{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:27:00Z","timestamp":1787286420950,"version":"build-2736575974"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Objectives<\/jats:title>\n Patient safety incidents remain an important healthcare concern, and patient safety education is essential for preparing nursing students to recognize and prevent preventable errors in clinical settings. Room of errors simulation is a low-cost and practical educational strategy that can help students identify and respond to patient safety hazards in a realistic environment. This study aimed to develop and implement a room of errors simulation for nursing students preparing for clinical practice and to evaluate its effects on patient safety knowledge, attitudes, and performance confidence.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This quasi-experimental study used a non-equivalent control group pretest-posttest design. Participants were 66 nursing students from three nursing colleges in South Korea. Patient safety knowledge was measured using Park and Park\u2019s instrument, and patient safety attitudes and performance confidence were measured using an adapted Healthcare Professionals Patient Safety Assessment Curriculum Survey. Data were collected in February and March 2024 and analyzed using SPSS version 24.0.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the experimental group, scores increased from 9.52\u202f\u00b1\u202f1.88 to 12.52\u202f\u00b1\u202f2.12 for patient safety knowledge, from 4.20\u202f\u00b1\u202f0.30 to 4.67\u202f\u00b1\u202f0.30 for patient safety attitudes, and from 4.18\u202f\u00b1\u202f0.50 to 4.59\u202f\u00b1\u202f0.41 for patient safety performance confidence. In the control group, corresponding scores were 7.93\u202f\u00b1\u202f1.89 to 8.13\u202f\u00b1\u202f1.52, 4.10\u202f\u00b1\u202f0.31 to 3.98\u202f\u00b1\u202f0.35, and 4.00\u202f\u00b1\u202f0.76 to 3.86\u202f\u00b1\u202f0.89, respectively. After adjusting for baseline scores, the experimental group showed significantly higher posttest scores than the control group for patient safety knowledge (\n F<\/jats:italic>\n \u202f=\u202f57.56,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001, partial \u03b7\n 2<\/jats:sup>\n \u202f=\u202f0.477), patient safety attitudes (\n F<\/jats:italic>\n \u202f=\u202f77.08,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001, partial \u03b7\n 2<\/jats:sup>\n \u202f=\u202f0.550), and patient safety performance confidence (\n F<\/jats:italic>\n \u202f=\u202f21.41,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001, partial \u03b7\n 2<\/jats:sup>\n \u202f=\u202f0.254).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Room of errors simulation was associated with significant improvements in patient safety knowledge, attitudes, and performance confidence among nursing students preparing for clinical practice. These findings suggest that room of errors simulation may be a feasible educational strategy for strengthening patient safety education before clinical practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1931432","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:22:45Z","timestamp":1787286165000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Room of errors simulation for improving patient safety knowledge, attitudes, and performance confidence among nursing students: a quasi-experimental study"],"prefix":"10.3389","volume":"13","author":[{"given":"Sunmi","family":"Jeon","sequence":"first","affiliation":[{"name":"Department of Nursing, Daedong College","place":["Busan, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Nursing, University of Ulsan","place":["Ulsan, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"287","DOI":"10.3928\/01484834-20180420-06","article-title":"Nursing students' perceptions of safety and communication issues in the clinical setting","volume":"57","author":"Gropelli","year":"2018","journal-title":"J Nurs Educ"},{"key":"ref2","volume-title":"To Err Is Human: Building a Safer Health System","author":"Kohn","year":"2000"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"i2139","DOI":"10.1136\/bmj.i2139","article-title":"Medical error\u2014the third leading cause of death in the US","volume":"353","author":"Makary","year":"2016","journal-title":"BMJ"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1787\/761f2da8-en","article-title":"The economics of patient safety: from analysis to action","volume":"145","author":"Slawomirski","year":"2022","journal-title":"OECD Health Work Pap"},{"key":"ref5","year":"2024"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1111\/j.1466-7657.2011.00882.x","article-title":"Patient safety: nursing students' perspectives and the role of nursing education to provide safe care","volume":"58","author":"Vaismoradi","year":"2011","journal-title":"Int Nurs Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3912\/OJIN.Vol20No02Man04","article-title":"The nursing code of ethics: its value, its history","volume":"20","author":"Epstein","year":"2015","journal-title":"Online J Issues Nurs"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"39","DOI":"10.7587\/kjrehn.2023.39","article-title":"Development and evaluation of patient safety education program for undergraduate nursing students","volume":"26","author":"Kim","year":"2023","journal-title":"Korean J Rehabil Nurs"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.apnu.2022.12.030","article-title":"Medical errors room: the effect of simulation training on increasing the awareness of nursing students about the medical errors they may encounter in psychiatry clinics","volume":"43","author":"Yalcinturk","year":"2023","journal-title":"Arch Psychiatr Nurs"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.nedt.2019.05.033","article-title":"Effects of a patient safety course using a flipped classroom approach among undergraduate nursing students: a quasi-experimental study","volume":"79","author":"Kim","year":"2019","journal-title":"Nurse Educ Today"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.nedt.2018.01.019","article-title":"The influence of situation awareness