Abstract
Background: The Healthcare Simulation Standards of Best Practice framework (1) guides the design of healthcare simulation and related research. These standards advance the science of simulation by enhancing rigor in simulation design to support interventional fidelity. Few studies describe how to achieve this goal (2,3,4). The aim of this study was to develop and validate a rigorous scenario to examine the impact of simulation-based learning (SBL) on nursing students’ self-efficacy in communicating about stigmatized health topics (e.g., intimate partner violence (IPV) and sexually transmitted infections (STIs)).
Methods: Content experts in IPV, STI, and SBL designed the scenario using a standardized human participant framework, guided by the NLN/Jeffries Simulation Framework (5) and INASCL Standards (1). Three methods were employed to enhance scenario validity. First, experts in SBL, IPV, STIs, health assessment, and performing arts reviewed and revised the scenario over multiple iterations to enhance fidelity. An “exemplar” simulation was recorded as a resource for the performer and facilitators to maintain the reliability of the intervention (6). Nursing students evaluated the scenario in two ways. One group viewed the recording, and a second group participated in the SBL experience. Both groups completed the National League for Nursing Simulation Design Scale (NLNSDS) (7) providing additional feedback through focus group discussions.
Results: After six iterations, the team reached consensus that the scenario met the objectives for the design of the research intervention. Student feedback triangulated with expert consensus confirmed both content and process validity. Student ratings on the NLNSDS were high for Objectives, Information, Feedback, Guided Reflection, and Fidelity. One student evaluation was mixed on items within Problem Solving and Support, yet rated the importance of these items as “neutral.” Based on student feedback, revisions were made to the pre-briefing/debriefing scripts to emphasize problem solving and enhance learner support. The students also identified areas to enhance psychological safety for participants. Results demonstrate a replicable method to ensure fidelity and learner psychological safety for SBL in nursing education.
Conclusion: The methodology enhances the reliability of simulation research, informing curriculum design, and contributing to best practices in preparing nurses for sensitive patient communication.
Notes
References:
1. INACSL Standards Committee, Watts, P. I., McDermott, D. S., Alinier, G., Charnetski, M., & Nawathe, P. A. (2021). Healthcare Simulation Standards of Best Practice: Simulation Design. Clinical Simulation in Nursing, 58, 14–21. https://doi.org/10.1016/j.ecns.2021.08.009
2. Cantrell, M., Mariani, B. & Lengetti, E. (2022). A quantitative research study protocol to advance simulation science in nursing education. Nursing Education Perspectives, 43 (2), 103-108. doi:10.1097/01.NEP.0000000000000891
3. Klenke-Borgmann, L., & Cantrell, M. A. (2021). The design and validation of three interprofessional simulations: A feasibility study. Nursing Education Perspectives, 42(6), E37–E39. https://doi-org.10.1097/01.NEP.0000000000000737
4. Sessions, L., Nemeth, L. S., Catchpole, K., Kelechi, T. (2020). Use of simulation-based learning to teach high-alert medication safety: A feasibility study. Clinical Simulation in Nursing. 47, 60-64. https://doi.org/10.1016/j.ecns.2020.06.013
5. Cowperthwait, A. (2020). NLN/Jeffries Simulation Framework for simulated participant methodology. Clinical Simulation in Nursing, 42, 12 – 21. https://doi.org/10.1016/j.ecns.2019.12.009
6. Santacroce, S. J., Maccarelli, L. M., & Grey M. (2004). Intervention fidelity. Nursing Research, 53(1), 63–66. https://doi.org/10.1097/00006199-200401000-00010
7. National League for Nursing. (2005). Simulation Design Scale (Student Version). https://www.nln.org/education/teaching-resources/tools-and-instruments
Sigma Membership
Iota Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Mixed/Multi Method Research
Keywords:
Simulation, Teaching and Learning Strategies, Simulations Standards
Recommended Citation
Sessions, Laura C.; Lucea, Marguerite; Mark, Hayley; and King, Susan, "Developing a Reliable and Valid SBL Scenario to Ensure Fidelity in Nursing Research" (2026). International Nursing Research Congress (INRC). 57.
https://www.sigmarepository.org/inrc/2026/presentations_2026/57
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-25
Developing a Reliable and Valid SBL Scenario to Ensure Fidelity in Nursing Research
Toronto, Ontario, Canada
Background: The Healthcare Simulation Standards of Best Practice framework (1) guides the design of healthcare simulation and related research. These standards advance the science of simulation by enhancing rigor in simulation design to support interventional fidelity. Few studies describe how to achieve this goal (2,3,4). The aim of this study was to develop and validate a rigorous scenario to examine the impact of simulation-based learning (SBL) on nursing students’ self-efficacy in communicating about stigmatized health topics (e.g., intimate partner violence (IPV) and sexually transmitted infections (STIs)).
Methods: Content experts in IPV, STI, and SBL designed the scenario using a standardized human participant framework, guided by the NLN/Jeffries Simulation Framework (5) and INASCL Standards (1). Three methods were employed to enhance scenario validity. First, experts in SBL, IPV, STIs, health assessment, and performing arts reviewed and revised the scenario over multiple iterations to enhance fidelity. An “exemplar” simulation was recorded as a resource for the performer and facilitators to maintain the reliability of the intervention (6). Nursing students evaluated the scenario in two ways. One group viewed the recording, and a second group participated in the SBL experience. Both groups completed the National League for Nursing Simulation Design Scale (NLNSDS) (7) providing additional feedback through focus group discussions.
Results: After six iterations, the team reached consensus that the scenario met the objectives for the design of the research intervention. Student feedback triangulated with expert consensus confirmed both content and process validity. Student ratings on the NLNSDS were high for Objectives, Information, Feedback, Guided Reflection, and Fidelity. One student evaluation was mixed on items within Problem Solving and Support, yet rated the importance of these items as “neutral.” Based on student feedback, revisions were made to the pre-briefing/debriefing scripts to emphasize problem solving and enhance learner support. The students also identified areas to enhance psychological safety for participants. Results demonstrate a replicable method to ensure fidelity and learner psychological safety for SBL in nursing education.
Conclusion: The methodology enhances the reliability of simulation research, informing curriculum design, and contributing to best practices in preparing nurses for sensitive patient communication.
Description
Discover a replicable methodology for developing reliable, valid simulation scenarios that enhance interventional fidelity and learner psychological safety. Learn how expert collaboration, iterative validation, and student feedback strengthen simulation-based nursing education and prepare nurses for sensitive patient communication.