Purpose
This study aimed to evaluate the effects of a virtual reality (VR) program and simulation training on nursing students’ ability to measure vital signs in children.
Methods
This mixed-methods study, which included a randomized controlled trial and a qualitative study, was conducted from June 12 to November 15, 2023. Forty-four nursing students from a university in South Korea were randomly assigned to either the experimental or control group. The experimental group first participated in a VR program focused on measuring vital signs in children, followed by a high-fidelity simulation training. The control group received the training in the reverse order. The participants’ knowledge, confidence in practice, and satisfaction with the practice were analyzed using the repeated-measures analysis of variance. VR learning experiences were analyzed through qualitative content analysis.
Results
Both the experimental and control groups showed significant increases in knowledge and confidence in practice after the interventions compared to baseline. However, there were no significant differences in changes in knowledge, confidence in practice, and satisfaction with practice between the two groups. Three themes were identified from the nursing students’ experiences with VR learning: ‘realistic learning training,’ ‘overcoming learning limitations,’ and ‘perceiving drawbacks.’
Conclusion
The VR program was as effective as high-fidelity simulation training in improving nursing students’ ability to measure children’s vital signs. Moreover, VR program offered additional benefits in addressing limitations of simulation-based learning. These findings suggest that VR program can serve as a valuable educational tool to enhance pediatric nursing skills.

Purpose
Because fever is a common symptom in children, parents must have accurate knowledge and management ability about it to be able to provide appropriate management. This study aimed to develop a fever management education program, incorporating case-based simulation practice for parents of hospitalized children, and examine its effects on knowledge of fever in children, anxiety related to fever, and self-efficacy in child fever management.
Methods
A quasi-experimental, non-equivalent control group pretest-posttest design was employed. A total of 50 parents participated, with 24 and 26 in the experimental and control groups, respectively. The experimental group received both theoretical lectures and case-based simulation practice, whereas the control group received only theoretical lectures.
Results
No statistically significant differences were observed between the groups regarding knowledge of fever or anxiety related to fever immediately after the intervention or at the 4-week follow-up. However, the experimental group showed a significant improvement in self-efficacy in fever management from pre- to post-intervention.
Conclusion
The findings suggest that fever management education incorporating case-based simulation practice, in addition to theoretical instruction, could potentially enhance parents’ confidence in managing childhood fever. Developing simulation-based educational interventions that enhance long-term effectiveness, can be feasibly integrated into hospital settings, and provide practical and accessible approaches is essential to support parents in effectively managing fever in real-life situations.

Purpose
Simulation-based education plays a critical role in nursing by allowing students to acquire clinical competencies in a safe and controlled environment. However, current evaluation tools for simulation scenarios often lack standardization, resulting in inconsistencies when assessing the effectiveness of such programs.
Methods
This study aimed to develop a comprehensive Nursing Simulation Scenario Evaluation Tool using the Real-Time Delphi method. A panel of 10 experts in nursing and simulation education participated in two rounds of surveys. The evaluation criteria were derived from the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice and relevant literature. Survey items were refined through expert consensus using content validity ratios and coefficient of variation values. The finalized tool was further enhanced with artificial intelligence (AI)–based evaluation capabilities to support objective and systematic assessment. The tool was registered and patented in the Republic of Korea (Korean Intellectual Property Office Registration No. 10-2024-0051234) to acknowledge its innovation and technical merit.
Results
The process resulted in an evaluation tool comprising eight key domains and 36 items, covering scenario structure, learning objectives, preparation, script development, debriefing, facilitation, expected outcomes, and scenario validity. A Kendall’s coefficient of concordance of 0.739 indicated strong agreement among the experts.
Conclusion
This study successfully developed a standardized and validated tool to improve the reliability and effectiveness of simulation-based education in nursing. The tool addresses a key gap in current educational practices and enhances consistency in evaluating nursing simulation scenarios. Future studies should focus on validating its application across diverse educational environments.

