pilot warrants further investigation into the application of simulation in graduate-level nonclinical programs and may serve as a template for educator development programs.
{"title":"Transforming clinical faculty preparation: A multistudent, multipatient simulation for nurse educator students","authors":"Regina C. Kulacz MSN RN CHSE CHSOS, Amanda Lamberti MSN RN CHSE CHSOS, Pamela Forte DNP MSN RN CNE, Kimberly Lacey DNSc, MSN, RN, CNE, CNL","doi":"10.1016/j.ecns.2026.101904","DOIUrl":"10.1016/j.ecns.2026.101904","url":null,"abstract":"<div><div>Simulation is widely used in nursing education; however, its application in graduate nurse educator programs remains limited. This pilot explored the use of a novel multistudent, multipatient simulation in which nurse educator students assumed the role of clinical faculty. Designed in accordance with the <em>Healthcare Simulation Standards of Best Practice</em><sup>TM</sup>, this simulation focused on clinical facilitation, time management, and feedback. Participants (n = 2) reported increased confidence and insight into clinical teaching responsibilities following the encounter. This pilot warrants further investigation into the application of simulation in graduate-level nonclinical programs and may serve as a template for educator development programs.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101904"},"PeriodicalIF":2.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-30DOI: 10.1016/j.ecns.2025.101897
Soledad Armijo-Rivera (Mg) MD, MEd , Scarlett Vicencio-Clarke (Mg) MD, MEd , Hernán Caamaño , Pía Díaz , Carla Pino , Francesca Caldo , Daniel Herrera , Carlos Hinrichsen (Mg)
Background
Facilitation of debriefings is critical for fostering reflection and behavioral change. However, little is known about how novice instructors distribute their speaking time and how this impacts perceived debriefing quality. Artificial intelligence (AI)-driven conversational analysis offers an objective method to characterize facilitation patterns.
Methods
Participants were fifteen novice healthcare instructors with less than one year of experience who recently completed an online simulation course. A cross-sectional study was conducted using GailBot API for automated transcription and speech analysis of remote interprofessional debriefings. Standardized scenarios and consistent student participants controlled external variables. Instructor facilitation patterns were compared to DASH evaluations from students, instructors, and an expert observer.
Results
Instructors spoke for an average of 56.09% of debriefing time. Higher instructor talk time correlated negatively with DASH self-ratings (Spearman’s Rho = −0.627, p = .012).
汇报的便利性对于促进反思和行为改变至关重要。然而，关于新手教师如何分配他们的演讲时间，以及这如何影响感知的汇报质量，我们知之甚少。人工智能（AI）驱动的会话分析提供了一种客观的方法来表征促进模式。方法研究对象为15名经验不足一年的医疗保健指导新手，他们最近完成了一门在线模拟课程。使用GailBot API进行了一项横断面研究，用于远程跨专业汇报的自动转录和语音分析。标准化的场景和一致的学生参与者控制外部变量。教师促进模式与学生、教师和专家观察员的DASH评估进行了比较。结果讲师发言时间平均占汇报时间的56.09%。较高的教师谈话时间与DASH自我评分呈负相关（Spearman’s Rho = - 0.627, p = 0.012）。结论基于人工智能的分析为促进模式提供了有价值的见解，支持了多学科教师的发展。
{"title":"Analyzing instructor facilitation patterns in debriefings using AI-based speech metrics","authors":"Soledad Armijo-Rivera (Mg) MD, MEd , Scarlett Vicencio-Clarke (Mg) MD, MEd , Hernán Caamaño , Pía Díaz , Carla Pino , Francesca Caldo , Daniel Herrera , Carlos Hinrichsen (Mg)","doi":"10.1016/j.ecns.2025.101897","DOIUrl":"10.1016/j.ecns.2025.101897","url":null,"abstract":"<div><h3>Background</h3><div>Facilitation of debriefings is critical for fostering reflection and behavioral change. However, little is known about how novice instructors distribute their speaking time and how this impacts perceived debriefing quality. Artificial intelligence (AI)-driven conversational analysis offers an objective method to characterize facilitation patterns.</div></div><div><h3>Methods</h3><div>Participants were fifteen novice healthcare instructors with less than one year of experience who recently completed an online simulation course. A cross-sectional study was conducted using GailBot API for automated transcription and speech analysis of remote interprofessional debriefings. Standardized scenarios and consistent student participants controlled external variables. Instructor facilitation patterns were compared to DASH evaluations from students, instructors, and an expert observer.</div></div><div><h3>Results</h3><div>Instructors spoke for an average of 56.09% of debriefing time. Higher instructor talk time correlated negatively with DASH self-ratings (Spearman’s Rho = −0.627, <em>p</em> = .012).</div></div><div><h3>Conclusion</h3><div>AI-based analysis provides valuable insights into facilitation patterns, supporting multidisciplinary faculty development.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"112 ","pages":"Article 101897"},"PeriodicalIF":2.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146071128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-23DOI: 10.1016/j.ecns.2025.101900
Sorcha Magee , David B. Olawade
Background
Language barriers in maternity care compromise patient safety and quality, with poorer maternal outcomes observed when communication between obstetric staff and women with limited English proficiency is hindered, especially during emergencies.
