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Purpose: The purpose of the study was to investigate the satisfaction of paramedic students with simulation-based learning in an emergency intervention for bradycardia patients. Methods: Study participants were 72 paramedic students who experienced simulation-based learning. Data on satisfaction with the intervention were collected and analyzed using SPSS 18.0. Results: The mean satisfaction score for the simulation-based learning intervention was 4.28 by Likert 5 point scale. Conclusion: Simulation-based learning can facilitate adaptation to the scene of an emergency among paramedic students.

Purpose: Nursing students' competence in virtual simulation-based learning is a key factor in its success. This study explored the validity and reliability of a virtual-simulation-based learning competency self-evaluation tool for nursing students. Methods: Data were collected from a web-based survey. First, 11 nursing professors participated in a focus group interview, and 7 simulation education experts participated in the preliminary item content validity. The participants in these two aspects were not the same. Then, a preliminary survey was conducted with 15 fourth-year nursing students in I City. Next, based on these three efforts, a final survey comprising 20 evaluation items was developed. This survey was administered to third- and fourth-year nursing students at four nursing colleges in Korean provinces (Seoul, Gyeonggi, Gangwon, and Gyeongsan-do); 222 complete questionnaires were used for the final analysis. Further, Kirkpatrick’s evaluation model was used for four steps each of tool development and verification processes of the associated psychometric aspects, for a total of eight steps. An exploratory factor analysis was performed on the collected survey data, and verify the tool's validity and reliability. Results: Four factors comprising 15 items explained 66.59% of the variance: learning preparation and start-up (4 items), nursing assessment (3 items), data interpretation (3 items), and problem solving (5 items). The Cronbach's α of the tool was 0.74, and that of the factors ranged from 0.72 to 0.80. Conclusions: The tool's validity and reliability were demonstrated using established methodologies. This tool can be useful for evaluating Korean nursing students' virtual simulation learning competence.

Purpose: Clinical reasoning, which is based on an understanding of the pathophysiological mechanismsof diseases, is a core nursing competency that involves analyzing patient-related data and providingappropriate nursing practices. Simulation-based education is effective in improving clinical reasoningcompetencies and communication skills. This study evaluated the effectiveness of virtual simulation-basedlearning in improving the communication skills and clinical reasoning competencies ofundergraduate nursing students. Methods: This study used a single-group pretest and posttest quasi-experimentaldesign to evaluate the effectiveness of virtual simulation-based learning. Data werecollected from June to September 2020. Thirty-seven nursing students in their third and fourth yearsof study who understood the purpose of this study were selected as participants. The collected datawere analyzed using SPSS Statistics 25.0 and Winsteps 3.68.2. Results: The communication skills (t =?12.80, p < .001) and clinical reasoning competency (t = ?4.67, p < .001) of the undergraduate nursingstudents who participated in the virtual simulation-based learning program improved significantlyafter participation. Additionally, a Rasch model analysis revealed that the overall clinical reasoningcompetency of undergraduate nursing students improved. Conclusion: Virtual simulation-based learningprograms for nursing students should be developed and implemented.

Purpose: Simulation-based education combined with mastery learning is more effective than simulation-based education alone. This study aimed to evaluate its effectiveness with regard to both technical and non-technical skills of simulation-based mastery learning (SBML) in blood transfusion training among undergraduate nursing students. Method: A nonequivalent control group pretest-posttest design was used. Fifty-one second-year students at a college of nursing in W city, South Korea, who had not started clinical practice were selected by convenience sampling and allocated to either the experimental or control group using the zigzag method. SBML program was consisted of a diagnostic test, repeated learning and formative assessments for non-passers. All outcome variables were measured before and after completion of the program. Results: The experimental group showed significantly increased performance scores of blood transfusion as compared to the control group (z=29.50, p<.001), with better outcomes in number of students achieving minimum passing score (χ2 =20.07, p<.001), self-confidence (F=17.68, p<.001), and communication skills (z=166.00, p=.003). Conclusion: This program was effective for undergraduate students to better improvement in performance, self-confidence, and communication skills, which can ensure greater safety in the transfusion. The results suggest that SBML ensures skill acquisition for clinical practice through improved performances in both technical and non-technical skills.