Purpose
This pilot study aimed to develop a virtual reality (VR) nursing simulation for pediatric pneumonia care tailored to the Korean clinical context and evaluate its educational effectiveness for nursing students.
Methods
A single-group pretest–posttest design was employed with 20 senior nursing students from April to May 2025. The intervention was a 70-minute VR nursing simulation of pediatric pneumonia care, structured with pre-briefing, a main scenario, and debriefing. Data were collected on participants’ knowledge of pediatric pneumonia, clinical judgment (Nursing Clinical Judgment Scale), and simulation effectiveness (Simulation Effectiveness Tool-Modified) before and after the intervention. Usability (User Experience Questionnaire) and qualitative feedback were collected after the intervention. Pre-post comparisons were performed using paired t-tests.
Results
The program did not yield a statistically significant change in knowledge scores (p=.893). However, there were significant improvements in the mean scores for clinical judgment (p<.001) and simulation effectiveness (p=.013). A qualitative analysis revealed that, while the participants found the experience immersive and realistic, they also reported operational difficulties, indicating the need for usability improvements.
Conclusion
The VR nursing simulation is a promising pedagogical tool for enhancing nursing students’ clinical judgment and perceived learning effectiveness in a Korean pediatric context. The findings suggest that, while the intervention was effective in improving practical reasoning, future iterations should focus on reinforcing knowledge acquisition and optimizing user experience to maximize the educational impact.

Citations

• ORGANIZATION OF THE EDUCATIONAL PROCESS IN “CLINICAL NURSING IN PEDIATRICS” UNDER WARTIME CONDITIONS ON THE MOODLE PLATFORM: CHALLENGES AND ADAPTATION
  N. I. Makieieva, M. S. Diachenko, V. E. Domnich, V. V. Andrushchenko, V. A. Koval
  Медсестринство.2025; (3-4): 54.     CrossRef

Purpose
This study aimed to explore tutoring experiences related to a high-risk newborn care simulation among nurses and nursing students to derive insights into developing effective neonatal nursing practice.
Methods
A qualitative content-analysis study was conducted in March 2023. Data were collected through narrative surveys and focus group interviews with four neonatal intensive care unit nurses and 12 senior nursing students participating in a 1-day high-risk newborn care simulation program. A content analysis was performed on the collected data.
Results
Three categories (“efforts to foster a sense of presence,” “efforts to promote positive awareness of the neonatal intensive care unit,” and “establishing one’s role as an educator”) and six subcategories were derived from the nurses’ responses. Three categories (“growth through a realistic virtual simulation,” “improved learning effects,” and “hope for continued development”) and six subcategories were derived from the nursing students’ responses.
Conclusion
The nursing students experienced realistic practice with their nurse tutors in the high-risk newborn care simulation, which helped them form their professional identity as future nurses. After tutoring, the nurses’ perceptions of nursing students changed positively, which affected their teaching methods.

Purpose
Hybrid simulation has emerged to increase the practicality of simulation training by combining simulators and standardized patient (SP) that implement realistic clinical environments at a high level. This study aimed to develop a hybrid simulation program focused on case of pediatric cardiac catheterization and to evaluate its effectiveness. Methods: The hybrid simulation program was developed according to the Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model. And deep learning-based analysis program was used to analyze non-verbal communication with SP and applied it for debriefing sessions. To verify the effect of the program, a quasi-experimental study using a random assignment design was conducted. In total, 48 nursing students (n=24 in the experimental group; n=24 in the control group) participated in the study.
Results
Knowledge (F=3.53, p=.038), confidence in clinical performance (F=9.73, p<.001), and communication self-efficacy (F=5.20, p=.007) showed a significant difference in both groups and interaction between time points, and the communication ability of the experimental group increased significantly (t=3.32, p=.003).
Conclusion
Hybrid simulation program developed in this study has been proven effective, it can be implemented in child nursing education. Future research should focus on developing and incorporating various hybrid simulation programs using SP into the nursing curriculum and evaluating their effectiveness.

