Developmentally adaptive high-fidelity simulation: Associations of educational level and prior experience with learner satisfaction and self-confidence

Background High-fidelity simulation (HFS) is widely used in nursing education; however, learner outcomes may vary depending on educational level, prior simulation exposure, and readiness to engage in simulation-based learning. This study examined associations between educational level, prior simulation experience, willingness to participate, and learner satisfaction and self-confidence among nursing students participating in high-fidelity simulation. Methods A cross-sectional study was conducted among 165 nursing students, including 92 undergraduate and 73 graduate students. Satisfaction and self-confidence were assessed using the validated Polish version of the student satisfaction and self-confidence in learning scale (SSCL). Nonparametric tests were applied ( p ≤ .05). Results Overall satisfaction and self-confidence scores were high. Willingness to participate in simulation was moderately and positively associated with SSCL scores (ρ = 0.46; p < .001), whereas years of simulation experience were negatively associated with SSCL outcomes (ρ = −0.29; p < .01). Undergraduate students reported significantly higher SSCL scores than graduate students ( p < .05). Conclusions Educational level, prior simulation exposure, and willingness to participate were associated with satisfaction and self-confidence in high-fidelity simulation. These findings suggest that simulation scenarios should be progressively adapted to learners' educational stage, prior experience, and expected level of autonomy. Developmentally adaptive simulation design may help maintain engagement and perceived educational value across different stages of nursing education.