Objective
To explore obstetric and maternity staff understanding of language barriers when caring for women during obstetric emergencies.
Methods
A six-week mixed-methods quality improvement study in a UK National Health Service (NHS) Trust maternity unit. Forty maternity and obstetric clinicians were recruited. Participants engaged in postpartum hemorrhage simulations using a simulation mannikin programmed to speak a foreign language. Data collection involved presimulation Likert-scale questionnaires (five items) and postsimulation debriefs. Quantitative data were analyzed descriptively; qualitative data underwent thematic analysis.
Findings
Presimulation data revealed limited staff confidence: 52% were dissatisfied with interpretation services, 60% were very dissatisfied with communication support, and 57% were neutral about understanding communication in obstetric emergencies. Thematic analysis identified three key themes: (a) unavailability of interpreting services during emergencies, (b) undervaluing the importance of communication in urgent scenarios, and (c) opportunities for enhancing simulation-based communication training.
Discussion
Significant knowledge gaps and inadequate systems hinder effective communication with women facing language barriers during obstetric emergencies.
Conclusion
Urgent action is needed to strengthen training in interpretation services, enhance communication infrastructure, and raise awareness among maternity teams about the critical role of communication in emergency care.
{"title":"Addressing language barriers in maternity emergency care in the UK: A mixed methods quality improvement simulation study","authors":"Sorcha Magee , David B. Olawade","doi":"10.1016/j.ecns.2025.101900","DOIUrl":"10.1016/j.ecns.2025.101900","url":null,"abstract":"<div><h3>Background</h3><div>Language barriers in maternity care compromise patient safety and quality, with poorer maternal outcomes observed when communication between obstetric staff and women with limited English proficiency is hindered, especially during emergencies.</div></div><div><h3>Objective</h3><div>To explore obstetric and maternity staff understanding of language barriers when caring for women during obstetric emergencies.</div></div><div><h3>Methods</h3><div>A six-week mixed-methods quality improvement study in a UK National Health Service (NHS) Trust maternity unit. Forty maternity and obstetric clinicians were recruited. Participants engaged in postpartum hemorrhage simulations using a simulation mannikin programmed to speak a foreign language. Data collection involved presimulation Likert-scale questionnaires (five items) and postsimulation debriefs. Quantitative data were analyzed descriptively; qualitative data underwent thematic analysis.</div></div><div><h3>Findings</h3><div>Presimulation data revealed limited staff confidence: 52% were dissatisfied with interpretation services, 60% were very dissatisfied with communication support, and 57% were neutral about understanding communication in obstetric emergencies. Thematic analysis identified three key themes: (a) unavailability of interpreting services during emergencies, (b) undervaluing the importance of communication in urgent scenarios, and (c) opportunities for enhancing simulation-based communication training.</div></div><div><h3>Discussion</h3><div>Significant knowledge gaps and inadequate systems hinder effective communication with women facing language barriers during obstetric emergencies.</div></div><div><h3>Conclusion</h3><div>Urgent action is needed to strengthen training in interpretation services, enhance communication infrastructure, and raise awareness among maternity teams about the critical role of communication in emergency care.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"111 ","pages":"Article 101900"},"PeriodicalIF":2.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.ecns.2025.101896
Monica Millard PhD, RN , Du Feng PhD , Rebecca Benfield CNM, PhD, FACNM, FAAN , Clariana Ramos de Oliveira PhD., MSc, RN , Joseph Morgan PhD
Background
Virtual patient simulation (VPS) has been used as an alternative to in-person clinical placement and high-fidelity manikin simulation (HFMS). However, further research is needed to evaluate its effectiveness as an educational tool for developing clinical judgment in prelicensure nursing students. Limited evidence exists from mixed-design studies comparing the effects of HFMS and VPS alone versus VPS as a primer for HFMS in a blended modality.
