The effect of a virtual simulation-based educational application on nursing students' belief and self-efficacy in communicating with patients about complementary and alternative medicine

Simulation-based learning that focuses on the development and assessment of communication and counseling skills can help nursing students achieve better skill performance and gain self-confidence with decision-making ability. It is unknown whether virtual simulation as an instructional design significantly improves educational outcomes than a traditional lecture with low-fidelity simulation in students.The aim was to explore the effect of a virtual simulation-based educational smartphone application on nursing students' beliefs and self-efficacy in communicating with patients about complementary and alternative medicine (CAM) use.A quasi-experimental study with pretest-posttest nonequivalent control group design.A total of 101 nursing students, who were in their second or third-year nursing program at a Southern Taiwan university volunteered to participate in the academic year 2020-2021. Participants were assigned to an experimental or control group in an elective course.All participants received a 4-hour lecture that included an in-class lecture with low-fidelity simulation (paper-based scenarios) about the risk-benefit assessment of a patient's CAM use. The experimental group received a series of 13 virtual simulation exercises with clinical scenarios by means of a smartphone application. Data from belief and self-efficacy scales were collected at the beginning and end of the course from September 2020 to February 2021. Descriptive and inferential statistics were analyzed using the IBM® SPSS® version 23.0.Although both groups significantly improved their belief and self-efficacy scale scores, the experimental group had significant differences in overall self-efficacy in communicating with patients about CAM use compared with the control group, specifically the CAM perceptions and self-confidence scores.Although both in-class and virtual simulation improved nursing students' belief and self-efficacy, the virtual simulation-based educational app is effective as an adjunct learning tool in significantly increasing nursing students' self-efficacy in communicating with patients about CAM use to help minimize their risks.