Citations

• Enhancing nurse-parent partnership for NICU nurses by investigating multi-modal learning with a hybrid simulation approach that integrates metaverses and real-world training
  Hee Young Kim, Soon Hyun Myung, In Young Cho
  Nurse Education in Practice.2025; 84: 104294.     CrossRef
• The role of artificial intelligence in shaping nursing education: A comprehensive systematic review
  Jiatian Ma, Jiamin Wen, Ying Qiu, Yuling Wang, Qiao Xiao, Tingting Liu, Dong Zhang, Yangyang Zhao, Zebang Lu, Zhiling Sun
  Nurse Education in Practice.2025; 84: 104345.     CrossRef
• Developing scales for clinical emotional intelligence and clinical competency and initial testing in a randomized controlled trial with hybrid simulation
  Jefferson Garcia Guerrero
  Nurse Education in Practice.2025; 87: 104450.     CrossRef
• Clinical simulation in teaching nursing students: Scoping review
  Daniel Ferreira, Delfina Borges, Maria José Oliveira, Paula Flores, Hélder Cunha, Mafalda Silva
  Athena Health & Research Journal.2025;[Epub]     CrossRef

Purpose
To measure the level of reflection, this study analyzes diaries written by third-year nursing students before and after the debriefing stage in simulation training. A qualitative study using diary entries from 15 nursing students to explore reflection depth.
Methods
Students engaged in simulation training and the debriefing stage, documenting their reflections in diaries. Before and after debriefing, reflections were rated from Level 1 (reflectivity) to Level 7 (theoretical reflectivity).
Results
The total number of reflection levels rose significantly from 545 to 829 post-debriefing, enhancing higher-order reflection.The shift signifies a move from superficial to deep reflection, highlighting debriefing's role in fostering critical thinking.
Conclusion
The findings underscore the critical role of debriefing in enhancing reflective thinking in nursing education. There is a demonstrated need for further research into the specific elements of debriefing that are most effective at promoting deep reflection. Future studies should conduct comparative analyses of different debriefing methods and approaches across various educational settings. This research could lay the foundation for designing more effective debriefing strategies that foster critical thinking and improve learning outcomes in nursing education.

Purpose
This study aimed to describe the process of developing a validated pediatric nursing simulation scenario template using the real-time Delphi method.
Methods
A panel of 13 pediatric nursing experts participated in a real-time Delphi survey conducted over two rounds. Initially, 83 items were included in the questionnaire focusing on the structure and content of the simulation scenario template. Data analysis involved calculating the content validity ratio (CVR) and the coefficient of variation to assess item validity and stability.
Results
Through iterative rounds of the Delphi survey, a consensus was reached among the experts, resulting in the development of a pediatric nursing simulation scenario template comprising 41 items across nine parts. The CVR values ranged from 0.85 to 1.0, indicating a high consensus among experts regarding the inclusion of all items in the template.
Conclusion
This study presents a novel approach for developing a pediatric nursing simulation scenario template using real-time Delphi methods. The real-time Delphi method facilitated the development of a comprehensive and scientifically grounded pediatric nursing simulation scenario template. Our template aligns with the International Nursing Association for Clinical Simulation and Learning standards, and provides valuable guidance for educators in designing effective simulation scenarios, contributing to enhanced learning outcomes and better preparation for pediatric clinical practice. However, consideration of cultural and contextual adaptations is necessary, and further research should explore alternative consensus criteria.

Citations

• Development of an artificial intelligence-based nursing simulation scenario evaluation tool: a methodological study using the Real-Time Delphi method in South Korea
  Eun Joo Kim, Bitna Park, Geun Myun Kim, Ji Young Lim, Seong Kwang Kim
  Child Health Nursing Research.2025; 31(4): 257.     CrossRef