Methods
A quasi-experimental study with a repeated-measures mixed design examined the effectiveness of VPS in acquiring clinical judgment among third-year bachelor of nursing prelicensure students, compared with HFMS and VPS as a primer for HFMS, using the Lasater Clinical Judgment Rubric.
Results
The mixed ANCOVA revealed no significant interaction effect of Time by study group for the clinical judgment total scale score between T1 and T2 (p = .33) or T1 and T3 (p = .12). Similarly, the mixed MANCOVA showed no significant differences in clinical judgment subscale scores between T1 and T2 (p = .54) or T1 and T3 (p = .65).
Conclusion
HFMS, VPS, and blended simulation approaches were similarly effective in fostering students’ clinical judgment.
{"title":"A comparative analysis of the impact of virtual patients versus high-fidelity manikin-based blended simulation on nursing students’ self-evaluation of clinical judgment skills","authors":"Monica Millard PhD, RN , Du Feng PhD , Rebecca Benfield CNM, PhD, FACNM, FAAN , Clariana Ramos de Oliveira PhD., MSc, RN , Joseph Morgan PhD","doi":"10.1016/j.ecns.2025.101896","DOIUrl":"10.1016/j.ecns.2025.101896","url":null,"abstract":"<div><h3>Background</h3><div>Virtual patient simulation (VPS) has been used as an alternative to in-person clinical placement and high-fidelity manikin simulation (HFMS). However, further research is needed to evaluate its effectiveness as an educational tool for developing clinical judgment in prelicensure nursing students. Limited evidence exists from mixed-design studies comparing the effects of HFMS and VPS alone versus VPS as a primer for HFMS in a blended modality.</div></div><div><h3>Methods</h3><div>A quasi-experimental study with a repeated-measures mixed design examined the effectiveness of VPS in acquiring clinical judgment among third-year bachelor of nursing prelicensure students, compared with HFMS and VPS as a primer for HFMS, using the Lasater Clinical Judgment Rubric.<!--> </div></div><div><h3>Results</h3><div>The mixed ANCOVA revealed no significant interaction effect of Time by study group for the clinical judgment total scale score between T1 and T2 (<em>p</em> = .33) or T1 and T3 (<em>p</em> = .12). Similarly, the mixed MANCOVA showed no significant differences in clinical judgment subscale scores between T1 and T2 (<em>p</em> = .54) or T1 and T3 (<em>p</em> = .65).</div></div><div><h3>Conclusion</h3><div>HFMS, VPS, and blended simulation approaches were similarly effective in fostering students’ clinical judgment.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"111 ","pages":"Article 101896"},"PeriodicalIF":2.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.ecns.2025.101894
Eleanor Rawson DNP, CRNA, CHSE, FAANA, Brittney McDowell DNP, CRNA, Kevin Nagapen DNP, CRNA, Morgan LaPorte DNP, CRNA
Background
This project explored high-fidelity simulation, utilizing an evidence-based practice emergency manual, for the purpose of improving Certified Registered Nurse Anesthetists’ (CRNAs) usage and belief of evidence-based practice.
Methods
Use of a cognitive aid helps providers deliver better evidence-based care during low-frequency, high-mortality perioperative events. CRNAs rotated through three different scenarios with the Stanford Emergency Manual available for reference.
Results
There was an increase in Evidence-Based Practice Belief Scale (EBP-BS) scores from presimulation to postsimulation (Z = 2.023, p = .043) and an increase from presimulation to three months postsimulation (Z = 2.023, p = .043). There was not a statistically significant change in EBP-IS scores pre- and three months postsimulation (Z = 0.944, p = .345).
Conclusion
An increase in EBP-BS scores reflected practitioners’ perceived ability to use EBP in their daily clinical practice, and most participants intended to include the cognitive aid in their anesthesia practice, providing an opportunity for future utilization.
