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Effects of Simulation Fidelity on Patient-Centered Care Competency, Empathy, and Learning Outcomes in Nursing Students: A Randomized Controlled Trial

NCT07637136 — Not applicable, Active not recruiting, 45 participants, Atılım University

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The Effect of Perceived Patient Fidelity on Patient-Centered Care Competency, Empathy, Learning Self-Confidence, and Satisfaction in Simulation-Based Nursing Education: A Randomized Controlled Trial

RegistryNCT07637136
StatusActive not recruiting
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, other
Enrollment45 (Estimated)
SponsorAtılım University (Other)
ConditionsNursing Education, Simulation Based Learning, Patient-centered Care, Empathy, Nursing Students
InterventionsSimulation-Based Nursing Education (Behavioral)
Datesstart 2026-05-12, primary completion 2026-07-30 (estimated), completion 2026-07-30 (estimated), first posted 2026-06-09, last updated 2026-06-09
Locations1 site in Turkey (Türkiye)

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-Summary

This randomized controlled trial examines the effects of simulation fidelity on nursing students' patient-centered care competency, empathy, learning self-confidence, and satisfaction. Participants will be randomly assigned to two groups: one group will practice with a standardized patient (actor) and the other with a manikin in a myocardial infarction scenario. All sessions will follow the same structured simulation protocol including briefing, simulation, and debriefing phases. The study aims to provide evidence on whether the type of simulated patient affects learning outcomes in nursing education.

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+Detailed description

Simulation-based education is widely used in nursing training to develop clinical competency in safe environments. The fidelity of simulation particularly whether a standardized patient or a manikin is used may influence the realism of the experience and subsequently affect learning outcomes. However, evidence comparing these two modalities on patient-centered care competency, empathy, and learning outcomes remains limited.

This study will be conducted at Atılım University School of Health Sciences Nursing Skills Laboratory in Ankara, Turkey. Second, third, and fourth-year nursing students who have completed the Internal Medicine Nursing course.

Eligible participants will be randomly assigned. The Standardized Patient Group (experimental) will practice a myocardial infarction nursing care scenario with a trained actor portraying the patient. The Manikin Group (active comparator) will perform the same scenario using a high-fidelity manikin. Both groups will follow an identical structured simulation protocol consisting of three phases: education and briefing (45 minutes), simulation (10-15 minutes), and debriefing (20 minutes).

A semi-structured perceived reality interview will be conducted with the standardized patient group following the simulation. Data will be collected using four instruments: the Patient-Centered Care Competency Scale, the Jefferson Empathy Scale, the Student Satisfaction and Self-Confidence in Learning Scale, and a Descriptive Information Form. All instruments will be administered immediately after the simulation session.

Each group will have at least 20 participants. Data will be analyzed using independent samples t-test or Mann-Whitney U test depending on normality of distribution.

+Arms and interventions

ArmTypeInterventionsDescription
Standardized Patient GroupExperimentalBehavioral: Simulation-Based Nursing EducationParticipants in this group will perform a myocardial infarction nursing care scenario with a trained actor portraying the patient in a standardized patient simulation.
Manikin GroupActive comparatorBehavioral: Simulation-Based Nursing EducationParticipants in this group will perform the same myocardial infarction nursing care scenario using a high-fidelity manikin simulation.
  • Simulation-Based Nursing Education (Behavioral): A structured simulation protocol consisting of education and briefing (45 min), simulation (10-15 min), and debriefing (20 min) phases applied to both groups. The standardized patient group uses a trained actor; the manikin group uses a high-fidelity manikin in an identical myocardial infarction scenario.

+Outcome measures

Primary outcomes

  • Patient-Centered Care Competency Scale Score [Immediately after the simulation session]: Total score obtained from the Patient-Centered Care Competency Scale measuring nursing students' competency in providing patient-centered care
  • Jefferson Scale of Empathy Score [Immediately after the simulation session]: Total score obtained from the Jefferson Scale of Empathy measuring nursing students' empathy levels toward patients

Secondary outcomes

  • Student Satisfaction and Self-Confidence in Learning Scale Score [Immediately after the simulation session]: Total score obtained from the Student Satisfaction and Self-Confidence in Learning Scale measuring students' satisfaction and self-confidence following simulation
  • Perceived Reality of Simulation [Immediately after the simulation session]: Semi-structured interview responses assessing students' perceived realism of the simulation experience

+Eligibility

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Second, third, and fourth year undergraduate nursing students at Atılım University School of Health Sciences
* Successfully completed the Internal Medicine Nursing course
* Willingness to participate voluntarily and providing written informed consent

Exclusion Criteria:

* Did not complete the informed consent form
* Withdrawal of consent at any point during the study

+Locations (1)

FacilityCityCountryStatus
Atilim University, Faculty of Health Sciences, Nursing Skills LaboratoryAnkaraTurkey (Türkiye)

+Publications

  • Results publication: Kim J, Park JH, Shin S. Effectiveness of simulation-based nursing education depending on fidelity: a meta-analysis. BMC Med Educ. 2016 May 23;16:152. doi: 10.1186/s12909-016-0672-7. PMID 27215280
  • Results publication: Britz V, Sterz J, Koch Y, Schreckenbach T, Stefanescu MC, Zinsser U, Verboket RD, Sommer K, Ruesseler M. Impact of simulated patient-based communication training vs. real patient-based communication training on empathetic behaviour in undergraduate students - a prospective evaluation study. BMC Med Educ. 2024 Aug 12;24(1):870. doi: 10.1186/s12909-024-05801-8. PMID 39134984
  • Results publication: Karaçay, Pelin, and Hatice Kaya. "Simulasyonla Egitimde Kullanilan Ogrenci Memnuniyeti ve Ogrenmede Kendine Guven Olcegi'nin Turkce'ye Uyarlanmasi/The Turkish Adaptation of the Student Satisfaction and Self-Confidence Learning Scale Used in Simulation Education." Florence Nightingale Journal of Nursing 25.2 (2017): 95-104.
  • Results publication: Yanik, Aygül, and Sefa Saygili. "Validity and reliability of the Turkish version of jefferson scale of empathy for nursing students." Turkiye Klinikleri Journal of Medical Sciences 34.1 (2014): 111-119.
  • Results publication: Saygılı, Meltem, Ahmet Kar, and Özgür Uğurluoğlu. "Hasta merkezli bakım yetkinlik ölçeği: Türkçe geçerlilik ve güvenilirlik çalışması." Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi 11.4 (2020): 416-426.
  • Results publication: Akpinar Soylemez B, Ozgul E, Akyol MA, Kucukguclu O. Effectiveness of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults: A systematic review and meta-analysis. Nurse Educ Pract. 2024 May;77:103990. doi: 10.1016/j.nepr.2024.103990. Epub 2024 May 7. PMID 38733958
  • Results publication: Cant RP, Cooper SJ. Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Educ Today. 2017 Feb;49:63-71. doi: 10.1016/j.nedt.2016.11.015. Epub 2016 Nov 22. PMID 27902949
  • Results publication: Shin S, Park JH, Kim JH. Effectiveness of patient simulation in nursing education: meta-analysis. Nurse Educ Today. 2015 Jan;35(1):176-82. doi: 10.1016/j.nedt.2014.09.009. Epub 2014 Oct 29. PMID 25459172

+Investigators

  • ECEM OZGUL, PhD, Principal investigator, Atilim University School of Health Sciences, Department of Nursing

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