Purpose
This systematic literature review and meta-analysis explored extended reality (XR)-based pediatric nursing simulation programs and analyzed their effectiveness.
Methods
A literature search was conducted between May 1 and 30, 2022 in the following electronic databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The search period was from 2000 to 2022. In total, 6,095 articles were reviewed according to the inclusion and exclusion criteria, and 14 articles were selected for the final content analysis and 10 for the meta-analysis. Data analysis was performed using descriptive statistics and the Comprehensive Meta- Analysis program.
Results
XR-based pediatric nursing simulation programs have increased since 2019. Studies using virtual reality with manikins or high-fidelity simulators were the most common, with six studies. The total effect size was statistically significant at 0.84 (95% confidence interval=0.50-1.19, z=4.82, p<.001).
Conclusion
Based on the findings, we suggest developing standardized guidelines for the operation of virtual pediatric nursing simulation education and practice. Simultaneously, the application of more sophisticated research designs for effect measurement and the combined applications of various virtual simulation methods are needed to validate the most effective simulation methodology.

Citations

• Extended reality technologies in child health education for undergraduate healthcare students: A scoping review
  Emma Collins, Chris Paton, Steve Gallagher
  Nurse Education in Practice.2026; 90: 104627.     CrossRef
• Identifying Research Priorities in Digital Education for Health Care: Umbrella Review and Modified Delphi Method Study
  Alison Potter, Chris Munsch, Elaine Watson, Emily Hopkins, Sofia Kitromili, Iain Cameron O'Neill, Judy Larbie, Essi Niittymaki, Catriona Ramsay, Joshua Burke, Neil Ralph
  Journal of Medical Internet Research.2025; 27: e66157.     CrossRef
• Augmenting pediatric nursing clinical education with low-cost simulations
  Valerie C. Martinez, Desiree A. Díaz, Mindi Anderson, Samantha Stephenson, Syretta Spears
  Journal of Pediatric Nursing.2025; 81: 136.     CrossRef
• Effects of a virtual reality program and simulation training for nursing students on the measurement of vital signs in children: a mixed-methods study in South Korea
  Sun Nam Park, Hyun Young Koo, Hye Young Hwang
  Child Health Nursing Research.2025; 31(4): 296.     CrossRef
• Child Nursing Simulation Scenario Content Analysis: A Directed Qualitative Content Analysis
  Eun Joo Kim, Kyung Mi Cho, Sung Sook Song
  Clinical Simulation in Nursing.2024; 87: 101488.     CrossRef
• Development of neonatal Apgar scoring training program utilizing contactless hand tracking in immersive virtual reality
  Sun-Yi Yang, Yun-Hee Oh
  Nurse Education Today.2024; 140: 106294.     CrossRef
• Enhancing Nursing Simulation Education: A Case for Extended Reality Innovation
  Shanna Fealy, Pauletta Irwin, Zeynep Tacgin, Zi Siang See, Donovan Jones
  Virtual Worlds.2023; 2(3): 218.     CrossRef

Purpose
This study aimed to explore nursing students' experiences of neonatal nursing simulations using peer tutoring.
Methods
In this qualitative content analysis study, data were collected using a narrative survey and focus group interviews with 27 third-year nursing students and six fourth-year nursing students from April to May 2022. Content analysis of the collected data was conducted.
Results
Four categories—"stabilizing emotionally through each other", "advancing together", "difficulties in relationships", and "hoping to continue"—and nine sub-categories were extracted. The sub-categories "reduced burden" and "gaining confidence" were grouped into the first category, "stabilizing emotionally through each other". The sub-categories "being motivated to learn," "increased learning ability", and "preparation as a process" were grouped under "advancing together", and "attitudes affecting study environment" and "depending on help" were grouped into the third category of "difficulties in relationships". The fourth category of "hoping to continue" had "wanting to supplement for development" and "wanting to participate in different roles" as sub-categories.
Conclusion
Based on the results of this study, we expect pediatric nursing practicum education to improve through the active use of neonatal nursing simulation education incorporating peer tutoring.

