Exploring nursing students’ self-confidence and perceptions in simulation-based education: a mixed-method approach

Simulation-based education (SBE) has emerged as a vital teaching–learning strategy in nursing education, enabling students to practice in realistic but controlled settings. It enhances self-confidence, clinical competence, and positive perceptions toward learning while reducing risks associated with direct patient care. The present study aimed to assess the self-confidence and perceptions of undergraduate nursing students regarding simulation-based education at a selected nursing college. A mixed-method research design was employed, incorporating both quantitative and qualitative approaches. The quantitative phase included 80 students selected through purposive sampling, assessed using the NLN Self-Confidence in Learning Scale and the Perception of Simulation-Based Learning Scale before and after structured simulation sessions. The qualitative phase involved semi-structured interviews with 20 students, analyzed thematically to gain deeper insights. Quantitative data were analyzed using descriptive statistics, paired t-tests, and correlation analysis. The findings revealed a significant improvement in students’ outcomes following simulation-based education. Self-confidence scores increased from 62.35 ± 8.12 to 78.40 ± 7.65, while perception scores improved from 65.10 ± 9.05 to 81.25 ± 8.40, both statistically significant at p < 0.001. A strong positive correlation (r = 0.72, p < 0.001) was observed between self-confidence and perceptions. Thematic analysis generated five themes, including emotional engagement, skill development, confidence enhancement, technological realism, and suggestions for diverse scenarios. The study concludes that simulation-based education significantly enhances nursing students’ confidence, satisfaction, and perceptions. Integration of simulation into nursing curricula is recommended to strengthen clinical preparedness and professional competence.