Standardized Patient Versus Virtual Patient Simulations in Tracheostomy Care: Effects on Nursing Students' Knowledge, Clinical Reasoning, Competence, and Knowledge Retention.
Tracheostomy care is a major skill that requires knowledge, clinical reasoning, and competency. Simulation-based education offers a safe learning environment; however, evidence comparing virtual and standardized patient simulations in tracheostomy care remains limited. The study compared the effects of virtual and standardized patient simulations on nursing students' knowledge, knowledge retention, clinical reasoning, and competency in tracheostomy care. A randomized, 2-arm, parallel-group, pre-test and post-test study was conducted with 68 senior nursing students (virtual patient group:34, standardized patient group: 34). Both groups received identical theoretical training and participated in simulation scenarios. The "Tracheostomy Care Knowledge Test", "Clinical Reasoning Scale", and "Nursing Student Competency Scale" were used for pre-test and post-test. Knowledge retention was assessed 4 weeks after the simulation with the "Tracheostomy Care Knowledge Test". No significant differences were found between groups in baseline measurements (P>.05). Both groups demonstrated significant improvements in knowledge, clinical reasoning, and competency (P<.05). Post-test and 4-week retention scores on the "Tracheostomy Care Knowledge Test" were significantly higher in the standardized patient group, with large effect sizes. "Clinical Reasoning Scale" scores increased significantly in both groups (P<.05). The standardized patient group achieved significantly higher post-test scores on the "Verification of Clinical Problems" subscale (P<.05). Regarding "Nursing Student Competency Scale", significant improvements across all subscales and total scores were observed only in the standardized patient group (P<.05). Both virtual and standardized patient simulations are efficacious simulation-based education strategies in tracheostomy care. Nevertheless, standardized patient simulation seems to be more efficacious in enhancing knowledge, knowledge retention, clinical reasoning, and competency.