本项目探索高保真模拟，利用循证执业急救手册，以提高注册麻醉师（crna）的使用和循证执业的信念。方法使用认知辅助工具可帮助医生在低频率、高死亡率围手术期事件中提供更好的循证护理。crna在三种不同的情况下轮流使用，可供参考的是《斯坦福应急手册》。结果循证实践信念量表（EBP-BS）评分从模拟前到模拟后呈上升趋势（Z = 2.023, p = 0.043），从模拟前到模拟后3个月呈上升趋势（Z = 2.023, p = 0.043）。模拟前和模拟后3个月EBP-IS评分变化无统计学意义（Z = 0.944, p = 0.345）。结论EBP- bs评分的增加反映了从业人员在日常临床实践中使用EBP的感知能力，大多数参与者打算在麻醉实践中包括认知辅助，为将来使用EBP提供机会。
{"title":"Certified Registered Nurse Anesthetists’ use of the Stanford Emergency Manual during high-fidelity simulation of emergency scenarios","authors":"Eleanor Rawson DNP, CRNA, CHSE, FAANA, Brittney McDowell DNP, CRNA, Kevin Nagapen DNP, CRNA, Morgan LaPorte DNP, CRNA","doi":"10.1016/j.ecns.2025.101894","DOIUrl":"10.1016/j.ecns.2025.101894","url":null,"abstract":"<div><h3>Background</h3><div>This project explored high-fidelity simulation, utilizing an evidence-based practice emergency manual, for the purpose of improving Certified Registered Nurse Anesthetists’ (CRNAs) usage and belief of evidence-based practice.</div></div><div><h3>Methods</h3><div>Use of a cognitive aid helps providers deliver better evidence-based care during low-frequency, high-mortality perioperative events. CRNAs rotated through three different scenarios with the Stanford Emergency Manual available for reference.</div></div><div><h3>Results</h3><div>There was an increase in Evidence-Based Practice Belief Scale (EBP-BS) scores from presimulation to postsimulation (Z = 2.023, <em>p</em> = .043) and an increase from presimulation to three months postsimulation (Z = 2.023, <em>p = .</em>043). There was not a statistically significant change in EBP-IS scores pre- and three months postsimulation (Z = 0.944, <em>p = .</em>345).</div></div><div><h3>Conclusion</h3><div>An increase in EBP-BS scores reflected practitioners’ perceived ability to use EBP in their daily clinical practice, and most participants intended to include the cognitive aid in their anesthesia practice, providing an opportunity for future utilization.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"111 ","pages":"Article 101894"},"PeriodicalIF":2.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-19DOI: 10.1016/j.ecns.2025.101889
Hao He , Xinhao Xu , Yuanyuan Gu , Yupei Duan , Shangman Li , Jhon Bueno Vesga
Background
Human simulated patient-based patient encounter practices, though effective, are limited by factors such as training, cost, and actors’ availability. Virtual reality (VR) could be an alternative. While traditional VR practices were preprogrammed and inflexible in responding to learners’ questions, generative artificial intelligence (GenAI)-enhanced VR practices point to a new way.
Methods
This study adopted a GenAI-enhanced VR learning environment for nursing students to practice conversation and information-gathering skills. We examined their skill-related performance transfer from the VR practice to the in-person test.
Results
Participants’ skill-related performance successfully transferred from the VR practice to the in-person test.
Conclusion
A GenAI-enhanced VR patient encounter practice can effectively prepare nursing students for in-person patient encounters.
{"title":"Preparing for meeting patients: A generative AI-enhanced virtual reality patient encounter practice","authors":"Hao He , Xinhao Xu , Yuanyuan Gu , Yupei Duan , Shangman Li , Jhon Bueno Vesga","doi":"10.1016/j.ecns.2025.101889","DOIUrl":"10.1016/j.ecns.2025.101889","url":null,"abstract":"<div><h3>Background</h3><div>Human simulated patient-based patient encounter practices, though effective, are limited by factors such as training, cost, and actors’ availability. Virtual reality (VR) could be an alternative. While traditional VR practices were preprogrammed and inflexible in responding to learners’ questions, generative artificial intelligence (GenAI)-enhanced VR practices point to a new way.</div></div><div><h3>Methods</h3><div>This study adopted a GenAI-enhanced VR learning environment for nursing students to practice conversation and information-gathering skills. We examined their skill-related performance transfer from the VR practice to the in-person test.</div></div><div><h3>Results</h3><div>Participants’ skill-related performance successfully transferred from the VR practice to the in-person test.</div></div><div><h3>Conclusion</h3><div>A GenAI-enhanced VR patient encounter practice can effectively prepare nursing students for in-person patient encounters.</div></div>","PeriodicalId":48753,"journal":{"name":"Clinical Simulation in Nursing","volume":"111 ","pages":"Article 101889"},"PeriodicalIF":2.5,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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