Abstract
BACKGROUND: Effective patient communication and mastery of technical skills, such as suturing, are essential competencies for nursing students that directly impact the quality and safety of patient care. Hybrid simulation, which integrates standardized patients with technical skill practice, has emerged as an innovative educational approach, yet empirical evidence on its effectiveness in undergraduate nursing education remains limited. This study aimed to evaluate the impact of hybrid simulation-based training on suturing skills and patient interaction among nursing students. METHODS: A quasi-experimental, two-group pretest–posttest design was conducted with undergraduate nursing students at Birjand University of Medical Sciences. Participants were randomly assigned to either a hybrid simulation intervention or a routine training control group. Data were collected using a demographic questionnaire and two validated checklists assessing communication and suturing skills. In the intervention group, training was conducted using a standardized patient equipped with an artificial arm. A pretest was administered solely to evaluate patient interaction skills using the standardized patient, whereas the posttest assessed both patient interaction and suturing skills using the hybrid simulator. Data were analyzed using Wilcoxon, Mann–Whitney, Analysis of Covariance, and two-way ANOVA tests (α ≤ 0.05). RESULTS: Following the intervention, the mean patient interaction score in the hybrid simulation group increased significantly (p < 0.001) and was also significantly higher than that of the control group (p < 0.001). Additionally, the mean post-intervention suturing skill score was 17.38 ± 1.18 out of 20 in the intervention group and 15.11 ± 3.60 out of 20 in the control group, demonstrating a statistically significant difference between the groups (P = 0.013). CONCLUSION: Hybrid simulation-based training is an effective, experiential approach for concurrently improving patient communication and suturing skills in nursing students. Its integration into clinical skills curricula can enhance learning quality, foster professional competence, and provide a safe environment for repeated practice. Future studies should investigate long-term effects, broader student populations, cost-effectiveness, and comparisons with alternative simulation modalities to optimize its implementation in nursing education. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-026-08841-4.