training on nurses' confidence about patient safety skills: a prospective cohort study","volume":"63","author":"Stomski","year":"2018","journal-title":"Nurse Educ Today"},{"key":"ref12","volume-title":"Simulation in Nursing Education: From Conceptualization to Evaluation","author":"Jeffries","year":"2020"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"869","DOI":"10.22251\/jlcci.2023.23.15.869","article-title":"The effects of college simulation practical education on new nurses' clinical competence","volume":"23","author":"Jeon","year":"2023","journal-title":"Korean Assoc Learn Centered Curric Instr"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.jss.2020.02.001","article-title":"Enhancing medical students' interprofessional teamwork through simulated room of errors experience","volume":"251","author":"Turrentine","year":"2020","journal-title":"J Surg Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e1026","DOI":"10.1097\/PTS.0000000000000806","article-title":"Training situational awareness for patient safety in a room of horrors: an evaluation of a low-fidelity simulation method","volume":"17","author":"Zimmermann","year":"2021","journal-title":"J Patient Saf"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"35","DOI":"10.17333\/JKSSN.2022.10.2.35","article-title":"Patient safety education for nursing students with room of errors simulation","volume":"10","author":"Kim","year":"2022","journal-title":"J Korea Soc Simul Nurs"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"105824","DOI":"10.1016\/j.nedt.2023.105824","article-title":"Room of horrors simulation in healthcare education: a systematic review","volume":"126","author":"Lee","year":"2023","journal-title":"Nurse Educ Today"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.2147\/JMDH.S368363","article-title":"Why an IPE team matters: improvement in identification of hospital hazards: a room of horrors pilot study","volume":"15","author":"Reime","year":"2022","journal-title":"J Multidiscip Healthc"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1513\/AnnalsATS.201610-773OC","article-title":"How prepared are medical and nursing students to identify common hazards in the intensive care unit?","volume":"14","author":"Clay","year":"2017","journal-title":"Ann Am Thorac Soc"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1111\/jep.12558","article-title":"Medication errors room: a simulation to assess the medical, nursing and pharmacy staffs\u2019 ability to identify errors related to the medication-use system","volume":"22","author":"Daupin","year":"2016","journal-title":"J Eval Clin Pract"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"10868","DOI":"10.15766\/mep_2374-8265.10868","article-title":"Patient safety escape room: a graduate medical education simulation for event reporting","volume":"15","author":"Diemer","year":"2019","journal-title":"MedEdPORTAL"},{"key":"ref22","volume-title":"WHO patient Safety Curriculum guide: multi-Professional edition","year":"2011"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"3073","DOI":"10.11124\/JBIES-20-00256","article-title":"Patient safety education for undergraduate nursing students: a scoping review protocol","volume":"19","author":"Mugerwa","year":"2021","journal-title":"JBI Evid Synth"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"465","DOI":"10.4040\/jkan.21051","article-title":"Development and effects of head-mounted display-based home-visits virtual reality simulation program for nursing students","volume":"51","author":"Ahn","year":"2021","journal-title":"J Korean Acad Nurs"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"5","DOI":"10.5977\/jkasne.2014.20.1.5","article-title":"Knowledge, attitude, and confidence on patient safety of undergraduate nursing students","volume":"20","author":"Park","year":"2014","journal-title":"J Korean Acad Soc Nurs Educ"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"559","DOI":"10.3928\/01484834-20100730-02","article-title":"Frameworks for patient safety in the nursing curriculum","volume":"49","author":"Chenot","year":"2010","journal-title":"J Nurs Educ"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e58","DOI":"10.1016\/j.nedt.2013.09.020","article-title":"A systematic review of the effectiveness of simulation debriefing in health professional education","volume":"34","author":"Levett-Jones","year":"2014","journal-title":"Nurse Educ Today"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1097\/00001888-200601000-00022","article-title":"Changing and sustaining medical students' knowledge, skills, and attitudes about patient safety and medical fallibility","volume":"81","author":"Madigosky","year":"2006","journal-title":"Acad Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1186\/s12912-024-01831-1","article-title":"Knowledge, attitudes, and practices toward patient safety among nurses in health centers","volume":"23","author":"Ayyad","year":"2024","journal-title":"BMC Nurs"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"667","DOI":"10.7475\/kjan.2017.29.6.667","article-title":"Effect of team debriefing in simulation-based cardiac arrest emergency nursing education","volume":"29","author":"Ko","year":"2017","journal-title":"Korean J Adult Nurs"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"107","DOI":"10.17333\/JKSSN.2023.11.2.107","article-title":"Effects of room of errors simulation education for nursing students on patient safety management behavior intention and confidence in performance","volume":"11","author":"Jung","year":"2023","journal-title":"J Korea Soc Simul Nurs"},{"key":"ref32","article-title":"Nursing and patient safety. PSNet","author":"Phillips","year":"2021"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1931432\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:22:46Z","timestamp":1787286166000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1931432\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":32,"alternative-id":["10.3389\/fmed.2026.1931432"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1931432","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"1931432"}}