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\"Pam Jefferies and Jim Battin provide a very thoughtful, step by step approach to create a collaborative health care simulation consortium.It is inspiring to witness many stakeholders come together in Southeast Indiana to effectively educate and train people entering the healthcare profession (and current nurses, doctors, and allied health.

Critical thinking is a crucial skill in the nursing profession and must be fostered through nursing education. Simulation-based learning (SBL) with technological modalities is a pedagogical approach to enhance critical thinking skills for nursing students. The use of technology in SBL to achieve critical thinking skills is diverse. No previous scoping review has systematically mapped studies on SBL supported by technology to enhance critical thinking in nursing students. This scoping review aimed to systematically map research on the use of SBL supported by technology to enhance critical thinking in nursing students. This scoping review was conducted according to the framework by Arksey and O'Malley and was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic, comprehensive literature search was performed in the LILACS, ERIC, MEDLINE, Embase, PsycINFO, and Web of Science databases in 2021 and repeated in 2023 and 2024. Pairs of authors independently assessed titles, abstracts, and full-text papers and extracted data from the included studies. The data underwent summative and thematic analysis and were categorized according to the findings. In total, 4 main categories of technology applied in SBL were identified: computer-based simulations, human-patient simulators, virtual reality or immersive virtual reality, and others. The findings revealed a shift across time in the technology used for SBL to enhance critical thinking, from human patient simulators to computer-based simulations. A dominant part of the included studies published after 2018 (21/44, 48%) incorporated a combination of asynchronous and synchronous learning activities. The theoretical foundation of the studies revealed a range of scientific theories and conceptual frameworks and models. Enablers of or barriers to the enhancement of critical thinking skills in nursing students were identified within the following themes: affinity for and availability of technology, realism, accessibility, engagement and motivation, validation, return on investment, and enhanced critical thinking through SBL using technology. There has been a noticeable shift in the technology and use of technology in SBL. Descriptions of the applied technology and pedagogical considerations are pivotal for comparing or synthesizing research results. There has been a trend toward a blended educational approach combining synchronous and asynchronous learning activities. User technological proficiency and the perceived quality of the technology are imperative in the development of critical thinking. Realism, engagement, and motivation play pivotal roles in the enhancement of critical thinking in technologically supported SBL. The establishment of robust theoretical foundations of research and standardized research practices will strengthen the evidence obtained from the research conducted.

To compare the effectiveness of VR based training and traditional simulation in improving the knowledge, psychomotor skills, attitudes, learning styles and self-directed learning skills of nursing students participating in CPR training. Randomized controlled trial with a pre-test/post-test control group design. Study was conducted with 144 s-year nursing students at an accredited state university in Turkey. Participants were randomly assigned to either a VR group or a traditional simulation group. Both groups received theoretical instruction in CPR followed by VR-based training using Oculus Quest 2 headsets or a traditional simulation-based exercise. Data were collected using the CPR Knowledge Test, the Self-Directed Learning Skills Scale, the Kolb Learning Style Inventory, the Simulation Design Scale and an Objective Structured Clinical Examination (OSCE) for CPR skills. Both groups showed significant improvements in CPR skills after the intervention, with no significant difference between groups. The traditional simulation group showed a significant increase in self-directed learning skills, while no significant change was observed in the VR group. The VR group showed a supportive effect on abstract conceptualization in learning styles, but had no significant effect on learning preferences. Students in the VR group outperformed the control group on several critical psychomotor CPR skills measured by OSCE. Both groups rated their simulation experiences favorably. VR-based CPR training is an effective, scalable, and engaging teaching method that enhances psychomotor skill acquisition and promotes cognitive engagement. Future research should explore hybrid models and long-term outcomes to optimize the use of VR in CPR education.

To evaluate the effectiveness of virtual simulation experiments for early intervention in psychiatric violence among nursing undergraduates, compared with offline scenario simulation in terms of knowledge, skills, attitudes, cognitive load, learning satisfaction and confidence. Early intervention in psychiatric violence is complex and differs from general hospital violence intervention. Existing virtual experiments and games for general hospital violence prevention are not easily adaptable for psychiatric violence prevention training. Offline scenario simulation learning is impractical for large-scale education due to high demands on time, space and manpower. A repeated measures randomized controlled trial. Fifty-eight third-year nursing undergraduates participated (intervention group = 29, control group = 29). Theoretical knowledge tests, violence management ability questionnaires and attitude scales were administered before and end of the intervention, one week after and one month after. Post-intervention measurements included objective structured clinical examination, workload profile self-assessment scale and student satisfaction and self-confidence scale. The intervention group demonstrated significant improvements in knowledge, skills and attitudes (p < 0.001), with higher objective structured clinical examination scores (p < 0.001) and lower cognitive load (p = 0.020) than the control group. No significant differences were found between the groups in self-assessed violence management skills, attitudes, learning confidence and satisfaction (p > 0.05). The virtual simulation experiment for early intervention in psychiatric violence outperformed offline scenario simulation in enhancing nursing undergraduates' early intervention skills and knowledge retention, with lower cognitive load. •Study compared virtual simulation with scenario simulation for nursing students' early intervention in psychiatric violence.•Virtual simulation outperformed scenario simulation by improving knowledge and skills while reducing cognitive load.•A one-month follow-up revealed that virtual simulation better promotes knowledge retention compared to scenario simulation.

Background Debriefing is the essential element of simulation teaching. Peer-led structured debriefing simulations could be a suitable approach because of the peers’ similarity in age and experience to the students. The purpose of this study was to compare the teaching effectiveness of peer-led debriefing versus instructor-led debriefing in high-fidelity simulation scenarios. Methods The study used a mixed-method approach, integrating quasi-experimental and qualitative components. A total of 88 third-year nursing students were randomly distributed into the instructor-led or peer-led group, with equal sample sizes in both cohorts. The study compared knowledge acquisition, simulation performance, student satisfaction and self-confidence in learning, and debriefing experience between the two groups. In addition, interviews were conducted with students in the peer-led group after the course. Results The scores of students’ simulation performance scale were higher in the peer-led group than in the instructor-led group, and both groups made significant gains in knowledge. The peer-led group and instructor-led group demonstrated similar performance in terms of knowledge, simulated performance, reporting experience, student satisfaction, and learning confidence. The semi-structured interview results indicated that students in the peer-led group expressed approval of peer facilitators. Conclusions Our study demonstrated that students in the peer-led group showed better performance in the simulation, and both groups demonstrated improved knowledge. Thus, with the premise of peers receiving training, the peer-led simulation teaching method can be regarded as a supplementary strategy for simulation teaching to enrich the form of simulation teaching and improve the effectiveness of simulation teaching.

To compare the effectiveness of high- and low-fidelity simulation, combined with theoretical foundations, in acquiring theoretical and practical knowledge, as well as in self-perceived gains from simulation. The administration of medication to critically ill patients is a complex and high-risk process that requires specialized knowledge and vigilance to prevent medication errors. In response, educational interventions have been widely implemented to enhance patient safety, with simulation-based education emerging as a key strategy. Randomized clinical trial, based on the CONSORT guidelines for simulation studies. Sixty nursing students were randomly assigned to either the experimental group (high-fidelity simulation) or the control group (low-fidelity simulation). Both groups received theoretical instruction, followed by simulation exercises. The study assessed theoretical knowledge, perceived gains from the simulation, practical performance and the evaluation of the simulation design. The study found significant improvements in theoretical knowledge and perceived gains in both groups, with the experimental group showing more substantial progress. Interestingly, practical performance was higher in the low-fidelity group. No significant differences were observed in the evaluation of the simulation design between the two groups. Both high- and low-fidelity simulations are effective in nursing education, though their impacts vary. High-fidelity simulations are more effective for enhancing theoretical understanding, while low-fidelity simulations tend to improve immediate practical skills.

