Simulation-Based Learning Engagement and Perceived Clinical Competency among Fourth-Year Nursing Students: A Correlational Study

Abstract

Simulation-based learning provides nursing students with structured opportunities to apply theoretical knowledge, practise clinical procedures, and develop professional attitudes in a controlled environment. This study examined fourth-year nursing students’ engagement in four simulation-based learning strategies and the perceived contribution of these strategies to clinical competency in knowledge, skills, and attitude. A quantitative descriptive-correlational design was employed among 203 fourth-year nursing students selected through proportionate stratified random sampling from a private university in Manila, Philippines. Data were collected using a researcher-developed questionnaire guided by the 2012 National Nursing Core Competency Standards. The instrument demonstrated good to excellent internal consistency, with Cronbach’s alpha coefficients ranging from .859 to .973. Frequencies, percentages, means, rankings, and Kendall’s tau were used for analysis. Case scenarios were the most frequently used strategy, followed by low-fidelity mannequins, partial-task simulators, and role-playing. All four strategies received favorable ratings for their perceived contribution to knowledge, skills, and attitude. Significant positive associations were found between engagement frequency and perceived competency; however, the coefficients were only very weak to weak. Satisfaction with implementation was generally favorable, although 35.96% rated it only satisfactory. Clinical instructor effectiveness was the most frequently identified contributing factor at 81%. The findings support continued use of simulation-based learning while emphasizing instructional quality, feedback, reflection, and appropriate resource utilization rather than exposure frequency alone.