Effects of simulation-based learning on nursing students' perceived competence, self-efficacy, and learning satisfaction: A repeat measurement method

Background: Simulation-Based Learning is beneficial to nursing education. Nevertheless, recent studies have shown a side effect of being overwhelmed by repeated exposures to simulation. Thus, how many times simulation scenarios should be provided to students remains a question for nursing faculty. Objectives: The objectives of this study were to (1) explore the changes in nursing students' perceived competence, self-efficacy, and learning satisfaction after repeated exposures to simulations, and (2) determine the acceptable frequency of SBL in the 'Integrated Care in Emergency and Critical Care' course. Design: A one-group repeated measurement experimental design with self-administered questionnaires in a convenient sample of senior nursing undergraduate students was used. Settings: Department of Nursing at a nonprofit university in southern Taiwan. Participants: Seventy-nine out of 84 senior nursing students who enrolled in the course in 2019 volunteered to complete all measurements. Methods: After taking the baseline measurements (T0), students were exposed to 75-min simulation scenarios from Time 1 (T1) to Time 3 (T3) three weeks apart throughout the semester. Students' nursing competence, self-efficacy, and learning satisfaction were measured immediately after each exposure. Descriptive statistics, t-test and repeated measurement analysis of variance were used for data analysis. Results: There were statistically significant improvements from T0 to T3 (p < .001) in nursing competence, self-efficacy, and learning satisfaction scores after repeated exposures to simulation. When comparing scores from T1 to T2 and from T2 to T3, there was no significant difference. Conclusion: Simulation based learning is effective in improving nursing students' perceived competence, self-efficacy, and learning satisfaction. While the primary changes occur at the first simulation effort, it is the accumulated multiple exposure experiences collectively improve students' learning outcomes. Multiple instructional strategies besides simulation are recommended to maintain nursing students' learning interests to achieve optimal learning outcomes of the course across a semester.