Simulation-based Pediatric Nursing Laboratory Education

The Effects of Simulation-based Pediatric Nursing Laboratory Education on Nursing Students' Clinical Competence, Self-efficacy, and Anxiety: A Randomized Controlled Trial

This study aimed to examine the effect of a simulation-based laboratory program in the pediatric nursing course on students' pediatric nursing competency levels and their levels of clinical anxiety and comfort.

Study Overview

• Status: Completed
• Conditions: Nursing Education Research; Simulation-based Learning
• Intervention / Treatment: Other: Simulation based education; Other: classic education

Detailed Description

Student nurses experience significant anxiety and concern in clinical practice. Particularly in the clinical application of pediatric nursing courses, students are more worried about harming children or making mistakes when calculating medication dosages. It is essential to enhance students' self-confidence in pediatric nursing, support them in acquiring competencies specific to the field, and foster their teamwork skills. Simulation, an innovative interactive method in nursing education, provides students with a realistic learning environment where they experience real-life situations through scenarios, offering opportunities to develop their cognitive, psychomotor, and behavioral knowledge and skills.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Atakum
    • Samsun, Atakum, Turkey (Türkiye), 55200
      • Ondokuz Mayıs University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Being a third-year nursing student,
• Not having previously taken the Pediatric Nursing course,
• Not having practiced in pediatric clinics,
• Not being a graduate of a health vocational high school,
• Volunteering to participate in the study.

Exclusion Criteria:

• Not participating in the laboratory practice,
• Not completing all forms to be used in the study,
• Withdrawing from the study at any stage,
• Working as a nurse.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Simulation based education; Inclusion Criteria: Being a third-year nursing student,; Not having previously taken the Pediatric Nursing course,; Not having practiced in pediatric clinics,; Not being a graduate of a health vocational high school,; Volunteering to participate in the study. Exclusion Criteria: Not participating in the laboratory practice,; Not completing all forms to be used in the study,; Withdrawing from the study at any stage,; Working as a nurse	Other: Simulation based education; Introduction, warm-up, and presentation of the training program (30 min.), taking vital signs in infants and children (45 min.), meeting the hygiene needs of newborns/children (oral care, umbilical cord care, body bathing, perineal cleaning) (45 min.), pediatric nursing care skills (taking blood and urine samples from infants and children, oxygen administration) (45 min.), and pediatric medication preparation and administration skills (oral, IM, IV medication preparation and administration) (45 min.). Each laboratory skill for the course is organized as 45 min of training and a 15-min break. Each skill was demonstrated to students by researchers individually on a simulation model according to cases prepared for simulation within the time allocated to it. Subsequently, the procedures within the case were performed piece by piece by different students under the guidance of a researcher, and feedback was provided on any missing or incorrect points.
Other: Classic education; Inclusion Criteria: Being a third-year nursing student,; Not having previously taken the Pediatric Nursing course,; Not having practiced in pediatric clinics,; Not being a graduate of a health vocational high school,; Volunteering to participate in the study. Exclusion Criteria: Not participating in the laboratory practice,; Not completing all forms to be used in the study,; Withdrawing from the study at any stage,; Working as a nurse	Other: classic education; Introduction, warm-up, and presentation of the training program (30 min.), taking vital signs in infants and children (45 min.), meeting the hygiene needs of newborns/children (oral care, umbilical cord care, body bathing, cleaning the lower body) (45 min.), pediatric nursing care skills (taking blood and urine samples from infants and children, oxygen administration) (45 min.), and pediatric medication preparation and administration skills (oral, IM, IV medication preparation and administration) (45 min.). Each laboratory skill for the course was organized into 45 minutes of instruction and a 15-minute break, using student-centered active learning methods such as lecturing, discussion, video viewing, individual work, question-and-answer sessions, and brainstorming as teaching techniques.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Competence	The primary outcome of the study was perceived pediatric nursing competence. Pediatric Nursing Competency Scale was used for evaluation. Bektas et al. (2000) developed this scale to assess nursing students' competency in pediatric nursing. The scale consists of 39 items across eight subscales. The items on the five-point Likert scale are answered as follows: 1 = strongly disagree, 2 = disagree, 3 = undecided, 4 = agree, 5 = strongly agree. The Cronbach's alpha reliability coefficient was found to be higher than 0.80 for the scale and its subdimensions. The lowest possible score on the scale is 39, and the highest possible score is 195. It is thought that as the score on the scale increases, students' pediatric nursing competence increases (Bektas et al., 2020).	8 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
clinical comfort, anxiety	The secondary outcomes included self-efficacy, clinical comfort, anxiety, and attitudes toward vital signs monitoring. The following tools were used in the study: Vital Signs Scale (V-Scale), developed initially by Mok et al. (2015), was further adapted to Turkish by Ertug (2018) (Ertug, 2018; Mok et al., 2015). Self-Efficacy Scale for Nursing Students in Medication Administration in Children: The scale was developed by Bektaş et al. based on pediatric medication administration guidelines and studies conducted in the literature on medication administration in children by nursing students. Pediatric Nursing Student Clinical Comfort and Anxiety Assessment Tool: Al-Qaaydeh & Lassche Macintosh (2012) first developed this tool to determine the comfort and anxiety levels of nursing students entering the pediatric clinic for the first time (Al-Qaaydeh et al., 2012). Arslan et al. (2018) conducted a study on the validity and reliability of the scale in Turkish.	16 hours

Collaborators and Investigators

• Sponsor: Ondokuz Mayıs University

Publications and helpful links

General Publications

• Al-Qaaydeh, S., Lassche, M., & Macintosh, C. (2012). Exploratory factor analysis of the pediatric nursing student clinical comfort and worry assessment tool. Journal of Pediatric Nursing, 27(5), 39-43. DOI: 10.1016/j.pedn.2012.05.003.
• Akdeniz Kudubes, A., Zengin, H., Ayar, D., Bektas, I., & Bektas, M. (2024). The effect of nursing students' liking of children and attitudes toward clinical practice on their comfort and worry levels in the pediatric clinic. Comprehensive Child and Adolescent Nursing, 47(1), 31-43. DOI: 10.1080/24694193.2023.2269264

Study record dates

Study Major Dates

• Study Start (Actual): April 15, 2024
• Primary Completion (Actual): April 22, 2024
• Study Completion (Actual): May 6, 2024

Study Registration Dates

• First Submitted: December 27, 2025
• First Submitted That Met QC Criteria: March 30, 2026
• First Posted (Actual): April 6, 2026

Study Record Updates

• Last Update Posted (Actual): April 6, 2026
• Last Update Submitted That Met QC Criteria: March 30, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Anxiety; Nursing students; Clinical competence; Simulation-based education; Pediatric nursing education
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: 27.01.2023, 2023-1295

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: other researhers may view the study once it is published.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No