Development and Evaluation of an Online Oncology Nursing Septic Shock Simulation Module for Nursing Students: A Mixed Methods Experimental Design

Contemporary nursing education faces the critical challenge of adapting to a rapidly evolving healthcare landscape and the changing characteristics of learners.Modern nursing students, particularly those from the Millennial and Generation Z cohorts, are digital natives who exhibit a distinct preference for interactive, multimediabased learning experiences over traditional lecture-centric instruction. 1,2)This generational shift necessitates the adoption of innovative teaching and learning strategies within the nursing curricula, with online simulation-based education emerging as a prominent and effective alternative. 3,4)mulation-based education provides a safe and controlled environment for learners to develop clinical judgment and essential nursing skills systematically, closely mirroring real-world clinical situations without posing risks to actual patients. 5)Online simulation, in particular, transcends the limitations of time and physical location, providing unparalleled flexibility for learners. 6,7)It supports autonomous learning, enables repeated practice, and has been consistently reported to influence clinical performance, confidence, and learning immersion positively. 8,9)Various online strategies, including virtual reality, serious games, blended learning, and mobile applications, are being increasingly integrated into nursing education, establishing themselves as effective preparatory tools for new nurses transitioning into practice. [10][11]12][13][14][15] Despite the growing adoption of simulation, existing research predominantly focuses on relatively routine clinical scenarios such as