Citations

• Tutoring experiences of a high-risk newborn care simulation among nurse tutors and nursing student tutees in South Korea: a qualitative study
  Hyun Young Koo, Bo Ryeong Lee, Hyeran An
  Child Health Nursing Research.2025; 31(1): 40.     CrossRef
• Child Nursing Simulation Scenario Content Analysis: A Directed Qualitative Content Analysis
  Eun Joo Kim, Kyung Mi Cho, Sung Sook Song
  Clinical Simulation in Nursing.2024; 87: 101488.     CrossRef
• Effects of peer tutoring-based simulation education on caring for children with respiratory infections among nursing students: A mixed-methods study
  Hyun Young Koo, Bo Ryeong Lee
  Heliyon.2024; 10(16): e36014.     CrossRef
• The effect of peer tutoring on pediatric nursing education: a systematic review
  Hyun Young Koo, Hyeran An, Bo Ryeong Lee
  Child Health Nursing Research.2024; 30(4): 215.     CrossRef

Purpose
The present study aimed to develop and examine the effectiveness of a pediatric nursing competency-building program for nursing students.
Methods
This was a quasi-experimental study with a nonequivalent control group pretest-posttest design conducted between October and December 2021. The participants included 40 nursing students (20 each in the experimental and control groups) at a university in a South Korean city. The pediatric nursing competency-building program integrated problem-based learning and simulation into clinical field practice. The experimental group participated in the program, while the control group did not. Data were analyzed using the x² test, the independent t-test, and repeated-measures analysis of variance.
Results
Pediatric nursing competency and clinical performance showed a greater increase in the experimental group than in the control group. However, the change in problem-solving ability in the experimental group was not significantly different from that in the control group.
Conclusion
The pediatric nursing competency-building program effectively improved students' pediatric nursing competency and clinical performance.

Citations

• Effects of a virtual reality program and simulation training for nursing students on the measurement of vital signs in children: a mixed-methods study in South Korea
  Sun Nam Park, Hyun Young Koo, Hye Young Hwang
  Child Health Nursing Research.2025; 31(4): 296.     CrossRef
• Nursing students’ experiences using photovoice with team-based learning in pediatric nursing education
  Fatemeh Ebrahimpour
  BMC Medical Education.2025;[Epub]     CrossRef
• Development of a virtual reality program in South Korea for the measurement of vital signs in children: a methodological study
  Sun Nam Park, Hye Young Hwang, Hyun Young Koo
  Child Health Nursing Research.2023; 29(2): 137.     CrossRef

Purpose
This study was conducted to explore the core educational components of interprofessional education (IPE) for pediatric emergencies to establish a basis for interprofessional simulation education.
Methods
Using Whittemore and Knafl's integrative review method, we searched for studies in PubMed, Embase, Cochrane Library, CINAHL, and four South Korean databases (RISS, NDSL, DBpia, and KISS).
Results
We identified 21 studies on the general characteristics of IPE in pediatric emergency situations and integrated the core components of IPE according to a PRISMA flowchart. Three core components were identified (individual - competent professionals, team - cooperative professions, and outcome - optimal achievement), with the subthemes of role and responsibility, clinical judgment, performance, leadership, communication, teamwork, patient safety, and quality improvement.
Conclusion
We recommend that IPE pediatric emergencies should contain the three dimensions of these core components to enhance individual and team performance and to promote optimal achievement in terms of patient outcomes. IPE programs should consider these characteristics and include a valid tool for evaluating the programs' effectiveness.

Citations

• Intraprofessional boundary crossing in acute paediatric care: A rich journey for general practice and paediatric residents
  Rosalin van Schie, Ester Coolen, Anne van Tuijl, Janielle van der Velden, Bart Thoonen, Nynke Scherpbier‐de Haan
  Medical Education.2024; 58(11): 1350.     CrossRef
• Effectiveness of simulation-based interprofessional education on teamwork and communication skills in neonatal resuscitation
  Shinhye Chae, Soonyoung Shon
  BMC Medical Education.2024;[Epub]     CrossRef
• Experiences of Indonesian nurses in improving preterm oral feeding readiness in special care units: A qualitative descriptive study
  Dyah Dwi Astuti, Rinawati Rohsiswatmo, Dessie Wanda, Diah Mulyawati Utari
  Belitung Nursing Journal.2023; 9(5): 478.     CrossRef