Effects of simulation-based learning on knowledge of pediatric nursing and clinical decision-making abilities among third-year nursing students in Thailand

Background Clinical constraints often limit nursing students' independent decision-making in pediatric settings. This study evaluated the effectiveness of simulation-based learning (SBL) on pediatric nursing knowledge and clinical decision-making abilities. Method A quasi-experimental study using a one-group pretest posttest design was conducted with 30 third-year nursing students in Thailand. The SBL intervention was designed based on the NLN Jeffries Simulation Theory and Kolb's Experiential Learning Theory, featuring two realistic pediatric scenarios. Data were collected using a pediatric nursing knowledge test and self-reported clinical decision-making scale, then analyzed using paired t-tests. Results Post-intervention scores for pediatric nursing knowledge significantly increased from 6.47 to 8.00 ( p < .001). Clinical decision-making abilities also improved significantly from 3.84 to 4.41 ( p < .001), with "Effective Reflection" demonstrating the most prominent improvement. These findings suggest that scenario realism and psychological safety within the high-fidelity simulation (HFS) fostered self-confidence and error-based learning without patient risk. Conclusion SBL bridges the theory-practice gap and enhances clinical readiness through structured design and systematic reflection. Its integration into nursing curricula is recommended to maximize pediatric competency and prepare students for complex environments.