본 연구의 목적은 SIM-PBL이 간호대학생의 정보활용능력, 자기주도적 학습능력, 학업적 효능감에 미치는 효과를 규명하기 위함이다. 대상자는 한국의 일개 대학교 간호학과 4학년 학생 81명이었다. SIM-PBL은 4주 동안, 주 1회(150분) 제공하였고, 교육 전후에 구조화된 설문지를 활용하여 정보활용능력, 자기주도적 학습능력, 학업적 효능감을 조사하였다. 교육 후에 정보활용능력의 하부영역 중 정보통합(p=.030), 정보표현(p=.003) 및 정보윤리(p=.016) 영역의 능력이 향상되었다. 그러나, 자기주도적 학습능력과 학업적 효능감은 교육 후에 변화가 없었다. SIM-PBL은 간호대학생의 정보활용능력을 향 상시키는데 효과적인 교수법임을 확인하였다. 앞으로, 신뢰성 높은 유용한 정보를 윤리적으로 활용할 수 있도록 돕는 SIM-PBL 교육방안이 필요하다.

The objective of this study was to determine the effects of simulation education with problem-based learning (SIM-PBL) on information literacy, self-directed learning ability, and academic self-efficacy of nursing students. The subjects were 81 fourth-year nursing students attending a university in Chungcheongnam-do, Korea. SIM-PBL was provided once per week (150 minutes each) for four weeks, and a structured questionnaire was used to survey information literacy, self-directed learning ability, and academic self-efficacy before and after educational training. After completing the four-week program, abilities in the sub-items of information literacy, such as information integration (p=.030), information expression (p=.003), and information ethics (p=.016) were improved. However, no differences in self-directed learning ability and academic self-efficacy were noted. Findings confirmed that SIM-PBL is an effective teaching method for improving the information literacy of nursing students. Therefore, it is necessary to come up with an SIM-PBL education plan for utilizing reliable and useful information ethically.

This paper discusses the performance of linear regression, regression tree, support vector regression, and ensemble learners in modelling airflow between two spaces based on accuracy and training time. To obtain training data, different scenarios from an existing computational fluid dynamics (CFD) model are simulated via transient analysis using Cradle scSTREAM. The raw dataset is transformed to having time step sizes of 2.5s, 5.0s, and 50.0s. Feature scaling is also employed on the each data set using both min-max scaling and z-score methods for a total of 9 datasets. Hyperparameters according to machine learning (ML) algorithms are varied such that 15 ML models across the four algorithms are developed. The results show that the regression trees perform the best over all other algorithms, with all models maintaining R2 values above 0.95 at the different datasets. On the other hand, as expected, all linear models demonstrated poor performance compared to nonlinear models. Data resolution affects model accuracy and training time, with accuracy declining slightly as time step size increased. It is also found that there is no significant effect of feature scaling. Lastly, ML models yield substantially cheaper simulation costs than CFD to simulate airflow.

Purpose: This study aimed to examine the mediating effect of teamwork on the relationship between immersion in simulations and clinical competency among nursing students. Method: A total of 173 nursing students who participated in simulation-based learning were included. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and PROCESS Macro Model 4. Results: Clinical competency differed significantly according to satisfaction with clinical practice, previous semester’s GPA, major satisfaction, team relationships, level of preparation, and adequacy of pre-orientation. Mean scores were 4.27±0.51 for learning immersion in simulation, 4.53±0.49 for teamwork, and 4.47±0.49 for clinical competency. All the variables showed significant positive correlations. Learning immersion in simulation had both direct and indirect effects on clinical competency through teamwork. Bootstrapping confirms that teamwork partially mediats this relationship. Conclusion: Learning immersion in simulations was significantly associated with clinical competency and teamwork played a significant mediating role. Educational strategies should promote immersion and teamwork to improve clinical competency.

Purpose: The purpose of this study was to investigate the effectiveness of pre-briefing in simulation-based learning on nursing students’ satisfaction with simulation. Method: A quasi-experimental post-test study was applied with 174 senior nursing students at a private university in South Korea. The experimental group (n=88) underwent a pre-briefing program, whereas the control group (n=86) did not. During pre-briefing, students had time to study simulation scenarios, discuss nursing processes related to simulation scenarios, and experience a simulation environment before simulation practice. Satisfaction scores were measured using the Satisfaction with Simulation Experience scale(SSE). Results: The mean scores in satisfaction with simulation were higher in the experimental group than in the control group, and the difference was statistically significant (t=-4.23, p<.001). Conclusion: This study emphasizes that pre-briefing in simulation-based learning is important in increasing students’ satisfaction and should be included in the planning of simulation-based learning programs.

