Simulation-based training for crisis management in nursing students: a randomized controlled trial on competency development and skill retention

Purpose This study aimed to examine the effect of simulation-based education on nursing students’ crisis management competencies and to determine whether these competencies were maintained over a three-month follow-up period. Design/methodology/approach This randomized controlled trial was conducted with 70 undergraduate nursing students at a foundation university in Türkiye. Participants were randomly assigned to an experimental group (n = 35) that received simulation-based crisis management training and a control group (n = 35) that received traditional lecture-based instruction. Data were collected using a structured student information form, the Crisis Management Scale, and a crisis management knowledge test. Measurements were obtained at baseline, immediately after the intervention, and at a three-month follow-up. Data were analyzed using descriptive statistics, independent and paired-samples t-tests, and Pearson’s correlation analysis. Findings The two groups were comparable at baseline. Following the intervention, students in the simulation group demonstrated significantly higher crisis management scores than those in the control group, particularly in early warning recognition, preparation and prevention, and crisis response. These gains were largely maintained at the 3-month follow-up, indicating that the intervention’s benefits were sustained over time. Research limitations/implications This study has some clear limitations. It was conducted with students from a single institution, so the findings may not fully reflect the experiences of nursing students in different educational or clinical contexts. The follow-up period was limited to three months, which does not allow conclusions about long-term skill retention or real-world application. In addition, the study relied on self-reported measures, meaning that students’ perceptions may not always match their actual performance. Even so, the findings suggest that simulation-based training can play a meaningful role in helping students feel more prepared for practice and in developing skills relevant to work-based learning. Practical implications The findings suggest that simulation-based crisis management training can be effectively integrated into nursing curricula to support skill development in a safe learning environment. Educators can use simulation to help students practice decision-making, communication, and teamwork before entering real clinical settings. Incorporating structured debriefing may further strengthen learning and confidence. For institutions, embedding such training within work-based learning approaches may improve students’ readiness for practice and ease the transition from education to clinical work. These results also highlight the value of aligning educational strategies with real workplace demands. Social implications By supporting the development of crisis management skills, simulation-based training may contribute to a more confident and prepared nursing workforce. Better-prepared graduates can enhance patient safety and the quality of care in high-pressure clinical situations, which ultimately benefits society. Helping students build confidence before entering the workforce may also reduce stress during the transition to professional practice. In the long term, educational approaches that strengthen practical skills and teamwork may help create safer healthcare environments and foster public trust in health services. Originality/value This study adds value by examining not only the immediate effects of simulation-based crisis management training but also its short-term sustainability. By focusing on skill development and practice readiness, the study links simulation-based learning with work-based learning outcomes in nursing education. Unlike many studies that assess learning immediately after training, this research provides insight into how students retain and perceive their skills beyond the intervention. The findings provide practical evidence to support the integration of simulation into higher education programmes that prepare work-ready nursing graduates. Highlights