Effects of Simulation-Based Education for Hypovolemic Shock on Nursing Students' Clinical Competence and Clinical Judgment

The ultimate goal of nursing education is to prepare nursing students to make critical decisions and deliver safe, high-quality care based on sound scientific knowledge. However, due to concerns regarding patient safety, patient rights, and stringent infection control protocols, clinical practicums have increasingly become observation-oriented, limiting direct nursing care opportunities. To overcome these constraints, this study developed an emergency care simulation scenario for acute hypovolemic shock tailored to the clinical environment and evaluated its educational effectiveness on nursing students' clinical competence and clinical judgment. A methodological and quasi-experimental study using a one-group pretest-posttest design was conducted with 48 fourth-year nursing students. The program consisted of pre-briefing (10 min), simulation execution (15 min), and debriefing using the Gather-Analyze-Summarize (GAS) model (15 min). Data were collected using structured self-report instruments before the intervention and one week following completion, and analyzed using paired t-tests in IBM SPSS Statistics 25.0. Following the simulation-based education, clinical competence (t = 10.42, p < .001) and clinical judgment (t = 2.48, p = .017) significantly improved compared to baseline. In sub-domain analysis of clinical judgment, the 'Reflecting' domain showed a statistically significant increase (t = 2.67, p = .010). These findings demonstrate that realistic, scenario-based emergency simulation coupled with structured debriefing effectively fosters clinical competence and reflective clinical reasoning among prospective nurses.