The Impact of High Fidelity Patient Simulation on the Level of Knowledge and Critical Thinking Skills in Code Blue Management Among Undergraduate Nursing Students in Malaysia

The efficacy of high fidelity patient simulation (HFPS) over low fidelity patient manikins (LFPM) in improving learning outcomes among undergraduate nursing students in Malaysia remains unknown. The aim of this study is to compare learning outcomes (knowledge and critical thinking skills) using an adult code blue drill simulated program using HFPS versus LFPM among undergraduate nursing students in Malaysia. In an experimental study, final-year undergraduate nursing students ( N = 407) from three centers in Malaysia were trained in code blue management and assigned to either control (LFPM) or intervention (HFPS) group. Pre- and post-test assessment was conducted using 30-single best answer questions and the California Critical Thinking Disposition Inventory. A repeated-measures analysis of covariance (ANCOVA) showed significant differences in knowledge levels (intervention, η 2 = 0.146; control, η 2 = 0.130) and critical thinking skills (intervention, η 2 = 0.119; control, η 2 = 0.066). Simulation-based education using HFPS is advantageous over LFPM in increasing knowledge and critical thinking skills in code blue management among nursing students.