Purpose: This study aimed to examine the effects of simulation-based learning on the critical thinking disposition, communication confidence, and performance confidence in nursing care for children with fever. Methods: A one-group pre- and post-test design was used. A total of 59 nursing students participated. Results: The results of this study showed that the effectiveness of simulation-based learning showed statistically significant improvement in critical thinking disposition, communication confidence and performance confidence. Conclusion: The findings indicate that simulation-based learning in the nursing care of children with fever may be an effective teaching-learning method for nursing students.

This study aimed to develop a simulation-based scenario for pediatric nursing based on Kawasaki disease and to evaluate its impact on nursing students' knowledge, critical thinking disposition, self-efficacy, stress levels, and clinical performance. Methods: The scenario template was developed using the ADDIE model based on the National League for Nursing/Jeffries Simulation Framework. A quasi-experimental, single-group pretest-posttest was used. The study was conducted between March 3 and April 18, 2025, with 64 fourth-year nursing students. Self-report questionnaires were used to assess knowledge, critical thinking disposition, and selfefficacy. Stress was measured using physiological indicators, and clinical performance after the simulation was independently evaluated by both the instructor and researcher. Results: The scenario template required approximately six hours, and the simulation scenario operated for 20 minutes. Evaluation of the simulation`s effectiveness showed significant improvements in knowledge of Kawasaki disease (t=-6.96, p<.001), critical thinking disposition (t=-4.08, p<.001). The average clinical performance score was 64.81±6.61 out of a total of 86 points. Conclusion: The simulation-based learning method using the developed Kawasaki pediatric nursing scenario template was shown to be effective in enhancing clinical performance among nursing students. It may serve as a valuable educational tool for pediatric nursing education and future simulation-based training programs.

Purpose: Improving students’ self-confidence is an important strategy in simulation learning. This study aimed to identify the factors influencing students’ self-confidence in simulation learning based on the Jeffries Simulation Framework. Method: A cross-sectional survey was conducted with 140 senior nursing students’ at a university, and data were collected through self-reported questionnaires. Data on students’ self-confidence were collected for student/ facilitator factors (satisfaction on major, overall grade average, and facilitator satisfaction), educational practice factors (active learning, collaboration, diverse ways of learning and educational goals), and simulation design characteristics factors (objectives/information, support, problem solving, feedback, and fidelity). Data were analyzed using an independent t-test, one-way ANOVA, Pearson’s correlation, and hierarchical multiple regression analysis. Results: The regression model had an adjusted R2 of .61, indicating that education goal, active learning, facilitator satisfaction, and fidelity were significant predictors of students’ self-confidence in simulation learning. Conclusion: To increase students' self-confidence with simulation learning strategies, it is necessary to design lessons that include educational goals, active learning, improved student satisfaction with the facilitator and fidelity based on the Jeffries Simulation Framework.

Purpose: This study aimed to perform an integrated literature review to identify evidence for developing a problem-based learning (PBL) method based on a simulation education program for nursing students. Methods: In May 2022, 10 electronic databases were used to conduct a literature search using the keywords simulation, PBL, nursing, and education in Korean and English. Finally, 21 studies were selected. Results: There were more single-type simulation studies than studies using a hybrid model that combined two simulation types. Most simulation studies were for a single domain of adult nursing rather than for various integrated domains. Four studies (19%) applied a theory during debriefing, but most did not conduct a systematically structured debriefing. All studies selected attitude and competency as the outcome variables to study the effects of the intervention. Two variables (attitude and competency) or three variables (knowledge [or skill], attitude, and competency) were typically selected, and their effects were measured. Conclusion: PBL based on simulation education can be effective in improving nursing practice competency in nursing students. Future studies ought to develop interprofessional education programs based on PBL simulations through multidisciplinary cooperation.

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.

