目的：本研究旨在评估护理本科生中虚拟仿真和现场仿真的结合。
背景：目前，仿真是我国仿真的主要形式。随着计算机技术的发展,计算机虚拟仿真在仿真中逐渐得到应用,并显示出独特的优势。然而,将虚拟仿真与现场仿真相结合的仿真格式在中国很少见。
方法：这是一项混合方法研究，应用了QUAN→QUAL顺序解释方法。
方法：在定量阶段，一项非随机对照试验(NRCT)在来自中国一所大学护理学院的93名大三护生中进行.选取平行班1、2、3的学生(45名)作为实验组,而平行班4，5和6的学生（48名学生）作为对照组。对照组完成了现场模拟，而实验组需要完成虚拟仿真和现场仿真。教师根据演示清单评估了学生在现场模拟中的表现。模拟后，邀请学生回答“学生学习满意度和自信心量表”(SSS)，模拟教育实践量表(EPSS)和临床学习环境比较调查(CLECS)。在定性阶段进行了描述性定性研究。通过目的抽样方法从实验组中招募了10名学生，并接受了研究人员的采访。采用半结构化访谈法对他们进行了深入访谈。
结果：实验组学生成绩的平均得分高于对照组（63.00vs57.67）。学习满意度没有显着差异，两组患者的自信心和模拟实践得分(合作维度除外)(P>0.05)。对于实验组，现场模拟的CLECS总分高于虚拟模拟，分别为84.98±12.50和72.58±13.04,差异有统计学意义(t=5.270,p<0.001)。在定性阶段采访了10名学生。通过采访,我们了解到，学生认为虚拟仿真与现场仿真相结合有助于提高他们的知识，提高他们的学习信心，帮助他们发展非技术技能(即决策和批判性思维)。
结论：现场仿真是仿真的首选形式，虚拟仿真是现场仿真的有益补充。建议将两者的结合引入护理本科生的模拟课程中。
OBJECTIVE: This study aimed to evaluate the combination of
virtual simulation and in-person simulation among undergraduate nursing students.
BACKGROUND: At present, in-person simulation is the main form of simulation in
China. With the development of computer technology, computer-based
virtual simulation is gradually applied in simulation and has shown unique advantages. However, simulation format that combines
virtual simulation with in-person simulation is rare in
China.
METHODS: This was a mixed methods study, which applied a QUAN→qual sequential explanatory approach.
METHODS: In the quantitative phase, a non-randomized controlled trial (NRCT) was employed among 93 junior nursing students from nursing school of a university in
China. Students from parallel classes 1, 2 and 3 (45 students) were selected as experimental group, while students from parallel classes 4, 5 and 6 (48 students) were selected as control group. The control group completed the in-person simulation, while the experimental group was required to complete both virtual simulation and in-person simulation. The students\' performance in in-person simulation was evaluated by the teachers according to a demonstrating checklist. After simulation, Students were invited to answer the Students\' Satisfaction and Self-confidence in Learning Scale (SSS), Educational Practices in Simulation Scale (EPSS) and Clinical Learning Environment Comparison Survey (CLECS). A descriptive qualitative study was conducted in qualitative phase. Ten students were recruited by a purposive sampling method from the experimental group and were interviewed by the researcher. A semi-structured interview method was used to conduct in-depth interviews with them.
RESULTS: The mean score of the students\' performance in the experimental group was higher than that in the control group (63.00 vs 57.67). There were no significant differences in learning satisfaction, self-confidence and simulated practice score (except cooperation dimension) between the two groups (P>0.05). For experimental group, the total CLECS score in in-person simulation was higher than that in virtual simulation, which was 84.98±12.50 and 72.58±13.04 respectively and the difference was statistically significant (t=5.270, p<0.001). Ten students were interviewed in the qualitative phase. Through the interview, we have learned that students believed that virtual simulation combined with in-person simulation is helpful to enhance their knowledge, improve their learning confidence and help them develop non-technical skills (i.e., decision-making and critical thinking).
CONCLUSIONS: In-person simulation is the preferred form of simulation and virtual simulation is a beneficial supplement to in-person simulation. The combination of the two is suggested to be introduced into the simulation curriculum for undergraduate nursing students.
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