Simulation-based pressure ulcer/injury education in undergraduate nursing: perceived effectiveness versus demonstrated clinical competence

Abstract

OBJECTIVE: To evaluate the effectiveness of a simulation-based educational programme designed to support evidence-based pressure ulcer/injury (PU/I) prevention and management among undergraduate nursing students (P.J. Šafárik University in Košice, Slovakia) and to examine the relationship between perceived educational effectiveness and objectively demonstrated clinical competence. METHOD: A single-group post-intervention observational study was conducted among second-year undergraduate nursing students. The educational programme was developed according to international PU/I clinical practice guidelines and the Healthcare Simulation Standards of Best Practice. Students' perceived educational effectiveness was assessed using the simulation effectiveness tool-modified (SET-M), while clinical competence was evaluated using an objective structured clinical examination (OSCE). Associations and group differences were examined using non-parametric tests. RESULTS: The experimental cohort comprised 61 second-year undergraduate nursing students. Students demonstrated high levels of psychomotor competence, with >90% correct performance across all assessed OSCE competencies. The SET-M total score was 46.13±6.54, indicating highly positive perceptions of the simulation experience. No significant association was found between the SET-M total score and OSCE performance (ρ=-0.129, p=0.321), nor between individual SET-M domains and objectively assessed competence. Previous simulation experience and previous secondary education were not associated with either educational outcome. CONCLUSION: The simulation-based educational programme was associated with high levels of objectively demonstrated psychomotor competence and highly positive learner perceptions. However, perceived educational effectiveness was not associated with objectively assessed clinical competence, highlighting the importance of combining learner-reported and performance-based outcome measures when evaluating simulation-based education. These findings support simulation as a strategy for teaching evidence-based PU/I management in undergraduate nursing education.

The authors' abstract, as published at the source. Journal of Wound Care, 2026 · DOI ↗