{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T05:09:58Z","timestamp":1778735398173,"version":"3.51.4"},"reference-count":83,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023674","name":"Deanship of Scientific Research at King Khalid University","doi-asserted-by":"crossref","award":["RGP 2\/263\/46"],"award-info":[{"award-number":["RGP 2\/263\/46"]}],"id":[{"id":"10.13039\/501100023674","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background: Enhanced Recovery After Surgery (ERAS) pathways depend on nursing-led safety behaviours such as early mobilisation, opioid-sparing analgesia, device minimisation, and reliable discharge teaching to prevent immobility-related, opioid-related, and device-related harms. However, pre-licensure medical\u2013surgical preparation inconsistently embeds these competencies, leaving ERAS delivery and patient-safety vulnerable to variation. Objective: To develop an evidence-informed, practice-development framework that translates ERAS principles into measurable nursing competencies and management priorities explicitly linked to patient-safety, quality improvement, and harm reduction in acute surgical care. Methods: This practice-development framework paper used a narrative literature review of ERAS guidelines, AACN Essentials, and published simulation reports (MEDLINE, CINAHL, Embase, Scopus, ERIC) to identify recurring competencies and scenario features. These were inductively organised and mapped to patient-safety priorities to derive a four-domain framework. Findings: Identified simulations emphasised early mobilisation and multimodal analgesia; nutrition, fluid stewardship, device minimisation, and ERAS-focused patient education were less represented. High-fidelity and virtual formats improved knowledge and confidence but rarely reported patient-level outcomes. These gaps informed a four-domain framework: (1) ERAS clinical pillars and priority nursing competencies; (2) scenario and modality design (including a worked POD-1 colorectal case); (3) assessment and feedback strategies anchored by the Lasater Clinical Judgement Rubric; and (4) implementation tools for nurse managers and ERAS leads to integrate simulation into orientation and quality dashboards. The framework conceptually links competencies to safety-relevant endpoints including opioid-related adverse events, immobility-related complications, device-related harms, and discharge-education reliability. Conclusions: ERAS-aligned simulation may offer a feasible, scalable patient-safety and practice-development strategy for aligning pre-licensure preparation with nursing-management priorities for harm reduction. The framework provides a conceptual model that warrants empirical evaluation. It maps ERAS pillars to nursing competencies, operationalises these through a reusable colorectal scenario, and links simulation-derived competencies to unit-level recovery and safety agendas.<\/jats:p>","DOI":"10.3390\/healthcare14101317","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:04:36Z","timestamp":1778601876000},"page":"1317","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Strengthening Patient-Safety in ERAS Pathways: An Evidence-Informed Framework for Simulation-Based Nursing Practice Development in Acute Surgical Care"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3196-0605","authenticated-orcid":false,"given":"Ramasubbamma","family":"Ramaiah","sequence":"first","affiliation":[{"name":"College of Nursing, Khamis Mushait, King Khalid University, Abha 61413, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Lobelle Sampayan","sequence":"additional","affiliation":[{"name":"College of Nursing, Khamis Mushait, King Khalid University, Abha 61413, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasha","family":"Elsayed Ahmed","sequence":"additional","affiliation":[{"name":"College of Nursing, Khamis Mushait, King Khalid University, Abha 61413, Saudi Arabia"},{"name":"College of Nursing, Tanta University, Tanta 31527, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enas A.","family":"Assaf","sequence":"additional","affiliation":[{"name":"College of Nursing, Khamis Mushait, King Khalid University, Abha 61413, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ester","family":"Mary Pappiya","sequence":"additional","affiliation":[{"name":"Department of Maternity and Child Health Nursing, College of Nursing, Najran University, Najran 61441, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalaiselvi","family":"Duraisamy","sequence":"additional","affiliation":[{"name":"College of Nursing, Khamis Mushait, King Khalid University, Abha 61413, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9822-8446","authenticated-orcid":false,"given":"Mathar Mohideen","family":"Nagoor