The Effect Of Team-Based Sımulatıon On Developıng Communıcatıon, Self-Awareness, And Teamwork Skılls Of Nursıng Students: A Randomızed Controlled Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 112
- Locations
- 1
- Primary Endpoint
- Change in nursing students' teamwork attitudes.
Study Overview
Brief Summary
Objective:
This study aims to investigate the effects of "team-based simulation" on the development of communication skills, self-awareness levels, and teamwork competencies among first-year nursing students.
Hypotheses:
H1: Team-based simulation training significantly increases the self-awareness levels of nursing students compared to individual-based training.
H2: Team-based simulation practices lead to a statistically significant improvement in students' attitudes toward teamwork, specifically regarding mutual support and team structure.
H3: Students who participate in team-based simulations demonstrate higher levels of satisfaction with learning and self-confidence compared to those in individual-based settings.
Study Description:
The research was conducted with 112 first-year nursing students using a randomized controlled and "cross-over" design. Participants were divided into two groups, experiencing both team-based and individual-based simulation applications in different sequences. Data were collected at four different time points-pre-test, intra-post-simulation, and one-month follow-up-using various scales. The study determined that team-based simulation lays the groundwork for the development of students' self-awareness, enhances teamwork skills, and increases satisfaction levels. To ensure the sustainability of these gains, it is recommended that such interactive and repetitive simulation methods be systematically integrated into nursing education curricula.
Detailed Description
This study utilizes a randomized, cross-over experimental design to evaluate the efficacy of team-based simulation versus individual-based simulation in nursing education. By employing a cross-over methodology, each participant serves as their own control, which minimizes inter-individual variability and enhances the statistical power of the analysis despite the sample size of 112 students.
The protocol involves a systematic delivery of clinical scenarios focused on fundamental nursing skills. In the team-based arm, participants are organized into groups of four, with designated roles such as team leader, medication administrator, primary caregiver, and documenter, which rotate to ensure comprehensive experience. The individual-based arm requires students to navigate the same clinical scenarios independently, focusing on autonomous decision-making and task prioritization without peer interaction.
The intervention is structured in three distinct phases:
Pre-intervention baseline assessment: Standardized measurement of participants' baseline self-awareness, communication traits, and existing teamwork perceptions.
Active simulation phase: Implementation of high-fidelity clinical simulations followed by immediate structured debriefing sessions. The debriefing component is grounded in reflective practice models to facilitate the transition of experiential learning into clinical competence.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Crossover
- Primary Purpose
- Other
- Masking
- Single (Participant)
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Must be currently enrolled as a first-year student in the Faculty of Nursing
- •Must have voluntarily agreed to participate in the study and signed the informed consent form.
- •Must be physically and cognitively capable of participating in the simulation-based learning activities.
- •Must have completed the introductory nursing orientation program.
Exclusion Criteria
- •Students who have previously received formal simulation-based training in a clinical environment.
- •Students who are unable to commit to the full duration of the crossover study protocol, including the one-month follow-up assessment.
- •Students who have an active participation in another concurrent educational research study that may influence self-awareness or teamwork scores.
- •Students who are unable to attend the scheduled simulation sessions due to pre-existing academic or personal obligations.
Arms & Interventions
Group A: Team-Based Simulation Followed by Individual-Based Simulation
Initial Phase: Participants are assigned to a team-based simulation module where groups of four students engage in structured clinical scenarios.
Sequence: Following the initial intervention and a defined washout period, these participants transition to the individual-based simulation module to perform the same clinical tasks independently.
Goal: To assess the impact of collaborative learning on clinical performance and team dynamics before evaluating the impact of independent practice.
Intervention: Team-Based Simulation (Behavioral)
Group A: Team-Based Simulation Followed by Individual-Based Simulation
Initial Phase: Participants are assigned to a team-based simulation module where groups of four students engage in structured clinical scenarios.
Sequence: Following the initial intervention and a defined washout period, these participants transition to the individual-based simulation module to perform the same clinical tasks independently.
Goal: To assess the impact of collaborative learning on clinical performance and team dynamics before evaluating the impact of independent practice.
Intervention: Individual-Based Simulation (Behavioral)
Group B: Individual-Based Simulation Followed by Team-Based Simulation
Initial Phase: Participants begin with the individual-based simulation module, focusing on autonomous decision-making and task completion without peer assistance.
Sequence: Following the initial intervention and a defined washout period, these participants transition to the team-based simulation module, where they participate in group-based clinical scenarios.
Goal: To establish a baseline of individual clinical competency before introducing the collaborative elements of team-based learning.
Intervention: Team-Based Simulation (Behavioral)
Group B: Individual-Based Simulation Followed by Team-Based Simulation
Initial Phase: Participants begin with the individual-based simulation module, focusing on autonomous decision-making and task completion without peer assistance.
Sequence: Following the initial intervention and a defined washout period, these participants transition to the team-based simulation module, where they participate in group-based clinical scenarios.
Goal: To establish a baseline of individual clinical competency before introducing the collaborative elements of team-based learning.
Intervention: Individual-Based Simulation (Behavioral)
Outcomes
Primary Outcomes
Change in nursing students' teamwork attitudes.
Time Frame: Measured at baseline (pre-intervention), within 24 hours post-first simulation, within 24 hours post-second simulation (cross-over point), and at 1-month follow-up post-second simulation
The metric is the mean change in scores on the Teamwork Attitudes Scale, which evaluates key domains including mutual support, team structure, and leadership dynamics within the clinical simulation environment. Total scores on this scale range from 28 to 140, where higher scores indicate a better outcome (higher teamwork attitudes)
Change in nursing students' self-awareness levels.
Time Frame: Measured at baseline (pre-intervention), within 24 hours post-first simulation, within 24 hours post-second simulation (cross-over point), and at 1-month follow-up post-second simulation
The metric is the change in mean scores on the validated Self-Awareness Scale. This scale assesses the students' ability to recognize their own clinical decision-making processes, emotional responses, and professional behaviors during simulation scenarios. Total scores on this scale range from 0 to 75, where higher scores indicate a better outcome (higher self-awareness)
Change in nursing students' communication skills.
Time Frame: Measured at baseline (pre-intervention), within 24 hours post-first simulation, within 24 hours post-second simulation (cross-over point), and at 1-month follow-up post-second simulation
The metric is the mean change in scores obtained from a standardized clinical communication assessment rubric. This tool evaluates the clarity, accuracy, and efficiency of information exchange between students and simulated patients or team members. Total scores on this scale range from 25 to 125, where higher scores indicate a better outcome (higher communication skills)
Secondary Outcomes
No secondary outcomes reported
Investigators
pınar dogan
Asst.Prof.
Istanbul Medipol University Hospital