Effects of NICU Scenario-Based Simulation on Nursing Students' Perceived Stress, Satisfaction, Self-Confidence, and Learning: A Mixed-Methods Study
12 juin 2026 mis à jour par: 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.
Aperçu de l'étude
Statut
Actif, ne recrute pas
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Interventionnel
Inscription (Réel)
18
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Ankara, Turquie (Türkiye), 06830
- Atılım University Faculty of Health Sciences, Department of Nursing Simulation Laboratory
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Oui
La 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
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Autre
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: 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.
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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.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Perceived Stress Scale for Nursing Students Score
Délai: Baseline (before simulation) and immediately after debriefing
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Pre- and post-simulation total scores on the Perceived Stress Scale for Nursing Students measuring students' perceived stress levels during clinical training
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Baseline (before simulation) and immediately after debriefing
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Simulation-Based Learning Evaluation Scale Score
Délai: Immediately after debriefing
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Post-simulation total score on the Simulation-Based Learning Evaluation Scale measuring nursing process, patient safety, professional knowledge, communication, and reflective behavior
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Immediately after debriefing
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Student Satisfaction and Self-Confidence in Learning Scale Score
Délai: Immediately after debriefing
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Post-simulation total score measuring students' satisfaction and self-confidence following simulation-based education
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Immediately after debriefing
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Simulation Experience - Qualitative Findings
Délai: Immediately after debriefing
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Themes emerging from semi-structured focus group interviews exploring students' perceptions of stress, self-confidence, communication skills, teamwork, and learning during NICU simulation
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Immediately after debriefing
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Didem Yüksel, PhD, Atılım University, Faculty of Health Sciences, Department of Nursing
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Shi Z, Li X, Hu Y, Yang R, Zeng Z, Hou S. Barriers and facilitators to the implementation of the kangaroo mother care in NICUs of high-income and low- and middle-income countries: a scoping review. Front Public Health. 2026 Jan 12;13:1701738. doi: 10.3389/fpubh.2025.1701738. eCollection 2025.
- Salifu DA, Christmals CD, Reitsma GM. Frameworks for the design, implementation, and evaluation of simulation-based nursing education: A scoping review. Nurs Health Sci. 2022 Sep;24(3):545-563. doi: 10.1111/nhs.12955. Epub 2022 Jun 6.
- Masten M, Sommerfeldt S, Gordan S, Greubel E, Canning C, Lioy J, Chuo J. Evaluating Teamwork in the Neonatal Intensive Care Unit: A Survey of Providers and Parents. Adv Neonatal Care. 2019 Aug;19(4):285-293. doi: 10.1097/ANC.0000000000000604.
- Karaca, A., Yıldırım, N., Ankaralı, H., Açıkgöz, F. ve Akkuş, D. (2015). Hemşirelik Öğrencileri İçin Algılanan Stres, Biyo-Psiko-Sosyal Cevap ve Stresle Başetme Davranışları Ölçeklerinin Türkçe'ye uyarlanması. Psikiyatri Hemşireliği Dergisi, 6(1), 15-25.
- Eyikara, E., & Baykara, Z. G. (2017). The Importance of Simulation in Nursing Education. World Journal on Educational Technology: Current Issues, 9(1), 2-7.
- Decataldo A, Lauritano G, Paleardi F. The fragile dialogue: communication barriers, authority and adaptive strategies in NICU parent-healthcare worker relationships. Front Sociol. 2025 Nov 26;10:1683833. doi: 10.3389/fsoc.2025.1683833. eCollection 2025.
- Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). Sage Publications.
- Bry A, Wigert H, Bry K. Need and benefit of communication training for NICU nurses. PEC Innov. 2023 Feb 14;2:100137. doi: 10.1016/j.pecinn.2023.100137. eCollection 2023 Dec.
- Bilyk, A. (2024). The Lived Experience of Parents with Newborns in the Neonatal Intensive Care Unit (NICU): A Heuristic Inquiry (Doctoral dissertation, Walden University).
- Andretta, V., Cerrone, V., Strini, V., & Prendin, A. (2025). Family-centered care in pediatric and neonatal intensive care units: A systematic review. Patient Experience Journal, 12(2), 76-82. https://pxjournal.org/journal/vol12/iss2/14/
- Zebreski L, Bloodgood K, Wyble K. Preparing Neonatal Nurses for Improved Performance, Professional Development, and National Certification Through Simulation. Adv Neonatal Care. 2022 Aug 1;22(4):E131-E136. doi: 10.1097/ANC.0000000000000946. Epub 2021 Oct 12.
- Yousef N, Moreau R, Soghier L. Simulation in neonatal care: towards a change in traditional training? Eur J Pediatr. 2022 Apr;181(4):1429-1436. doi: 10.1007/s00431-022-04373-3. Epub 2022 Jan 12.
- World Health Organization. (2025). Kangaroo mother care: Clinical practice guide. https://www.who.int/publications/m/item/kangaroo-mother-care--a-clinical-practice-guide
- Welikala, D., & Xavier, M. (2023). Student Nurses Experiences of Learning in Clinical Placement in NICU: a descriptive literature review. (Bachelor's Thesis, Metropolia University of Applied Sciences).