Purpose: This study examines the effects of clinical nursing simulation education program based on problem-based learning (S-PBL) on clinical reasoning, confidence in handover reports, confidence in nursing performance, and simulation effectiveness in nursing students. Method: We used a one-group pretest-posttest design. The participants were 4th-year university nursing students who had taken a core clinical nursing practice, and 90 students participated in the S-PBL program. Data were collected before and after the S-PBL program and analyzed using descriptive statistics and paired t-tests. Results: The S-PBL program significantly increased clinical reasoning, confidence in handover reports, and confidence in nursing performance. More than 90% of students were satisfied with the education program and the simulation education effectiveness was 2.54 on a 3-point Likert scale. Conclusion: The S-PBL program could be useful in clinical nursing education for nursing students seeking to become clinical nurses. It is necessary to develop various S-PBL programs and apply them to the curriculum.

목적 본 연구의 목적은 아동대상자의 수술 후 간호를 주제로 문제기반 학습 연계 시뮬레이션 교육 프로그램(simulation integrated with problembased learning, SIM-PBL) 개발과정을 기술하고, 교육 프로그램이간호대학생의 임상간호 수행능력과 자아 효능감에 미치는 효과를 파악하기 위함이다. 방법 본 연구는 대조군 중재군 전후 시차 설계를 통한 유사 실험 연구이다. 자료수집 기간은 2012년 4월 23일부터 5월 18일까지 총 4주간이었다. 연구대상은 4년제 간호학과의 3학년에 재학 중인 학생을 대상으로아동간호학 임상실습 중인 학생을 편의표집 하였고, 시차를 이용하여대조군 18명, 중재군 18명으로 구성하였다. 대조군에게는 기존 임상실습교육이 제공되고, 중재군에게는 임상실습 시간 중 150분을 SIM-PBL로 대체하였다. SIM-PBL의 효과 평가를 위해 시뮬이션을 기반으로 한임상간호 수행능력 평가(simulation based clinical examination, SCE)와자아효능감이 이용되었다. 결과 SIM-PBL 교육을 받은 중재군은 대조군과 비교하여, 교육 후 임상간호 수행능력의 향상 정도가 일부 영역에서 통계적으로 유의한 차이를보였다(신체검진: 3.019, p =.005; 수술 후 교육: t=2.428, p =.021). 그러나자아효능감은 두 군 사이에 통계적으로 유의한 어떤 차이도 보여주지못하였다. 결론 본 연구에서 사용된 SIM-PBL은 간호대학생들의 아동대상자를 위한 수술 후 간호 및 투약수행에 대한 임상간호 수행능력의 일부 영역을 향상시키는데 효과적이었다. 본 연구는 시뮬레이션 기반 교육과 문제기반학습의 두 가지 교육방법을 혼합하여 교육 프로그램을 구성하였고, 구조화된 체크리스트 도구를 통해 객관적으로 임상간호 수행능력을 평가하였다는 점에 의의가 있으며, 추후 이러한 교육 프로그램의적극적 활용 및 중재의 크기에 따라 효과를 다양하게 입증하는 연구가 수행될 것을 제언한다.

Purpose: This study was conducted to examine the effects of simulation education integrated with problem based learning (SIM-PBL) on clinicalcompetency and self-efficacy in post operation nursing care for children. Methods: This study was a quasi-experimental design. Thirty sixstudents in the third year of a 4-year baccalaureate nursing program were recruited conveniently and assigned to the control or interventiongroups using time difference. Students were all in a pediatric nursing clinical practicum. The control group received the regular clinical practicumin a hospital setting. For the intervention group, a SIM-PBL education replaced 150 minutes of their clinical practicum. Results: The interventiongroup showed greater improvement in two areas of clinical competency compared with the control group; physical assessment (t=3.019, p=.005) and post operation advice (t=2.428, p=.021). However, no statistically significant differences in improvement in any areas ofself-efficacy were found between two groups. Conclusion: The results indicate that the SIM-PBL education is effective in improving some areasof clinical competence, but not self-efficacy in post operation nursing care for children. Further study is needed to develop SIM-PBL programsfor various clinical topics and evaluate the effectiveness on the learning outcomes.

