Analysis of Knowledge and Satisfaction in Virtual Clinical Simulation among Nursing Students: A Mixed Study

Round 1

Reviewer 1 Report

The abstract lacks the fact that more sentences are not dedicated to stating and introducing the topic of the research. We almost go directly to talking about the rest of the sections: objectives, methodology, results and conclusions.

The research objectives are well stated. The research generated is of interest and contributes with its results to the improvement of science. The integration of virtual simulation into nursing curricula is very necessary and therefore many more studies like this one are necessary to provide results on its effectiveness or not.

It's a shame the sample isn't larger. There are only 159 nursing students.

Congratulations on Figure 1, which provides a graphic view of the lexicometric discourse on the satisfaction perceived by students in the virtual simulation and the latent meaning in their responses. This is a very revealing, ingenious and very interesting figure for better analysis of the results.

I found the discussion very accurate and the references provided very pertinent.

I consider that the references are scarce, and more references could be incorporated to support both the introduction and the discussion of the research carried out.

Author Response

Manuscript ID: nursrep-2928063

Reviewer 1

The abstract lacks the fact that more sentences are not dedicated to stating and introducing the topic of the research. We almost go directly to talking about the rest of the sections: objectives, methodology, results and conclusions.

Thank you. We have addressed your input by incorporating additional information into the abstract.

Abstract Pag 1, Line 18-20

The research objectives are well stated. The research generated is of interest and contributes with its results to the improvement of science. The integration of virtual simulation into nursing curricula is very necessary and therefore many more studies like this one are necessary to provide results on its effectiveness or not.

Thank you very much for your motivating comments.

 It's a shame the sample isn't larger. There are only 159 nursing students.

You are absolutely right. The students constitute a naturally limited group. We have added this information to the limitations section.

Limitations Pag 10, Line 320

Congratulations on Figure 1, which provides a graphic view of the lexicometric discourse on the satisfaction perceived by students in the virtual simulation and the latent meaning in their responses. This is a very revealing, ingenious and very interesting figure for better analysis of the results.

Thank you very much for your words. We are truly pleased with the visual result achieved, as it enhances reader comprehension.

I found the discussion very accurate and the references provided very pertinent.

 I consider that the references are scarce, and more references could be incorporated to support both the introduction and the discussion of the research carried out.

As you suggested, we have added several more recent studies to both the introduction and the discussion sections.

Introduction Pag 2, Line 48-53, 54-66

Discussion Pag 8, Line 233-35, 237-39, 268-70, 280-84, 286-89, 298-301

Thank you once again for your time and review. We remain at your disposal.

Author Response File: Author Response.pdf

Reviewer 2 Report

Dear Authors,

Congratulations on your study. You have submitted a very interesting article for our readers. I would suggest enhancing the introduction by adding some more recent studies and similarly, revising the discussion by enriching it with some more studies as a comparison. Also, it is important to add the information regarding the supervision in the text about the authors' contributions conceptualization.

Best regards

Author Response

Manuscript ID: nursrep-2928063

Reviewer 2

Dear Authors,

Congratulations on your study. You have submitted a very interesting article for our readers. I would suggest enhancing the introduction by adding some more recent studies and similarly, revising the discussion by enriching it with some more studies as a comparison. Also, it is important to add the information regarding the supervision in the text about the authors' contributions conceptualization.

Best regards

Thank you very much for this opportunity, and we greatly appreciate your comments. We remain at your disposal.

Introduction Pag 2, Line 48-53, 54-66

Discussion Pag 8, Line 233-35, 237-39, 268-70, 280-84, 286-89, 298-301

Thank you very much for your contribution regarding the authors. We have revised the section.

Authors’ Contributions Pag 11, Line 356-63

Thank you once again for your time and review. We remain at your disposal.

Author Response File: Author Response.pdf

Reviewer 3 Report

The title is confusing. I thought it was a typo at first.  The study is a qualitative and quantitative study - you could put 'a mixed methods approach'. 

