Development and Evaluation of an Online Oncology Nursing Septic Shock Simulation Module for Nursing Students: A Mixed Methods Experimental Design
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Purpose: This study aimed to develop an online oncology nursing simulation module focused on septic shock care for cancer patients. Additionally, it sought to evaluate the module’s effectiveness in improving nursing students’ clinical performance, clinical confidence, learning satisfaction, and learning flow. Methods: A mixed-methods experimental design was employed. The simulation module was developed using the ADDIE model and delivered via a web-based platform. Fifty nursing students were randomly assigned to an experimental group (n=25) or a control group (n=25). As normality assumptions were not met, the Mann-Whitney U test was used for group comparisons, and Spearman’s rank correlation was employed to examine relationships among dependent variables. Additionally, three focus group interviews were conducted with the experimental group, and qualitative data were analyzed using a thematic analysis approach. Results: The experimental group showed significantly higher scores in clinical confidence, learning satisfaction, and learning flow compared with the control group (all variables p<.001). Clinical performance also improved, but the difference was not significant (p=.070). Exploratory correlation analysis indicated strong interrelationships among clinical confidence, learning satisfaction, and learning flow (ρ=.53-.76, p<.001), whereas clinical performance was only weakly related to learning flow (ρ=.28, p=.047). Qualitative findings supported these results, highlighting immersive learning and enhanced clinical reasoning. Conclusion: The online oncology nursing simulation module effectively enhanced core competencies, particularly clinical confidence, while also supporting interrelated experiences of learning satisfaction and learning flow, as indicated by exploratory correlation analysis. These findings suggest that web-based simulation is a practical and scalable strategy for nursing education in the digital era.
Abstract
Purpose: This study aimed to develop an online oncology nursing simulation module focused on septic shock care for cancer patients. Additionally, it sought to evaluate the module’s effectiveness in improving nursing students’ clinical performance, clinical confidence, learning satisfaction, and learning flow. Methods: A mixed-methods experimental design was employed. The simulation module was developed using the ADDIE model and delivered via a web-based platform. Fifty nursing students were randomly assigned to an experimental group (n=25) or a control group (n=25). As normality assumptions were not met, the Mann-Whitney U test was used for group comparisons, and Spearman’s rank correlation was employed to examine relationships among dependent variables. Additionally, three focus group interviews were conducted with the experimental group, and qualitative data were analyzed using a thematic analysis approach. Results: The experimental group showed significantly higher scores in clinical confidence, learning satisfaction, and learning flow compared with the control group (all variables p<.001). Clinical performance also improved, but the difference was not significant (p=.070). Exploratory correlation analysis indicated strong interrelationships among clinical confidence, learning satisfaction, and learning flow (ρ=.53-.76, p<.001), whereas clinical performance was only weakly related to learning flow (ρ=.28, p=.047). Qualitative findings supported these results, highlighting immersive learning and enhanced clinical reasoning. Conclusion: The online oncology nursing simulation module effectively enhanced core competencies, particularly clinical confidence, while also supporting interrelated experiences of learning satisfaction and learning flow, as indicated by exploratory correlation analysis. These findings suggest that web-based simulation is a practical and scalable strategy for nursing education in the digital era.