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Ethics code: IR.MARAGHEHPHC.REC.1398.010

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1- Department of Nursing, Maragheh University of Medical Sciences, Maragheh, Iran
2- Clinical department, medical school, Maragheh university of medical sciences, Maragheh, Iran
3- Department of General & Vascular Surgery, Maragheh University of Medical Sciences, Maragheh, Iran
4- Maragheh University of Medical Sciences, Maragheh, Iran , nikejordan863@gmail.com
Abstract:   (5 Views)
simulation-only and participation-based clinical training for nurses remains limited. This study compared simulation-based and participation-based clinical training for improving endotracheal intubation competency among acute care nurses.
Materials & Methods: A convergent mixed-methods, quasi-experimental pre-test/post-test study was conducted across the Emergency Department (ED), Intensive Care Unit (ICU), Coronary Care Unit (CCU), and Neonatal Intensive Care Unit (NICU) over six months. Eighty nurses were randomly assigned to simulation-based or participation-based training. Outcomes included knowledge (0–40), attitude (10–40), and Direct Observation of Procedural Skills (DOPS) scores.
Results: The two groups were comparable at baseline (knowledge: 26.68 ± 5.91vs 26.20 ± 7.61, p = 0.756; attitude: 26.78 ± 7.11vs 26.90 ± 6.79, p = 0.936; DOPS: 11.55 ± 2.31vs 11.98 ± 2.64, p = 0.445). After adjustment, post-test scores favored participation-based training: knowledge mean difference = 2.47, Cohen’s d = 0.51(p = 0.025); attitude mean difference = 2.81, Cohen’s d = 0.61(p = 0.008); DOPS mean difference = 1.48, Cohen’s d = 0.78(p < 0.001); and satisfaction mean difference = 0.77, Cohen’s d = 0.51(p = 0.025). Qualitative themes highlighted realism, safety, feedback, and transfer to practice.
Conclusions: Participation-based training produced greater gains in knowledge, attitudes, and performance than simulation. Future research should examine whether hybrid models combining simulation and real-patient training can balance safety with realism. 

 
     
Article Type : Orginal Research | Subject: Medical Education
Received: 2026/01/8 | Accepted: 2026/06/20

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