- Uslu, Y. (2020). Simülasyona Dayalı Öğrenmenin Değerlendirilmesi Ölçeği: Türkçe Geçerlilik ve Güvenilirlik Çalışması•. Journal of Education & Research in Nursing/Hemşirelikte Eğitim ve Araştırma Dergisi, 17.
- Tajik F, Mahmoodi M, Azodi P, Jahanpour F. Nurse-mother communication and support: Perceptions of mothers in neonatal units. Heliyon. 2024 Apr 6;10(8):e29325. doi: 10.1016/j.heliyon.2024.e29325. eCollection 2024 Apr 30.
- Siva, N., Nayak, B. S., Lewis, L. E. S., Velayudhan, B., & Noronha, J. A. (2025). Intervention strategies to enhance early mother-infant interaction at NICU-A systematic review. Journal of Neonatal Nursing, 31(3), 101671.
- Rodrigues SM, Shin SS, Pinto MD, Bounds DT, Terry J, Burton CW. Parenting Expectations, NICU Experiences, and Maternal Psychological Outcomes: An Exploratory Mixed-Methods Study. Adv Neonatal Care. 2024 Apr 1;24(2):195-207. doi: 10.1097/ANC.0000000000001139. Epub 2024 Jan 12.
- Phuwayanon S, Healy M, Boyle B. Diverse Parental Experiences of Kangaroo Care in Neonatal Units Across Healthcare Systems: A Meta-Synthesis. J Adv Nurs. 2026 Mar;82(3):1901-1927. doi: 10.1111/jan.17058. Epub 2025 May 19.
- Osborne AD, Worsley D, Cullen C, Martin A, Christ L. Enhancing NICU Care and Communication: Perspectives of Moderately Preterm Infant Parents. Pediatrics. 2024 Jun 1;153(6):e2023064419. doi: 10.1542/peds.2023-064419.
- Neugebauer C, Oh W, McCarty M, Mastergeorge AM. Mother-Infant Dyadic Synchrony in the NICU Context. Adv Neonatal Care. 2022 Apr 1;22(2):170-179. doi: 10.1097/ANC.0000000000000855. Epub 2021 Mar 30.
- Karacay, P. Kaya, H. (2017). Simülasyonla eğitimde kullanılan "Öğrenci Memnuniyeti ve Öğrenmede Kendine Güven Ölçeği"nin Türkçeye uyarlanması. Florence Nightingale Hemşirelik Dergisi, 25(2), 95-103.
- Guttmann KF, Raviv GN, Fortney CA, Ramirez M, Smith CB. Parent Perspectives on Communication Quality in the Neonatal Intensive Care Unit. Adv Neonatal Care. 2024 Aug 1;24(4):382-388. doi: 10.1097/ANC.0000000000001178. Epub 2024 Jul 8.
- Gong Z, He J, Zhang L. The effects of short- and long-duration Kangaroo Mother Care and conventional care on improving weight gain in low birth weight infants: a systematic review and meta-analysis. BMC Pediatr. 2025 Nov 10;25(1):918. doi: 10.1186/s12887-025-06267-3.
- Garg D, Chaudhury S, Saldanha D, Kumar S. Stress, postpartum depression, and anxiety in mothers of neonates admitted in the NICU: A cross-sectional hospital-based study. Ind Psychiatry J. 2023 Jan-Jun;32(1):48-58. doi: 10.4103/ipj.ipj_93_22. Epub 2022 Dec 9.
- Bonnot Fazio S, Dany L, Dahan S, Tosello B. Communication, information, and the parent-caregiver relationship in neonatal intensive care units: A review of the literature. Arch Pediatr. 2022 Jul;29(5):331-339. doi: 10.1016/j.arcped.2022.05.013. Epub 2022 May 27.
- Hwa GG, Avoli M. Cesium potentiates epileptiform activities induced by bicuculline methiodide in rat neocortex maintained in vitro. Epilepsia. 1991 Nov-Dec;32(6):747-54. doi: 10.1111/j.1528-1157.1991.tb05529.x.
- Chae S, Shon S. Effectiveness of simulation-based interprofessional education on teamwork and communication skills in neonatal resuscitation. BMC Med Educ. 2024 May 31;24(1):602. doi: 10.1186/s12909-024-05581-1.
Liens utiles
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
18 mai 2026
Achèvement primaire (Estimé)
12 juin 2026
Achèvement de l'étude (Estimé)
12 juin 2026
Dates d'inscription aux études
Première soumission
12 juin 2026
Première soumission répondant aux critères de contrôle qualité
12 juin 2026
Première publication (Réel)
17 juin 2026
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
17 juin 2026
Dernière mise à jour soumise répondant aux critères de contrôle qualité
12 juin 2026
Dernière vérification
1 juin 2026
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- E-59394181-100-137319
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
NON
Description du régime IPD
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.
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .