Experimental Group 1 (High-Fidelity Simulation Group):

Nursing students in this group will receive training using a high-fidelity (high-reality) simulator. The simulation scenario will be conducted in a fully immersive environment designed to closely replicate clinical conditions.

Experimental Group 2 (Hybrid Simulation Group):

Nursing students in this group will be trained using a hybrid simulation model that combines simulation-based applications with additional instructional components.

Control Group (Routine Skills Training Group):

Students in the control group will receive traditional skills training using a standard skills mannequin as part of routine laboratory practice.

It is life-sized and allows for the application of different patient scenarios, simulating eye blinking, pupil reaction, speech sounds, normal and abnormal respiratory and heart sounds, enabling the measurement of normal and abnormal vital signs (oxygen saturation, respiration, pulse, blood pressure, body temperature), allowing for peripheral venous catheterization and bladder catheterization, featuring movable head and chin, a flexible mouth structure for insertion of the endotracheal tube, and facilitating aspiration procedures.

How do different simulation methods affect students' knowledge levels regarding tracheal aspiration procedure? The Tracheal Aspiration Knowledge Test is a 20-item assessment tool developed by researchers based on the literature.

Is there a significant difference in students' tracheal aspiration skill levels between applications performed with a high-fidelity simulator, a hybrid simulator, and a skill dummy? The Tracheal Aspiration Skills Checklist consists of three sections: pre-aspiration, implementation, and post-procedure evaluation. Each step is scored as "performed correctly" (2 points), "performed incompletely/incorrectly" (1 point), or "not performed" (0 points).

How do different simulation methods affect students' satisfaction and self-confidence levels regarding tracheal aspiration procedures? This scale measures students' satisfaction and self-confidence in learning within a simulation environment. It consists of a total of 12 items. Each item is rated on a five-point Likert scale, where 1 represents the lowest score and 5 represents the highest score.

The scale consists of two sections. The first section evaluates whether the best practice simulation design elements were implemented during the simulation, while the second section assesses the degree to which the simulation experience is important for students. The scale includes five subscales and a total of 20 items. Each item is evaluated in two ways. In the first section, responses range from "Strongly Disagree," "Disagree," "Undecided," "Agree," "Strongly Agree," to "Not Applicable." In the second section, which measures the importance of the simulation for students, responses range from "Not Important," "Somewhat Important," "Undecided," "Important," to "Very Important."