Thangam","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Nursing, Faculty of Nursing, University of Tabuk, Tabuk 71491, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Logapriya","family":"Rajagopal Sambasivan","sequence":"additional","affiliation":[{"name":"Government Medical College, Thiruvallur, TN Dr. MGR Medical University, Chennai 602024, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Jayapal","sequence":"additional","affiliation":[{"name":"Government Medical College, Thiruvallur, TN Dr. MGR Medical University, Chennai 602024, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavithra","family":"Jayapal","sequence":"additional","affiliation":[{"name":"Command Hospital Airforce, Rajive Gandhi University of Health Science, Bengaluru 560041, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishnaraju","family":"Venkatesan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 61413, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mervat","family":"Mostafa Arrab","sequence":"additional","affiliation":[{"name":"College of Nursing, Khamis Mushait, King Khalid University, Abha 61413, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.5114\/ait.2022.113961","article-title":"Enhanced recovery after surgery (ERAS) protocols for spine surgery: Review of literature","volume":"54","author":"Naftalovich","year":"2022","journal-title":"Anaesthesiol. Intensive Ther."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1007\/s00268-017-4436-2","article-title":"Consensus on training and implementation of enhanced recovery after surgery: A Delphi study","volume":"42","author":"Francis","year":"2018","journal-title":"World J. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"991","DOI":"10.2147\/JMDH.S440333","article-title":"Enhancing surgical nursing student performance: Comparative study of simulation-based learning and problem-based learning","volume":"17","author":"Ma","year":"2024","journal-title":"J. Multidiscip. Healthc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1213\/ANE.0000000000002231","article-title":"Enhanced recovery after surgery: Current controversies and concerns","volume":"125","author":"Kehlet","year":"2017","journal-title":"Anesth. Analg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1001\/jamasurg.2016.4952","article-title":"Enhanced recovery after surgery: A review","volume":"152","author":"Ljungqvist","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_6","first-page":"e47237","article-title":"Enhanced recovery after surgery: Exploring the advances and strategies","volume":"15","author":"Jain","year":"2023","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1007\/s00268-018-4844-y","article-title":"Guidelines for perioperative care in elective colorectal surgery: Enhanced recovery after surgery (ERAS\u00ae) society recommendations: 2018","volume":"43","author":"Gustafsson","year":"2019","journal-title":"World J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.clnu.2006.01.015","article-title":"ESPEN guidelines on enteral nutrition: Surgery including organ transplantation","volume":"25","author":"Weimann","year":"2006","journal-title":"Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"101740","DOI":"10.1016\/j.ecns.2025.101740","article-title":"Impact of simulation-based learning experiences on enhancing coping with death in nursing students: An experimental study","volume":"103","year":"2025","journal-title":"Clin. Simul. Nurs."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Rasesemola, R.M., and Molabe, M.P.T. (2025). Enhancing student nurses\u2019 ethical skills via simulation-based learning: Barriers and opportunities. BMC Nurs., 24.","DOI":"10.1186\/s12912-025-02742-5"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"342","DOI":"10.5489\/cuaj.693","article-title":"Enhanced recovery after surgery (ERAS) protocols: Time to change practice?","volume":"5","author":"Melnyk","year":"2011","journal-title":"Can. Urol. Assoc. J."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Maheta, B.J., Singh, N.K., Lorenz, K.A., Fereydooni, S., Dy, S.M., Wong, H.N., Bergman, J., Leppert, J.T., and Giannitrapani, K.F. (2023). Interdisciplinary interventions that improve patient-reported outcomes in perioperative cancer care: A systematic review of randomized control trials. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0294599"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.aorn.2015.08.015","article-title":"Successful implementation of an enhanced recovery pathway: The nurse\u2019s role","volume":"102","author":"Brady","year":"2015","journal-title":"AORN J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Ljungqvist, O., Francis, N., and Urman, R.D. (2020). Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes, Springer.","DOI":"10.1007\/978-3-030-33443-7"},{"key":"ref_15","unstructured":"Ignatavicius, D.D., Winkelman, C., Workman, M.L., Rebar, C.R., and Heimgartner, N.M. (2017). Clinical Companion for Medical-Surgical Nursing, Elsevier Health Sciences."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"28","DOI":"10.4103\/JOACC.JOACC_16_22","article-title":"Enhanced recovery after cesarean protocol versus traditional protocol in elective cesarean section: A prospective observational study","volume":"12","author":"Gupta","year":"2022","journal-title":"J. Obstet. Anaesth. Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.bpa.2015.11.001","article-title":"Enhanced recovery after surgery (ERAS) and its applicability for major spine surgery","volume":"30","author":"Wainwright","year":"2016","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_18","first-page":"49","article-title":"Early mobilization implementation for critically ill patients: A cross-sectional multicenter survey about knowledge, attitudes, and perceptions of critical care nurses","volume":"9","author":"Zhang","year":"2022","journal-title":"Int. J. Nurs. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1002\/nop2.1365","article-title":"ICU quasi-speciality nurses\u2019 knowledge, attitudes, and practices regarding early mobilization: A cross-sectional survey","volume":"10","author":"Zhang","year":"2023","journal-title":"Nurs. Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.bpa.2019.07.016","article-title":"Postoperative pain management in the era of ERAS: An overview","volume":"33","author":"Joshi","year":"2019","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/aas.12651","article-title":"Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 2: Consensus statement for anaesthesia practice","volume":"60","author":"Feldheiser","year":"2016","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1016\/j.anclin.2017.01.018","article-title":"Essential elements of multimodal analgesia in enhanced recovery after surgery (ERAS) guidelines","volume":"35","author":"Beverly","year":"2017","journal-title":"Anesthesiol. Clin."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.clnu.2005.02.002","article-title":"Enhanced recovery after surgery: A consensus review of clinical care for patients undergoing colonic resection","volume":"24","author":"Fearon","year":"2005","journal-title":"Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.clnu.2012.08.011","article-title":"Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced recovery after surgery (ERAS\u00ae) society recommendations","volume":"31","author":"Lassen","year":"2012","journal-title":"Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1007\/s11605-009-0927-2","article-title":"Enhanced recovery after surgery (ERAS) programs for patients having colorectal surgery: A meta-analysis of randomized trials","volume":"13","author":"Eskicioglu","year":"2009","journal-title":"J. Gastrointest. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1007\/s12630-014-0266-y","article-title":"Fluid management and goal-directed therapy as an adjunct to enhanced recovery after surgery (ERAS)","volume":"62","author":"Miller","year":"2015","journal-title":"Can. J. Anaesth."},{"key":"ref_27","first-page":"e72105","article-title":"Prevention and control of catheter-associated urinary tract infection (CAUTI): A patient safety and quality improvement project","volume":"16","author":"Plando","year":"2024","journal-title":"Cureus"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e22944","DOI":"10.2196\/22944","article-title":"Comparing an eHealth programme (My Hip Journey) with standard care for total hip arthroplasty: Randomized controlled trial","volume":"8","author":"Saunders","year":"2021","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100041","DOI":"10.1016\/j.apjon.2022.02.003","article-title":"Enhanced recovery after surgery (ERAS) nursing programme","volume":"9","author":"Achrekar","year":"2022","journal-title":"Asia Pac. J. Oncol. Nurs."},{"key":"ref_30","first-page":"e48795","article-title":"Revolutionizing surgical care: The power of enhanced recovery after surgery (ERAS)","volume":"15","author":"Mithany","year":"2023","journal-title":"Cureus"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"68","DOI":"10.26502\/acc.086","article-title":"Multimodal analgesia in the perioperative period of major surgeries: An in-depth analysis","volume":"7","author":"Kincaid","year":"2025","journal-title":"Anesth. Crit. Care"},{"key":"ref_32","first-page":"e101821","article-title":"Enhanced recovery after surgery (ERAS) protocols and their impact on quality of care and patient safety in peri-anaesthesia nursing: A narrative review","volume":"18","author":"Bourazani","year":"2026","journal-title":"Cureus"},{"key":"ref_33","first-page":"e42943","article-title":"Tolerance to and postoperative outcomes with early oral feeding following elective bowel surgery: A systematic review","volume":"15","author":"Mvoula","year":"2023","journal-title":"Cureus"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1007\/s00268-022-06884-4","article-title":"Impact of preoperative patient education on postoperative recovery in abdominal surgery: A systematic review","volume":"47","author":"Brodersen","year":"2023","journal-title":"World J. Surg."},{"key":"ref_35","unstructured":"Castera, M.R., and Borhade, M.B. (2025, December 25). Fluid management, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532305\/."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e61","DOI":"10.1590\/s1678-9946202567061","article-title":"Effective interventions to prevent catheter-associated urinary tract infections: A systematic review","volume":"67","author":"Li","year":"2025","journal-title":"Rev. Inst. Med. Trop. Sao Paulo"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"146","DOI":"10.11124\/01938924-201513080-00015","article-title":"Nurses\u2019 experiences of advocacy in the perioperative department: A systematic review","volume":"13","author":"Munday","year":"2015","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S42","DOI":"10.1016\/j.mjafi.2020.10.026","article-title":"Interprofessional simulation education to enhance teamwork and communication skills among medical and nursing undergraduates using the TeamSTEPPS\u00ae framework","volume":"77","author":"Mahmood","year":"2021","journal-title":"Med. J. Armed Forces India"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Yu, C., Xian, Y., Jing, T., Bai, M., Li, X., Li, J., Liang, H., Yu, G., and Zhang, Z. (2023). More patient-centered care, better healthcare: The association between patient-centered care and healthcare outcomes in inpatients. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1148277"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e199","DOI":"10.1097\/pq9.0000000000000199","article-title":"Patient-centered goal setting in developmental therapy: Discordance between documented goals and caregiver-perceived goals","volume":"4","author":"Angeli","year":"2019","journal-title":"Pediatr. Qual. Saf."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.profnurs.2024.04.007","article-title":"Roadmap for integrating the AACN essentials with perioperative nursing","volume":"53","author":"Vortman","year":"2024","journal-title":"J. Prof. Nurs."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"305","DOI":"10.2147\/JMDH.S483232","article-title":"Early mobilization in post-orthopedic surgery patients: A scoping review","volume":"18","author":"Rhamelani","year":"2025","journal-title":"J. Multidiscip. Healthc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e70254","DOI":"10.1111\/hex.70254","article-title":"Developing implementation strategies for the adoption of enhanced recovery after surgery (ERAS) protocols: A co-design study","volume":"28","author":"Tobiano","year":"2025","journal-title":"Health Expect."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"INACSL Standards Committee (2016). INACSL standards of best practice: Simulation SM simulation design. Clin. Simul. Nurs., 12, S5\u2013S12.","DOI":"10.1016\/j.ecns.2016.09.005"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ecns.2020.06.003","article-title":"Learning outcomes of the observer role in nursing simulation: A scoping review","volume":"49","author":"Rogers","year":"2020","journal-title":"Clin. Simul. Nurs."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Guerrero, J.G., Tungpalan-Castro, G.M., and Pingue-Raguini, M. (2022). Impact of simulation debriefing structure on knowledge and skill acquisition for postgraduate critical care nursing students: Three-phase vs. multiphase. BMC Nurs., 21.","DOI":"10.1186\/s12912-022-01100-z"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1365-2648.2009.05240.x","article-title":"Simulation-based learning in nurse education: Systematic review","volume":"66","author":"Cant","year":"2010","journal-title":"J. Adv. Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"McBride, S., and Tietze, M. (2022). Nursing Informatics for the Advanced Practice Nurse: Patient Safety, Quality, Outcomes, and Interprofessionalism, Springer Publishing Company.","DOI":"10.1891\/9780826185266"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"794","DOI":"10.11124\/JBIES-20-00100","article-title":"Approaches for defining and assessing nursing informatics competencies: A scoping review","volume":"19","author":"Kleib","year":"2021","journal-title":"JBI Evid. Synth."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Lervik, W., Solberg, M., Wiig, A.C., and Berg, H. (2025). Turning nursing students\u2019 mistakes into resources for learning in simulation-based training: Facilitators\u2019 assumptions about providing feedback in debriefing. BMC Med. Educ., 25.","DOI":"10.1186\/s12909-024-06628-z"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ecns.2021.08.009","article-title":"Healthcare simulation standards of best practice\u2122: Simulation design","volume":"58","author":"Watts","year":"2021","journal-title":"Clin. Simul. Nurs."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1002\/msj.20127","article-title":"The utility of simulation in medical education: What is the evidence?","volume":"76","author":"Okuda","year":"2009","journal-title":"Mt. Sinai J. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e055247","DOI":"10.1136\/bmjopen-2021-055247","article-title":"Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review","volume":"11","author":"Lo","year":"2021","journal-title":"BMJ Open"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ijsu.2008.11.004","article-title":"Implementation of ERAS and how to overcome the barriers","volume":"7","author":"Kahokehr","year":"2009","journal-title":"Int. J. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s13012-017-0597-5","article-title":"Implementation of enhanced recovery after surgery: A strategy to transform surgical care across a health system","volume":"12","author":"Gramlich","year":"2017","journal-title":"Implement. Sci."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1097\/SLA.0000000000000826","article-title":"Association for Surgical Education Simulation Committee. Simulation in surgery: What is needed next?","volume":"261","author":"Stefanidis","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Olla, P., Wodwaski, N., and Long, T. (2025). Beyond the bot: A dual-phase framework for evaluating AI chatbot simulations in nursing education. Nurs. Rep., 15.","DOI":"10.3390\/nursrep15080280"},{"key":"ref_58","first-page":"1","article-title":"The impact of enhanced recovery after surgery (ERAS)-based Islamic perioperative nursing education program on nurses\u2019 competence","volume":"19","author":"Kamil","year":"2025","journal-title":"Open Nurs. J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s13012-024-01398-0","article-title":"Effects of implementation strategies on nursing practice and patient outcomes: A comprehensive systematic review and meta-analysis","volume":"19","author":"Fontaine","year":"2024","journal-title":"Implement. Sci."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Wu, Q., Wang, Y., Lu, L., Chen, Y., Long, H., and Wang, J. (2022). Virtual simulation in undergraduate medical education: A scoping review of recent practice. Front. Med., 9.","DOI":"10.3389\/fmed.2022.855403"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"100227","DOI":"10.1016\/j.ijnsa.2024.100227","article-title":"The development of nursing-sensitive indicators: A critical discussion","volume":"7","author":"Gormley","year":"2024","journal-title":"Int. J. Nurs. Stud. Adv."},{"key":"ref_62","unstructured":"Kolb, D.A. (2014). Experiential Learning: Experience as the Source of Learning and Development, FT Press."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s41077-024-00300-8","article-title":"Improving quality through simulation; developing guidance to design simulation interventions following key events in healthcare","volume":"9","author":"Jones","year":"2024","journal-title":"Adv. Simul."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1177\/10901981251327185","article-title":"The application of cognitive load theory to the design of health and behavior change programs: Principles and recommendations","volume":"52","author":"Baxter","year":"2025","journal-title":"Health Educ. Behav."},{"key":"ref_65","unstructured":"Benner, P., Hughes, R.G., and Sutphen, M. (2008). Clinical reasoning, decisionmaking, and action: Thinking critically and clinically, Patient Safety and Quality: An Evidence-Based Handbook for Nurses."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e75432","DOI":"10.2196\/75432","article-title":"Work experience and anger management in nurses: Cross-sectional analysis based on Benner\u2019s novice to expert theory","volume":"9","author":"Rahmati","year":"2025","journal-title":"Asian\/Pac. Isl. Nurs. J."},{"key":"ref_67","first-page":"951","article-title":"Challenges and opportunities in enhanced recovery after surgery programs: An overview","volume":"68","author":"Gottumukkala","year":"2024","journal-title":"Indian J. Anaesth."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5005\/jp-journals-10071-24883","article-title":"Nurse-led Enhanced Recovery after Surgery Programs: Potential Solution to Shorten Postoperative Recovery","volume":"29","author":"Tyagi","year":"2025","journal-title":"Indian J. Crit. Care Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.4103\/joacp.JOACP_54_18","article-title":"Preoperative patient preparation in enhanced recovery pathways","volume":"35","author":"Iqbal","year":"2019","journal-title":"J. Anaesthesiol. Clin. Pharmacol."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Geng, Z., Bi, H., Zhang, D., Xiao, C., Song, H., Feng, Y., Cao, X., and Li, X. (2021). The impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery: A randomized controlled trial. BMC Anesthesiol., 21.","DOI":"10.1186\/s12871-021-01399-2"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Fern\u00e1ndez, M.C., Casti\u00f1eiras-Mart\u00edn, S., Li\u00e9bana-Presa, C., Fern\u00e1ndez-Mart\u00ednez, E., Gomes, L., and Marques-Sanchez, P. (2022). SBAR Method for Improving Well-Being in the Internal Medicine Unit: Quasi-Experimental Research. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192416813"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"194","DOI":"10.58545\/jkki.v3i2.118","article-title":"The SBAR Communication Method (Situation-Background-Assessment-Recommendation) in Nursing: A Literature Review","volume":"3","author":"Putri","year":"2023","journal-title":"J. Kesehat. Komunitas Indones."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e053687","DOI":"10.1136\/bmjopen-2021-053687","article-title":"Barriers to implementation of enhanced recovery after surgery (ERAS) by a multidisciplinary team in China: A multicentre qualitative study","volume":"12","author":"Wang","year":"2022","journal-title":"BMJ Open"},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Hew, K.F., and Lo, C.K. (2018). Flipped classroom improves student learning in health professions education: A meta-analysis. BMC Med. Educ., 18.","DOI":"10.1186\/s12909-018-1144-z"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jss.2020.02.001","article-title":"Enhancing medical students\u2019 interprofessional teamwork through simulated room of errors experience","volume":"251","author":"Turrentine","year":"2020","journal-title":"J. Surg. Res."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Yeganeh, L.N., Fenty, N.S., Chen, Y., Simpson, A., and Hatami, M. (2025). The future of education: A multi-layered metaverse classroom model for immersive and inclusive learning. Future Internet, 17.","DOI":"10.3390\/fi17020063"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"39","DOI":"10.12688\/mep.19449.2","article-title":"E-learning modules to improve clinical reasoning and practice: A prospective comparative study","volume":"13","author":"Stollar","year":"2024","journal-title":"MedEdPublish"},{"key":"ref_78","first-page":"80","article-title":"Pre-simulation preparation and briefing practices for healthcare professionals and students: A systematic review protocol","volume":"14","author":"Graham","year":"2016","journal-title":"JBI Evid. Synth."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/nmg.0000000000000133","article-title":"Nurse managers\u2019 contribution to the implementation of the enhanced recovery after surgery approach: A qualitative study","volume":"55","author":"Vermeulen","year":"2024","journal-title":"Nurs. Manag."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2614222","DOI":"10.1080\/07853890.2026.2614222","article-title":"Risk factors of venous thromboembolism in ICU patients: A systematic review and meta-analysis","volume":"58","author":"Yang","year":"2026","journal-title":"Ann. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/24740527.2020.1714431","article-title":"Risk factors for severe opioid-induced respiratory depression in hospitalized adults: A case-control study","volume":"4","author":"Boitor","year":"2020","journal-title":"Can. J. Pain"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1177\/17571774211012455","article-title":"Registration of catheter-related complications in adverse events reporting systems: A major underestimation of real complication practice","volume":"23","author":"Laan","year":"2022","journal-title":"J. Infect. Prev."},{"key":"ref_83","first-page":"CD000313","article-title":"Discharge planning from hospital","volume":"2","author":"Lannin","year":"2022","journal-title":"Cochrane Database Syst. Rev."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1317\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T04:19:27Z","timestamp":1778732367000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":83,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["healthcare14101317"],"URL":"https:\/\/doi.org\/10.3390\/healthcare14101317","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]}}}