Effects of NICU Scenario-Based Simulation on Nursing Students' Perceived Stress, Satisfaction, Self-Confidence, and Learning: A Mixed-Methods Study

June 12, 2026 updated by: Atılım University

The Effect of Neonatal Intensive Care Unit Scenario-Based Simulation Training on Nursing Students' Perceived Stress, Learning Satisfaction, Self-Confidence, and Simulation-Based Learning: A Mixed-Methods Study

This mixed-methods study examines the effects of neonatal intensive care unit (NICU) scenario-based simulation training on third-year nursing students' perceived stress, learning satisfaction, self-confidence, and simulation-based learning experiences. All eligible participants will receive a high-fidelity simulation session involving a NICU scenario that includes therapeutic communication with a postpartum mother, neonatal emergency intervention, and support for mother-infant interaction. The simulation protocol consists of prebriefing (3 minutes), environmental orientation (3 minutes), scenario-based simulation (10 minutes), and debriefing using the PEARLS model (30 minutes). Quantitative data will be collected before and after the simulation using validated scales. Qualitative data will be gathered through semi-structured focus group interviews following the simulation. The study aims to provide evidence on the effectiveness of NICU simulation-based education in nursing training.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

Neonatal intensive care units (NICUs) are complex clinical environments requiring advanced technical skills, rapid decision-making, teamwork, and effective communication. Nursing students often face significant challenges in these settings, including stress related to patient acuity, fear of making errors, and difficulties in communicating with emotionally vulnerable parents.

This study will be conducted at Atılım University Faculty of Health Sciences, Nursing Skills Laboratory in Ankara, Turkey. Third-year nursing students who have not yet completed the Child Health and Diseases (NURS302) course will be eligible to participate. The entire third-year cohort (n=18) will be invited to participate; no sampling will be applied.

The study employs a parallel mixed-methods design. The quantitative component uses a single-group pre-post quasi-experimental design. The qualitative component involves semi-structured focus group interviews to explore students' simulation experiences in depth.

The NICU simulation scenario includes three interconnected components: initiating therapeutic communication with a postpartum mother whose preterm infant is admitted to the NICU, performing emergency neonatal intervention during an acute event, and supporting the initiation of mother-infant contact and breastfeeding. The scenario was developed in accordance with the Healthcare Simulation Standards of Best Practice™.

Data collection will occur in three phases. In Phase 1, participants will complete the Student Descriptive Information Form and the Perceived Stress Scale for Nursing Students (pre-test). In Phase 2, the simulation and PEARLS-based debriefing will be conducted, followed by post-test administration of the Perceived Stress Scale, Simulation-Based Learning Evaluation Scale, and Student Satisfaction and Self-Confidence in Learning Scale. In Phase 3, semi-structured focus group interviews will be conducted and audio-recorded with participant consent.

Quantitative data will be analyzed using SPSS 29.0. Qualitative data will be analyzed using MAXQDA through thematic coding. Findings from both components will be integrated during the interpretation phase.

Study Type

Interventional

Enrollment (Actual)

18

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Ankara, Turkey (Türkiye), 06830
        • Atılım University Faculty of Health Sciences, Department of Nursing Simulation Laboratory

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Third-year undergraduate nursing students at Atılım University Faculty of Health Sciences
  • Voluntarily willing to participate and providing written informed consent
  • Have not yet completed the Child Health and Diseases (NURS302) course

Exclusion Criteria:

  • Withdrawal from the study at any stage
  • Incomplete completion of data collection forms

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: NICU Simulation Group
Third-year nursing students who received a high-fidelity NICU scenario-based simulation training including prebriefing, simulation, and PEARLS-based debriefing phases, followed by semi-structured focus group interviews.
Behavioral: NICU Scenario-Based Simulation Training
A structured high-fidelity simulation protocol consisting of prebriefing (3 min), environmental orientation (3 min), NICU scenario-based simulation (10 min), and PEARLS model debriefing (30 min). The scenario includes therapeutic communication with a postpartum mother, neonatal emergency intervention, and support for mother-infant interaction and breastfeeding initiation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived Stress Scale for Nursing Students Score
Time Frame: Baseline (before simulation) and immediately after debriefing
Pre- and post-simulation total scores on the Perceived Stress Scale for Nursing Students measuring students' perceived stress levels during clinical training
Baseline (before simulation) and immediately after debriefing
Simulation-Based Learning Evaluation Scale Score
Time Frame: Immediately after debriefing
Post-simulation total score on the Simulation-Based Learning Evaluation Scale measuring nursing process, patient safety, professional knowledge, communication, and reflective behavior
Immediately after debriefing

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Student Satisfaction and Self-Confidence in Learning Scale Score
Time Frame: Immediately after debriefing
Post-simulation total score measuring students' satisfaction and self-confidence following simulation-based education
Immediately after debriefing
Simulation Experience - Qualitative Findings
Time Frame: Immediately after debriefing
Themes emerging from semi-structured focus group interviews exploring students' perceptions of stress, self-confidence, communication skills, teamwork, and learning during NICU simulation
Immediately after debriefing

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Atılım University

Investigators

  • Principal Investigator: Didem Yüksel, PhD, Atılım University, Faculty of Health Sciences, Department of Nursing

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 18, 2026

Primary Completion (Estimated)

June 12, 2026

Study Completion (Estimated)

June 12, 2026

Study Registration Dates

First Submitted

June 12, 2026

First Submitted That Met QC Criteria

June 12, 2026

First Posted (Actual)

June 17, 2026

Study Record Updates

Last Update Posted (Actual)

June 17, 2026

Last Update Submitted That Met QC Criteria

June 12, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • E-59394181-100-137319

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because the study involves a small sample of nursing students from a single institution, which may increase the risk of participant identification despite de-identification procedures. In addition, the study includes qualitative interview data that may contain information that could potentially compromise participant confidentiality. Only aggregated and anonymized results will be reported in publications and presentations.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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