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This study aims to evaluate the effects of scenario-based simulation training for adolescent leukemia care on nursing students' perceived stress, knowledge level, and learning satisfaction. Nursing students often encounter challenges when managing complex clinical situations involving pediatric oncology patients. Simulation-based education may help students develop clinical skills and confidence in a safe learning environment.
The study investigates whether participation in an adolescent leukemia simulation scenario improves students' knowledge related to extravasation management, affects their perceived stress levels, and enhances their learning satisfaction. In addition, students' experiences and perceptions regarding the simulation training will be explored through qualitative interviews.
Simulation-based education is increasingly used in nursing programs to bridge the gap between theoretical knowledge and clinical practice. Pediatric oncology care requires specialized knowledge and clinical decision-making skills, particularly in managing complications such as chemotherapy extravasation. However, nursing students often have limited opportunities to encounter such situations during clinical placements.
This mixed-methods study will evaluate the effectiveness of an adolescent leukemia scenario-based simulation training program among third-year nursing students. The quantitative component will employ a single-group pretest-posttest quasi-experimental design. Participants will complete baseline assessments before the simulation intervention and follow-up assessments immediately after the simulation and debriefing sessions.
The simulation scenario focuses on the recognition and management of chemotherapy extravasation in an adolescent patient with leukemia. The intervention will be conducted in a simulation laboratory using a structured process including prebriefing, simulation implementation, and debriefing based on the Promoting Excellence and Reflective Learning in Simulation (PEARLS) framework.
Quantitative outcomes will include perceived stress, knowledge regarding extravasation management, and learning satisfaction. Qualitative data will be collected through semi-structured focus group interviews conducted after the simulation experience. The qualitative findings will provide a deeper understanding of participants' experiences, perceptions, clinical reasoning processes, and learning outcomes.
Data will be analyzed using appropriate descriptive and inferential statistical methods for the quantitative component and thematic analysis for the qualitative component. Findings from both components will be integrated to provide a comprehensive evaluation of the educational effectiveness of adolescent leukemia scenario-based simulation training in undergraduate nursing education.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Simulation Training Group | Experimental | Third-year nursing students who received scenario-based simulation training on extravasation management in an adolescent leukemia patient, followed by structured debriefing using the PEARLS model. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Scenario-Based Simulation Training | Other | A simulation-based educational intervention consisting of prebriefing (3 min), environmental orientation (3 min), scenario-based simulation on extravasation management in an adolescent leukemia patient (10 min), and structured debriefing using the PEARLS model (30 min). Pre- and post-tests were administered to assess perceived stress, knowledge level, and student satisfaction. |
| Measure | Description | Time Frame |
|---|---|---|
| Extravasation Knowledge Level | Change in nursing students' knowledge about extravasation management, assessed using a 10-item multiple-choice knowledge test developed by the researchers. Each correct answer scores 1 point (total: 0-10). Higher scores indicate better knowledge. | Baseline (pre-simulation) and immediately after simulation and debriefing (post-simulation, approximately 1 hour later) |
| Perceived Stress Level | Change in perceived stress measured with the Nursing Student Perceived Stress Scale (NSPSS; Karaca et al., 2015), a 29-item, 5-point Likert scale with 6 subscales. Total scores range from 0 to 116; higher scores indicate greater perceived stress. | Baseline (pre-simulation) and immediately after simulation and debriefing (post-simulation, approximately 1 hour later) |
| Measure | Description | Time Frame |
|---|---|---|
| Student Satisfaction and Self-Confidence in Learning | Student satisfaction assessed using the Student Satisfaction and Self-Confidence in Learning Scale (NLN; Turkish adaptation by Karaçay & Kaya, 2017), a 13-item, 5-point Likert scale with 2 subscales. Scores range from 13 to 65; higher scores indicate greater satisfaction and self-confidence. | Immediately after simulation and debriefing (post-simulation only, approximately 1 hour after baseline) |
| Measure | Description | Time Frame |
|---|---|---|
| Students' Simulation Experiences (Qualitative) | Themes derived from semi-structured focus group interviews conducted after simulation, exploring students' experiences regarding stress, clinical decision-making, teamwork, and learning processes. Analyzed using thematic analysis with MAXQDA. | Immediately after debriefing session (approximately 1-1.5 hours after baseline) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Didem Yüksel, PhD | Atilim University School of Health Sciences, Department of Nursing | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atılım University, Faculty of Health Sciences, Department of Nursing | Ankara | 06830 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Watts, P. I., Rossler, K., Bowler, F., Miller, C., Charnetski, M., Decker, S., & Hallmark, B. (2021). Healthcare simulation standards of best practice: Outcomes and objectives. Clinical Simulation in Nursing, 58, 45-48. https://doi.org/10.1016/j.ecns.2021.08.014 | ||
| 25459172 | Background | 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. | |
| 11755447 |
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| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| D007938 | Leukemia |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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Single-group pre-test/post-test quasi-experimental design with mixed methods approach. All participants underwent scenario-based simulation training on adolescent leukemia/extravasation management.
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| Background |
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| Background | Karaca, A., Yıldırım, N., Ankaralı, H., Açıkgöz, F., & Akkuş, D. (2015). Hemşirelik öğrencileri için algılanan stres, biyo-psiko-sosyal cevap ve stresle baş etme davranışları ölçeklerinin Türkçe'ye uyarlanması. Psikiyatri Hemşireliği Dergisi, 6(1), 15-25. https://doi.org/10.5505/phd.2015.40316 |
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| Background | European Oncology Nursing Society (EONS). (2018). Extravasation guidelines. EONS. |
| Background | Jeffries, P. R. (2016). The NLN Jeffries simulation theory. National League for Nursing. |
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| D006402 |
| Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |