Bulletin of Health Sphere

Published by Font Fusions Publication  •  eISSN: 3139-8634

Healthcare Students’ Perceptions of Simulation-Based Learning for Clinical Skill Reinforcement: A Cross-Sectional Survey

Volume 1, Issue 2 • 2026
Original Research

S Priya ORCID iD , K. Vijayalakshmi ORCID iD , Hilda Rose Mary , G Kanchana ORCID iD , J. Jaslina Gnanarani ORCID iD

Received:
2026-06-15
Accepted:
2026-08-26
Published:
2026-09-30

Abstract

Background: Simulation-based learning (SBL) has become a core strategy in health-professions education for consolidating clinical skills in a safe, deliberate-practice environment. However, the way students across different healthcare disciplines perceive its value for reinforcing skills learned in the classroom remains incompletely characterised, particularly in multi-programme cohorts.

Objective: To evaluate healthcare students’ perceptions of SBL for clinical skill reinforcement and to examine how those perceptions vary with discipline, academic year, and prior simulation exposure.

Methods: A cross-sectional survey was conducted among 380 healthcare students across six disciplines. Perceptions were measured with a 21-item questionnaire scored on a 5-point Likert scale spanning four domains: Skill Reinforcement, Confidence and Self-Efficacy, Satisfaction and Engagement, and Realism/Fidelity. Internal consistency was assessed with Cronbach’s alpha.

Results: All four subscales demonstrated good internal consistency (α = 0.82–0.88; overall scale α = 0.95). Mean perception scores were positive and significantly above the neutral midpoint of 3.0 for every domain (all p < 0.001), highest for Satisfaction and Engagement (3.74 ± 0.73) and lowest for Confidence and Self-Efficacy (3.22 ± 0.78); the overall mean was 3.44 ± 0.67, with 73.9% of students scoring above neutral. Students with prior simulation experience reported significantly higher perceptions across all domains (overall 3.55 vs 3.30; p < 0.001). Perceptions differed by discipline (overall ANOVA F = 3.42, p = 0.005) and rose steadily across academic years (F = 4.95, p = 0.002; linear trend p < 0.001). Subscales were strongly inter-correlated (r = 0.69–0.73, all p < 0.001).

Conclusion: Healthcare students perceived SBL favourably as a means of reinforcing clinical skills, with the strongest endorsement for engagement and satisfaction and comparatively more reserved views on independent competence. Prior exposure and later training stage were associated with more positive perceptions, supporting early, repeated, and curriculum-integrated simulation across disciplines.

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References

  1. Saifan A, Devadas B, Daradkeh F, Abdel-Fattah H, Aljabery M, Michael LM. Solutions to bridge the theory-practice gap in nursing education in the UAE: a qualitative study. BMC Med Educ. 2021;21(1):490. doi:10.1186/s12909-021-02919-x
  2. Abildgren L, Lebahn-Hadidi M, Mogensen CB, Toft P, Steffensen SV, Hounsgaard L. Transferring health professionals social and cognitive skills: key findings from a qualitative investigation. Adv Simul (Lond). 2025;10(1):30. doi:10.1186/s41077-025-00356-0
  3. Albert FA, Seidu AA, Mason HM, Anderson E, Alele FO, Heggarty P, et al. A systematic review of medical practitioners' retention and application of basic sciences to clinical practice. BMC Med Educ. 2024;24(1):997. doi:10.1186/s12909-024-05952-8
  4. Tung YC, Xu Y, Yang YP, Tung TH. The Effects of Learning Transfer on Clinical Performances Among Medical Staff: A Systematic Review of Randomized Controlled Trials. Front Public Health. 2022;10:874115. doi:10.3389/fpubh.2022.874115
  5. Challa KT, Sayed A, Acharya Y. Modern techniques of teaching and learning in medical education: a descriptive literature review. MedEdPublish (2016). 2021;10:18. doi:10.15694/mep.2021.000018.1
  6. Ackerhans S, Wehkamp K, Petzina R, Dumitrescu D, Schultz C. Perceived Trust and Professional Identity Threat in AI-Based Clinical Decision Support Systems: Scenario-Based Experimental Study on AI Process Design Features. JMIR Form Res. 2025;9:e64266. doi:10.2196/64266
  7. Jussupow E, Spohrer K, Heinzl A. Identity Threats as a Reason for Resistance to Artificial Intelligence: Survey Study With Medical Students and Professionals. JMIR Form Res. 2022;6(3):e28750. doi:10.2196/28750
  8. Sengul T, Sariköse S, Gul A. Ethical decision-making and artificial intelligence in nursing education: An integrative review. Nurs Ethics. 2025;32(8):2490-2515. doi:10.1177/09697330251366600
  9. Huang J, Xu Y, Wang Q, Wang QC, Liang X, Wang F, et al. Foundation models and intelligent decision-making: Progress, challenges, and perspectives. Innovation (Camb). 2025;6(6):100948. doi:10.1016/j.xinn.2025.100948
  10. Canales Morales P. Ethics and Technology in Nursing Education: Rethinking Artificial Intelligence. Invest Educ Enferm. 2025;43(3):e14. doi:10.17533/udea.iee.v43n3e14
  11. Guo P, Wang Z. Implementation fidelity of universal design for learning and effects on student achievement engagement and belonging. Sci Rep. 2025;15(1):45430. doi:10.1038/s41598-025-30079-1
  12. Gagné M, Parker SK, Griffin MA, Dunlop PD, Knight C, Klonek FE, et al. Understanding and shaping the future of work with self-determination theory. Nat Rev Psychol. 2022;1(7):378-92. doi:10.1038/s44159-022-00056-w
  13. Velásquez ST, Ferguson D, Lemke KC, Bland L, Ajtai R, Amezaga B, et al. Interprofessional communication in medical simulation: findings from a scoping review and implications for academic medicine. BMC Med Educ. 2022;22(1):204. doi:10.1186/s12909-022-03226-9
  14. Guraya SY. Transforming simulation in healthcare to enhance interprofessional collaboration leveraging big data analytics and artificial intelligence. BMC Med Educ. 2024;24(1):941. doi:10.1186/s12909-024-05916-y
  15. Jambroes M, Kersten A, Poot R, Neef C, Wijnen-Meijer M. Design and Evaluation of a Simulation-Based Program to Enhance Inter- and Intraprofessional Communication in Medical Education. J Med Educ Curric Dev. 2026;13:23821205251414795. doi:10.1177/23821205251414795
  16. Ismail FW, Ajani K, Baqir SM, Nadeem A, Qureshi R, Petrucka P. Challenges and opportunities in the uptake of simulation in healthcare education in the developing world: a scoping review. MedEdPublish (2016). 2024;14:38. doi:10.12688/mep.20271.1
  17. Moloney M, Murphy L, Kingston L, Markey K, Hennessy T, Meskell P, et al. Final year undergraduate nursing and midwifery students' perspectives on simulation-based education: a cross-sectional study. BMC Nurs. 2022;21(1):299. doi:10.1186/s12912-022-01084-w
  18. Gaspar AD, Banayat AC. Undergraduate Student Nurses' Satisfaction, Self-confidence, and Perception of High-fidelity Simulation-based Learning on Critically-ill Patients. Acta Med Philipp. 2024;58(12):110-7. doi:10.47895/amp.v58i12.10240
  19. Blaak H, Lkoul A, Iziki H, Arechkik A, Idrissi KS, El Hilali S, et al. Effectiveness of Simulation with a Standardized Patient on Knowledge Acquisition, Knowledge Retention, and Self-Efficacy Among Moroccan Nursing Students: A Quasi-Experimental Study. Healthcare (Basel). 2025;13(3):318. doi:10.3390/healthcare13030318
  20. Fung CY, Wraith C, Houghton N, Woods B, Brown C, Dharmarajah A, et al. Effectiveness of a centrally designed, large-scale, multisite undergraduate medical simulation programme: student-reported confidence across eight London hospitals in a UK medical school setting. BMJ Open. 2025;15(9):e094222. doi:10.1136/bmjopen-2024-094222
  21. Sörman K, El Alaoui S, Mårtensson S, Larsson M, Knez R, Ljudvåg M, et al. Virtual patient simulation strengthens confidence in clinical conversations among undergraduated nursing students: a randomized controlled trial. BMC Med Educ. 2025;25(1):1690. doi:10.1186/s12909-025-08413-y
  22. Jawabreh N, Hamdan-Mansour A, Harazne L, Ayed A. Effectiveness of high-fidelity simulation on practice, satisfaction, and self-confidence among nursing students in mental health nursing class. BMC Nurs. 2025;24(1):622. doi:10.1186/s12912-025-03300-9
  23. Xu L, Xu Q, Liu C, Chen B, Wang C. Virtual Standardized Patients for Improving Clinical Thinking Ability Training in Residents: Randomized Controlled Trial. JMIR Med Educ. 2025;11:e73196. doi:10.2196/73196
  24. Guerrero JG, Rosales NS, Castro GMT. Impact of high-fidelity simulation exposure of nursing students with their objective structured clinical examination: A quasi-experimental study. Nurs Open. 2023;10(2):765-72. doi:10.1002/nop2.1343
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