Enhancing Clinical Reasoning Competency for Undergraduate Nursing Students Using Virtual Simulation-based Education based on the Rasch model

We used "vSim® for Nursing - Nursing Medical-Surgical" as the virtual simulation-based education program. Four modules were included: (a) acute myocardial infarction, (b) diabetes mellitus, (c) transfusion, and (4) asthma. Each module learning sessions was conducted based on scenarios, which consisted of five steps: Suggested reading, Pre-simulation quiz, vSim, Post-simulation quiz, and Guide reflection questions. For each module, the intervention was performed for two hours. The participants attended four module learning sessions and received eight hours of training. Debriefing using guided reflection questions were completed in the form of a team reflection, followed by an instructor-learner discussion and feedback for 20 minutes of each module.

The Nurses Clinical Reasoning Scale (NCRS) includes 15 items rated on a five-point Likert scale (1=Strongly disagree, 5=Strongly agree, min:15 & max:75) (Liou et al., 2016). We used the Korean version of the NCRS in this study (Joung & Han, 2017). Higher scores indicated better clinical reasoning. Cronbach's α was 0.94 for the original NCRS, and 0.93 for the Korean version of the NCRS.

The Global Interpersonal Communication Competence Scale (GICC-15) includes 15 items rated on a five-point Likert scale (1= strongly disagree to 5= strongly agree. min:15 & max:75) (Rubin & Martin, 1994). We used the Korean version of the GICC-15 (Hur, 2003). Cronbach's α in Hur's (2003) study was 0.72.