Evaluating Satisfaction and Self-Confidence among Nursing Students in Clinical Simulation Learning

Round 1

Reviewer 1 Report

I congratulate the authors for the production. I describe the following considerations to contribute to writing the study:

ABSTRACT: inform the period in which the study was carried out in the methods.

KEYWORDS: check more words related to the study, to increase the chance of dissemination and citation.

INTRODUCTION: Give more evidence to the problem identified by the authors. Making the justification for the study clearer and more grounded. Include the impacts of low satisfaction rates and low promotion of self-confidence in nursing education and quality of care.

INTRODUCTION: Since the area emphasized in the study will be "Family and Community Nursing", mention the main gaps and themes that are addressed in clinical simulations in this area of knowledge. Listing the main skills worked. This will help to contextualize and specify the type of knowledge and simulation used in the study, making the study less generalist regarding the subject of "clinical simulations".

METHODS: identify in the study design whether the approach is quantitative or qualitative.

INCLUSION CRITERIA: describe the characteristics, the class was not random. Apparently, they had to be university nursing students, present during the application in one of the scenarios...

METHODS: LINE 116 - Avoid first-person language.

DATA COLLECTION: was the questionnaire entirely self-administered ? Or was there an interviewer? Did participants receive any guidance to answer the questionnaire?

DATA ANALYSIS: the student t test was used . Describe whether the authors used any test to check whether the dependent variable was parametric. To enable the use of the test.

TABLES: include information in the table titles (data collection location; collection period; total sample).

TABLES: identify in the table captions that the student t test was used .

RESULTS: If possible, I suggest highlighting in the description of the results the scores that signal the participants' weaknesses, the instrument statements with the lowest scores, and not just the participants' positive evaluations.

TABLE 5: In table 5, the results regarding the "previous preparation time" in Scenario 2 were not presented.

DISCUSSION: LINE 268 - I suggest mentioning that planning with students should be highlighted. In the method, in the description of the simulation scenarios, include the planning steps with the students in the period prior to the simulation. Prior to the day of execution of the scenarios, what was informed and carried out with the students? Was there any theoretical-practical reference disseminated to students? Or another intervention?

DISCUSSION: LINE 295 - The authors report that the highest satisfaction and self-confidence scores were due to the teaching strategy used in the study. I suggest that you compare the strategy you adopted with the strategy that other studies carried out. What steps in the teaching process did the authors of this study carry out or did not carry out, which differentiate them from previous studies?

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Suggestions for introduction: - Clarity and Flow: While the introduction is comprehensive, it might benefit from some restructuring to improve clarity and flow. Consider organizing the information more systematically, starting with the general importance of CS and then narrowing down to the specific objectives of the research. - Repetitions: There are some repetitive phrases and ideas that could be condensed to make the introduction more concise. For instance, the importance of satisfaction and self-confidence is reiterated multiple times; consider consolidating these points. - Grammar and Syntax: There are a few grammatical and syntactical issues that need to be addressed for clarity and correctness. For example: "satisfaction, which consists of the feeling..." could be rephrased for better clarity. "it has great relevance" could be clearer as "satisfaction is highly relevant." Ensure consistent use of terms and abbreviations. For instance, if "clinical simulation (CS)" is used as an abbreviation, ensure it is consistently used throughout the introduction.

Areas for Consideration in the methodology::

1. Sampling Method: While non-probabilistic convenience sampling is mentioned, it would be beneficial to justify this choice and discuss its potential limitations in the study.
2. Exclusion Criteria: The exclusion criteria only mention visual impairment. It might be relevant to mention other potential exclusion criteria that were considered but not included.
3. Simulation Scenarios: While the scenarios are described in detail, it might be helpful to explain how the scenarios were developed and validated to ensure their appropriateness and relevance.
4. Data Collection: More information on the reliability and validity of the questionnaire used for measuring satisfaction and self-confidence could strengthen the study.
5. Data Analysis: Consider providing more details on the statistical methods planned for analyzing the data to ensure they are appropriate for the study's objectives and the nature of the collected data.
6. Ethical Considerations: While the study was approved by the Ethics Committee and informed consent was obtained, it would be beneficial to provide more information on how participant confidentiality was ensured throughout the study.

7. Areas to improve results:

   1. Consistency: Ensure consistent presentation of results across scenarios. For example, the presentation of satisfaction and self-confidence constructs should follow a similar format in both scenarios for easier comparison.
   2. Statistical Significance: Clearly indicate the level of statistical significance (e.g., p-values) when discussing differences between groups or variables.
   3. Clarity in Results Interpretation: Some sections could benefit from clearer interpretation of the results. For instance, while mean differences are mentioned, their practical significance or implications for nursing education could be elaborated upon.
   4. Explanation for Lack of Statistical Significance: When statistical significance is not found, it may be helpful to discuss possible reasons or limitations that could have contributed to this outcome.
   5. Tables Detailing Mean Comparisons: Ensure that the tables detailing mean comparisons (Tables 3 and 5) are well-organized and easy to understand. Providing clear headings, footnotes, or explanations can enhance clarity.
8. The conclusions drawn are consistent with the results presented and provide a comprehensive summary of the study's findings. They effectively highlight the significance of clinical simulation in nursing education, the importance of preparation time, and potential areas for further exploration. Additionally, the conclusions offer valuable insights for educators and researchers in the field of nursing education, emphasizing the need for well-designed simulation scenarios and continuous improvement in teaching practices.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

This descriptive cross-sectional study attempts to characterize/describe the satisfaction and self-confidence of undergraduate nursing students in carrying out two clinical simulation practices/situations called scenarios 1 and 2 using a validated questionnaire.

It is a well-written and designed work that addresses aspects of great interest to nursing, although I consider some aspects to be improved.

It is explained that:

“The study involved 96 students in scenario 1 (family assessment) and 97 in scenario 2 (family intervention), with the majority being women.”

However, it is unclear if they are the same students who participated in two scenarios or if they are different students in each scenario.

How many students constituted the study population (students enrolled in the Family and Community Nursing III (F&CN III) course) must be explained.

It is a learning situation, but aspects that evaluate whether students have learned and achieved the objectives still need to be introduced.

To correctly evaluate the educational intervention and its evaluation, the script or simulation situation must be explained further. Perhaps this information could be provided as supplementary information.

The paragraph starting on line 126 needs more information about the group size and the sessions. A timetable may be helpful to make it more understandable.

On the line:

116 - I suggest erasing the acronym (SC). It does not correspond with the English wording and is never used again in the text.

117 - In international contexts, the Nursing Process instead of the Nursing Care Process (PAE) is more appropriate. Additionally, the acronym PAE does not correspond with the English wording.

150 – Eliminate the “it” article before “has great”.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf