Effects of Nursing Students’ Roles in Simulation-Based Education on Satisfaction, Self-Confidence, Self- Efficacy, and Knowledge Acquisition: A Quasi-Experimental Study

Abstract

The increasing number of learners, combined with the time- and resource-intensive nature of simulation-based learning (SBL), may limit opportunities for active participation. Most existing SBL research has focused on comparing active participants with observers. However, few studies have examined the impact of the ecological organisation of simulation training sessions, including active participants and observers (AP-O) formats versus observer-only formats, on learning outcomes in emergency simulation training. This quasi-experimental study aimed to evaluate the effects of AP-O versus observers-only roles on nursing students’ satisfaction, self-confidence, self-efficacy, and knowledge acquisition during an emergency SBL training session. A total of 69 undergraduate nursing students were randomly assigned to either the AP-O group or observers. All participants completed three emergency simulation scenarios using standardised patients. Data were collected using a multiple-choice questionnaire and three validated scales. Both groups showed significant improvements in knowledge scores after each simulation scenario (p < 0.001). However, no statistically significant differences were found between the AP-O and observer groups in terms of learning satisfaction, self-efficacy, self-confidence, or knowledge acquisition (p > 0.05). These findings suggest that SBL is effective in enhancing students’ learning outcomes and knowledge transfer, regardless of their simulation role.