Purpose: This study aimed to development and test the effects of patient safety/infection control simulation program based on a brain-based learning framework for nursing students. Methods: This pilot study used a one group pre-post test design. The study was conducted in one university in Korea. Participants were recruited using a convenience sample. Fifteen nursing students participated in this study. Results: The levels of perception of importance of patient safety management (Z=3.41, p=.001), confidence on patient safety (Z=3.30, p=.001), attitude toward personal protective equipment (Z=3.10, p=.002), and efficacy of personal protective equipment (Z=3.35, p=.001) were significantly increased. Conclusion: The application of brain-based learning framework in nursing simulation could be an effective education for nursing students.

Purpose: This study developed an educational program for structured discussion-based learning, problem-based learning (PBL), and simulation for nursing students. Its effects on learning attitude, problem-solving process, and clinical competence were then analyzed. Methods: This study used a one-group pretest?posttest experimental method among 135 fourth-year nursing students taking the simulation course at a university in D city. We operated the PBL by applying the structured discussion method and simulation education based on four modules covering major diseases among adults. The data collected before and after the program were analyzed using descriptive statistics and paired t-tests. Results: The program significantly improved nursing students’ learning attitude, problem-solving process, and clinical competence. Conclusions: We verified the effects of the simulation education program for structured discussion-based learning and PBL. Further studies are needed to develop and apply simulation educational programs utilizing various devices that can improve learners’ participation and professors’ operational protocols by systematically combining them with different teaching/learning methods.

본 연구는 시뮬레이션 학습에 플립러닝을 적용하여 졸업학년 간호대학생의 실습몰입, 학업자기효능감 및 임상수행 능력에 대한 효과를 검증하기 위하여 시행한 연구이다. 일개 대학의 간호학과 4학년 학생 48명을 연구 대상으로 하였으며, 실습 교육은 2024년 9월부터 12월까지 16주간 진행하였다. 교육 전후로 수집된 자료는 SPSS 22.0 프로그램을 사용하여 분 석을 진행하였다. 연구 결과, 실습 교육 후에 실습몰입(t=-8.280, p=<.001)과 학업자기효능감(t=-2.036, p=.043), 임상수행 능력(t=-6.487, p=<.001)이 유의미하게 향상된 것으로 나타났다. 이러한 결과는 플립러닝 기반 시뮬레이션 실습 교육이 졸업 학년 간호대학생의 실습몰입과 학업자기효능감을 높여 임상수행능력을 향상시키는 효율적인 교육방법임을 확인하였으며, 이 를 바탕으로 다양한 교육과정에 확대하여 적용해 볼 것을 기대한다.

This study aimed to evaluate the effects of applying flipped learning in a simulation-based course on practice immersion, academic self-efficacy, and clinical performance among senior nursing students. A total of 48 fourth-year nursing students from a university participated in the study. The simulation training was conducted over a 16-week period, from September to December 2024. Data were collected before and after the training and analyzed using SPSS version 22.0. The results showed significant improvements in practice immersion (t= -8.280, p< .001), academic self-efficacy (t= -2.036, p= .043), and clinical performance (t= -6.487, p< .001) following the intervention. These results confirm that flipped learning-based simulation practice education is an effective instructional method for enhancing practice immersion and academic self-efficacy, thereby improving clinical performance ability in graduating nursing students. Based on these findings, it is expected that this approach can be expanded and applied to various educational curricula.

Purpose: This study aimed to investigate the impact of implementing team-based learning (TBL) in postpartum nursing simulation practical education for nursing college students. Methods: The study design was a non-equivalent control group pretest-posttest quasi-experimental design. 128 nursing students divided into two groups: 61 in the experiment group and 67 in the control group. During the winter break in January 2023, students participating in simulation practicals were assigned to the control group, while students participating in simulation practicals during the regular semester (April 2023) were assigned to the experimental group, to prevent cross- ontamination between the groups due to experimental treatment. Both groups completed self- dministered questionnaires to assess self-directed learning abilities, collaborative self-efficacy, academic achievement, and learning satisfaction. Results: The experimental group showed significantly better compared to the control group, the experimental group showed higher levels of academic achievement and learning satisfaction. Conclusion: It was evident that TBL applied to postpartum nursing simulation practical education is a pedagogical teaching strategy that enhances academic achievement and learning satisfaction. It is necessary to develop and apply team-based simulation practical education not only for challenging obstetric cases but also for labor and delivery nursing, antepartum nursing, and other related areas in clinical practice.