Simulation Training and Immediate Changes in Experienced Nurses' Self‐Reported Clinical Decision‐Making and Patient Safety Competency: A One‐Group Pretest–Posttest Study

AIM: To examine immediate within-person changes in experienced nurses' self-reported clinical decision-making and patient safety competency after a structured simulation programme. DESIGN: A single-site, one-group pretest-posttest intervention evaluation. METHODS: The study was conducted in educational hospitals affiliated with King Faisal University. Fifty-eight registered nurses in unit-based advanced or specialist clinical roles completed baseline and immediate post-programme assessments. The programme comprised three high-fidelity simulation scenarios addressing septic shock, acute respiratory deterioration and medication safety. Sessions were delivered in small groups over a 4-week window; each session included a 15-min prebriefing, a 20-min scenario and a 40-min debriefing structured using Debriefing for Meaningful Learning. Self-reported clinical decision-making was assessed with the Clinical Decision-Making in Nursing Scale (CDMNS), and patient safety competency was assessed using an adapted reporting structure derived from the Patient Safety Attitudes, Skills and Knowledge Scale (PS-ASK). Paired-sample t-tests, Cohen's dz, and Pearson correlations were reported at both time points. RESULTS: The mean total CDMNS score increased from 136.85 (SD 14.22) at baseline to 152.22 (SD 12.74) immediately after the programme, t(57) = 6.14, p < 0.001, Cohen's dz = 0.81. The overall patient safety competency score increased from 3.35 (SD 0.44) to 3.84 (SD 0.36), t(57) = 6.21, p < 0.001, dz = 0.82. CDMNS and patient safety scores were positively correlated at baseline (r = 0.41, 95% CI [0.17, 0.60], p = 0.001) and immediately post-programme (r = 0.62, 95% CI [0.43, 0.76], p < 0.001). CONCLUSION: Self-reported clinical decision-making and patient safety competency scores were higher immediately after the programme than at baseline. Because the study had no concurrent control group, used self-report measures and did not assess retention or transfer to practice, it cannot establish that simulation caused the score changes or that clinical performance or patient outcomes improved. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was made. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Structured simulation and debriefing may be useful components of continuing professional development for experienced nurses. The present findings are hypothesis-generating and support controlled, multisite evaluations that combine self-report with observer-rated performance and practice-based safety outcomes.