The influence of prior professional experience is not listed in the aim or title.

Suggest adding in the abstract what type of virtual simulation based clinical intervention - if it was pediatrics, adults, outpatient etc.  Later in the introduction it states the simulation is respiratory pathology - if possible- with word count suggest adding that into the abstract.

Introduction:

Line 66 - sentence 'Here are elements of face to face clinical simulation that are challenging to replicate virtually.' Sentence seems to be missing what are the elements that are clinically challenging to replicate virtually. Maybe meant to say "There are elements...'

If the paper length allows - suggest adding some background on virtual simulation - its history and use in nursing schools, possibly data on how the pandemic impacted its use (I imagine it increased as an important tool in clinicals) and types of Virtual simulation - if there are different types where you physically don the VR glasses, or watch on a computer screen, or have an interactive mannequin etc. 

Appears to be a typo on line 100 - due to enrollment n - might mean enrollment in

Add if the study was approved by the IRB and how students were consented (verbal written etc). I see this appears at the very end of the article but suggest including this in the methods section as is typical with journal articles. Clarify if those who did not consent to participate in the research still participated in the virtual simulation - was this made a part of the course and only the surveys and data collected were part of the research study?

Just a note - access route to the university was confusing for someone from the US.  I initially thought you were asking students how they got to the university - for example if they took a bus or drove a car there.  Entry point or prior highest degree level might be more universally understood.

Describe the qualifications of the research team to design the virtual simulation case. 

Author Response

Manuscript ID: nursrep-2928063

Reviewer 3

The title is confusing. I thought it was a typo at first.  The study is a qualitative and quantitative study - you could put 'a mixed methods approach'.

Thank you for your input. We have changed the title as you suggested reflecting the study's mixed methods approach.

The influence of prior professional experience is not listed in the aim or title.

Yes, you are right, but we have added it as secondary objectives under prior work experience.

Suggest adding in the abstract what type of virtual simulation based clinical intervention - if it was pediatrics, adults, outpatient etc.  Later in the introduction it states the simulation is respiratory pathology - if possible- with word count suggest adding that into the abstract.

Thank you for your contribution. We have added the information to the abstract.

Abstract Pag 1, Line 26

Introduction:

Line 66 - sentence 'Here are elements of face to face clinical simulation that are challenging to replicate virtually.' Sentence seems to be missing what are the elements that are clinically challenging to replicate virtually. Maybe meant to say "There are elements...'

Thank you for your comment. You were right: this was due to a typographical error.

Introduction Pag 2, Line 89-90

If the paper length allows - suggest adding some background on virtual simulation - its history and use in nursing schools, possibly data on how the pandemic impacted its use (I imagine it increased as an important tool in clinicals) and types of Virtual simulation - if there are different types where you physically don the VR glasses, or watch on a computer screen, or have an interactive mannequin etc. 

Thank you for your input. We have added the information you requested to the introduction.

Introduction Pag 1, Line 48-53, 54-66

Appears to be a typo on line 100 - due to enrollment n - might mean enrollment in

Thank you, we have corrected the error.

Add if the study was approved by the IRB and how students were consented (verbal written etc). I see this appears at the very end of the article but suggest including this in the methods section as is typical with journal articles. Clarify if those who did not consent to participate in the research still participated in the virtual simulation - was this made a part of the course and only the surveys and data collected were part of the research study?

Thank you for your comment. We have added all this information.

Materials and Methods Pag 3, Line 124-36

Just a note - access route to the university was confusing for someone from the US.  I initially thought you were asking students how they got to the university - for example if they took a bus or drove a car there.  Entry point or prior highest degree level might be more universally understood.

Thank you, we have changed the term "pathway" to "entry point."

Describe the qualifications of the research team to design the virtual simulation case. 

We have added all this information.

Materials and Methods Pag 3, Line 141-46

Thank you very much again for reading our manuscript in such detail and offering us options for improvement.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Dear authors, many thanks for replying to my comments and revising the manuscript. It is a very interesting article for our readers.

Best regards