Background Education in nursing has noticed a positive effect of simulation-based education. There are many studies available on the effects of simulation-based education, but most of those involve a single institution, nonrandomized controlled trials, small sample sizes and subjective evaluations of the effects. The purpose of this multicenter randomized controlled trial was to evaluate the effects of high-fidelity simulation, computer-based simulation, high-fidelity simulation combined with computer-based simulation, and case study on undergraduate nursing students. Methods A total of 270 nursing students were recruited from five universities in China. Participants were randomly divided into four groups at each institution: the high-fidelity simulation group, the computer-based simulation group, the high-fidelity simulation combined with computer-based simulation group, and the case study group. Finally, 239 participants completed the intervention and evaluation, with 58, 67, 57, and 57 participants in each group. The data were collected at three stages: before the intervention, immediately after the intervention, and three months after the intervention. Results The demographic data and baseline evaluation indices did not significantly differ among the four groups. A statistically significant difference was not observed between the four methods for improving knowledge, interprofessional collaboration, critical thinking, caring, or interest in learning. While skill improvement differed significantly among the different groups after the intervention ( p  = 0.020), after three months, no difference was observed ( p  = 0.139). The improvement in skill in the computer-based simulation group was significantly lower at the end of the intervention than that in the high-fidelity simulation group ( p  = 0.048) or the high-fidelity simulation combined with computer-based simulation group ( p  = 0.020). Conclusions Nursing students benefit equally from four methods in cultivating their knowledge, interprofessional collaboration, critical thinking, caring, and interest in learning both immediately and over time. High-fidelity simulation and high-fidelity simulation combined with computer-based simulation improve skill more effectively than computer-based simulation in the short term. Nursing educators can select the most suitable teaching method to achieve the intended learning outcomes depending on the specific circumstances. Trial registration This clinical trial was registered at the Chinese Clinical Trial Registry (clinical trial number: ChiCTR2400084880, date of the registration: 27/05/2024).

Background Empathy and communication are critical abilities for nursing students, and in recent years, scenario-based teaching has played a crucial role in fostering empathy and professional skill development. However, novice nursing students in basic nursing education often lack prior experience in patient communication, making it challenging for them to prepare adequately for scenarios and effectively handle difficulties in real-life situations. This deficiency also hampers participants’ or observers’ ability to engage in deep reflection, feedback, and learning. Consequently, students frequently experience anxiety in patient communication, and the effectiveness of empathy building remains limited. The aim of the study was to use empathy mapping and mini-simulation in learning to enhance nursing students’ empathy and self-confidence in communication. Methods A prospective quasi-experimental research design was employed, targeting second-year students in the four-year nursing program at our institution, specifically in the Basic Nursing and Experimentation II class. The students were randomly divided into two groups: an experimental group and a control group, with a total of 98 students (52 in the experimental group and 46 in the control group). The experimental group received instruction using empathic communication digital materials and engaged in empathy mapping exercises, while the control group underwent conventional scenario-based teaching. Pre-test and post-test data were collected from both groups. Results A total of 98 students participated in the study, with 46 students in the control group and 52 students in the experimental group. The average age of the participants was 19.19 ± 0.53 years, with a predominance of females (82.7%). At the end of the semester, there was no significant difference in the average empathy levels between the two groups. However, the communication confidence levels of students in the control group (40.20 ± 6.54) were significantly lower than those in the experimental group (43.88 ± 6.35) ( P  = 0.006). Conclusions This teaching approach facilitated deeper and broader student learning, enhancing both empathy and communication confidence. The teaching materials developed in this study can be employed in future courses to teach empathy and patient communication effectively.

Background Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necessary to detect patient deterioration. Methods In a prospective multicenter study, and after consent, 2nd year nursing students were randomized into two groups: Simulation by gaming “SG”: the student played individually with a serious game consisting of 2 cases followed by a common debriefing with an instructor; Traditional Teaching “TT”: the student worked on the same cases in text paper format followed by a traditional teaching course with a PowerPoint presentation by an instructor. CR skill was measured by script concordance tests (80 SCTs, score 0–100) immediately after the session (primary outcome) and on month later. Other outcomes included students’ satisfaction, motivation and professional impact. Results One hundred forty-six students were randomized. Immediately after training, the SCTs scores were 59 ± 9 in SG group ( n  = 73) and 58 ± 8 in TT group ( n  = 73) ( p  = 0.43). One month later, the SCTs scores were 59 ± 10 in SG group ( n  = 65) and 58 ± 8 in TT group ( n  = 54) ( p  = 0.77). Global satisfaction and motivation were highly valued in both groups although significantly greater in the SG group ( p  < 0.05). The students declared that the training course would have a positive professional impact, with no difference between groups. Conclusions In this study assessing nursing student CR to detect patient deterioration, no significant educational difference (SCT), neither immediate nor 1 month later, was observed between training by SG and the TT course. However, satisfaction and motivation were found to be greater with the use of SG. Trial registration ClinicalTrials.gov; NCT03428269 . Registered 30 january 2018.