Simulation Education and Clinical Practice on Nursing Students' Competence

NCT07250451 | Completed

• 1 other identifier: DU-AE-01
• Study Type: interventional
• Target: 94
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to determine the effect of integrated education, combining clinical practice and simulation laboratory training, on the competence of second-year undergraduate nursing students. This research is designed as a multi-crossover quasi-experimental randomized controlled study. In this model, all groups were exposed to simulation training sessions in specific stages. This design is currently used in the clinical practice component of the Surgical Nursing course. Additionally, the researchers aimed to answer the question: "What is the most appropriate timing for simulation training to enhance nursing students' competence?" During the clinical practice of the Surgical Diseases Nursing course, approximately 29-33 students participated in the simulation laboratory sessions, while about 61-65 students were involved in clinical field practice. For the simulation sessions, subgroups consisting of 4-5 students were formed. After each subgroup completed the simulation practice, a debriefing session was conducted. Each simulation scenario and related training lasted approximately half a day.

Conditions

Health Knowledge, Attitudes, Practice

Keywords

nursing education; Simulation practice; nursing students

Outcome Measures

Primary Outcomes (2)

• Nursing Competence

  The primary outcome is the level of nursing competence of second-year undergraduate nursing students, measured using a validated Nursing Competence Scale. Competence assessment includes clinical skills, decision-making, and ability to apply theoretical knowledge in simulation and clinical practice settings.

  up to 12 weeks

• Simulation Learning

  Learning outcomes specific to simulation sessions were assessed using the Simulation Learning Evaluation Scale. This scale measures students' understanding, performance, and ability to apply skills in the simulated environment. Administered to each laboratory subgroup after simulation.

  up to 12 weeks

Secondary Outcomes (1)

• Demographic Data

  Baseline (pre-intervention)

Study Arms (3)

Simulation-First Hybrid Training

EXPERIMENTAL

Students in Simulation-First Hybrid Training participated in four days of simulation-based training followed by eight days of clinical practice. Simulation sessions were conducted in subgroups of 4-5 students, followed by debriefing sessions. Clinical practice was conducted in hospital settings under faculty supervision.

Other: Educational/training

Clinical Practice-Simulation-Clinical Practice (Integrated Training)

EXPERIMENTAL

Students in Clinical Practice-Simulation-Clinical Practice (Integrated Training) first completed four days of clinical practice, then four days of simulation-based training, followed by an additional four days of clinical practice. Simulation and clinical practice sessions were conducted as described for Simulation-First Hybrid Training.

Other: Educational/training

Clinical Practice-First Training Followed by Simulation

EXPERIMENTAL

Students in Clinical Practice-First Training Followed by Simulation completed eight days of clinical practice, followed by four days of simulation-based training. Simulation and clinical practice sessions were conducted as described for Simulation-First Hybrid Training.

Other: Educational/training

Interventions

Educational/training OTHER

Simulation-First Hybrid Training - Simulation → Clinical Practice: Students first participated in four days of simulation in subgroups of 4-5, using low-fidelity mannequins for scenarios such as colorectal surgery care, subdural hematoma, BPH surgery, coronary bypass, femur fracture, and total laryngectomy. Prebriefing and debriefing (GAS method) were conducted. This was followed by eight days of clinical practice under faculty supervision. Clinical Practice-Simulation-Clinical Practice (Integrated Training) - Clinical Practice → Simulation → Clinical Practice: Students completed four days of clinical practice, four days of simulation as above, then four additional clinical practice days. Clinical Practice-First Training Followed by Simulation - Clinical Practice → Simulation: Students completed eight days of clinical practice followed by four days of simulation. Simulation sessions and clinical practice were conducted under faculty supervision.

Clinical Practice-First Training Followed by Simulation; Clinical Practice-Simulation-Clinical Practice (Integrated Training); Simulation-First Hybrid Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Undergraduate nursing students enrolled in the second year of the program
• Willing to participate in the study

You may not qualify if:

• Students under 18 years of age
• Students who do not provide voluntary consent

Sponsors & Collaborators

• Duzce University: lead

Study Sites (1)

Duzce University

Düzce, 81000, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Behavior

Interventions

Training Support

Intervention Hierarchy (Ancestors)

Financial Support; Economics; Health Care Economics and Organizations

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: This study was conducted as an open-label educational intervention. Neither participants nor researchers were blinded to group assignment due to the nature of the simulation and clinical training interventions. Data were entered into a statistical program and analyzed by an expert statistician who was blinded to group allocation.
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: This study used a quasi-experimental, randomized, crossover design. All groups were exposed to both simulation-based training and clinical practice in different sequences. Each student participated in both intervention conditions at different time points, allowing within-subject comparison of competence outcomes. The study used a quasi-experimental, randomized, crossover design. After obtaining written consent, students who agreed to participate were stratified by gender and randomly assigned to one of three groups (A, B, or C) by a blinded faculty member to avoid allocation bias. Group A: Participated in four simulation days followed by eight clinical practice days. Group B: Completed four clinical practice days, then four simulation days, and finally four additional clinical practice days. Group C: Completed eight clinical practice days followed by four simulation days.

Study Record Dates

• First Submitted: November 18, 2025
• First Posted: November 26, 2025
• Study Start: January 15, 2024
• Primary Completion: June 15, 2024
• Study Completion: August 15, 2024
• Last Updated: November 26, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)