Abstract
BACKGROUND: Clinical thinking is essential for nursing students. However, traditional teaching focused on theory tends to reduce clinical thinking. METHODS: In this study, 69 undergraduate (third-year) nursing students at a university located in Hunan Province, China, were recruited from March to July 2023. In pediatric nursing, courses were taught using high-fidelity human patient simulator manikins (HF-HPSM) and standardized patient (SP) simulation scenarios. They participated in two scenario simulations and one skills assessment based on scenario simulation, and then the clinical thinking of nursing students before and after the course was compared. Furthermore, the participants' nursing skill differences were compared with 58 students who only participated in skill assessments in previous years. RESULTS: The simulation groups' clinical, critical, and systematic thinking were improved compared to their pre-test scores after the pediatric course(p<0.001). Additionally, the simulation group had significantly different skill performance than the control group(p<0.001). CONCLUSION: The results indicated that the introduction of combined HF-HPSM and SP simulation scenario courses allows for improved clinical, critical, and systematic thinking. Adding simulation with standardized patients portraying family members to the course further increases skill performance compared to theory-based teaching alone.