{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:45:55Z","timestamp":1785836755356,"version":"3.56.0"},"reference-count":34,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"School of Nursing, University of S\u00e3o Paulo","award":["480"],"award-info":[{"award-number":["480"]}]},{"award":["480"],"award-info":[{"award-number":["480"]}],"id":[{"id":"https:\/\/ror.org\/036rp1748","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005639","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014Brasil","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100005639","id-type":"DOI","asserted-by":"publisher"}]},{"award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"https:\/\/ror.org\/00x0ma614","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nurs. Rep.","Nursing Reports"],"abstract":"<jats:p>Aim\/Objective: To evaluate undergraduate nursing students\u2019 perceptions of the educational design, debriefing quality, satisfaction, and self-confidence associated with a leadership-focused high-fidelity simulation scenario involving the management of a sharps-injury event. Background: High-fidelity simulation provides structured opportunities for undergraduate nursing students to support learning of communication, prioritization, decision-making, teamwork, and leadership-related behaviors. Design: Single-group educational intervention study using post-intervention learner-reported outcomes. Methods: Fourth-year undergraduate nursing students from a public university in Brazil participated in a 15-min leadership-focused high-fidelity simulation involving the management of a sharps-injury event. After the simulation, participants completed validated instruments assessing simulation design, satisfaction and self-confidence in learning, educational practices, and debriefing. Descriptive statistics and exploratory Pearson correlation analyses were performed using complete data from all participants. Results: Fifty-six students participated in the simulation. Overall, participants reported favorable perceptions of the simulation design, satisfaction with learning, self-confidence, educational practices, and debriefing. Exploratory analyses showed positive correlations between satisfaction and active learning, high expectations, and debriefing quality, as well as between self-confidence and active learning, debriefing, and high expectations. Conclusions: Undergraduate nursing students perceived the leadership-focused high-fidelity simulation scenario as realistic, reflective, and educationally valuable. The scenario may represent a useful pedagogical strategy for introducing leadership-related behaviors in undergraduate nursing education. However, because the findings were based on self-reported perceptions collected after a single simulation activity, they should not be interpreted as evidence of objective leadership-related behaviors or transfer of learning to clinical practice.<\/jats:p>","DOI":"10.3390\/nursrep16080271","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:02:19Z","timestamp":1785830539000},"page":"271","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Educational Value of a Leadership-Focused High-Fidelity Simulation Scenario in Undergraduate Nursing Education: A Single-Group Educational Intervention Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4499-3716","authenticated-orcid":false,"given":"Chennyfer Dobbins Abi","family":"Rached","sequence":"first","affiliation":[{"name":"School of Nursing, University of S\u00e3o Paulo, 419, Av. Dr. En\u00e9as Carvalho de Aguiar, Cerqueira C\u00e9sar, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luiza Oliveira","family":"Sinzato","sequence":"additional","affiliation":[{"name":"School of Nursing, University of S\u00e3o Paulo, 419, Av. Dr. En\u00e9as Carvalho de Aguiar, Cerqueira C\u00e9sar, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thacyane Samara","family":"dos Santos","sequence":"additional","affiliation":[{"name":"School of Nursing, University of S\u00e3o Paulo, 419, Av. Dr. En\u00e9as Carvalho de Aguiar, Cerqueira C\u00e9sar, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria Dorneles Nery","family":"Galiotti","sequence":"additional","affiliation":[{"name":"School of Nursing, University of S\u00e3o Paulo, 419, Av. Dr. En\u00e9as Carvalho de Aguiar, Cerqueira C\u00e9sar, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4685-2423","authenticated-orcid":false,"given":"Reginaldo","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Central Institute, Hospital das Cl\u00ednicas, Faculty of Medicine, University of S\u00e3o Paulo (ICHC-HCFMUSP), R. 225 Dr. Ov\u00eddio Pires de Campos, Cerqueira C\u00e9sar, S\u00e3o Paulo 05403-010, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene Mari","family":"Pereira","sequence":"additional","affiliation":[{"name":"School of Nursing, University of S\u00e3o Paulo, 419, Av. Dr. En\u00e9as Carvalho de Aguiar, Cerqueira C\u00e9sar, S\u00e3o Paulo 05403-000, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0131-0815","authenticated-orcid":false,"given":"Nertila","family":"Podgorica","sequence":"additional","affiliation":[{"name":"Department of Nursing Science and Gerontology, Institute of Nursing Science, UMIT TIROL\u2014Private University for Health Sciences and Health Technology, 6060 Hall in Tirol, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101775","DOI":"10.1016\/j.ecns.2025.101775","article-title":"Healthcare Simulation Standards of Best Practice\u00ae: The debriefing process","volume":"105","author":"Decker","year":"2025","journal-title":"Clin. Simul. Nurs."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101776","DOI":"10.1016\/j.ecns.2025.101776","article-title":"Healthcare Simulation Standards of Best Practice\u00ae: Facilitation","volume":"105","author":"DiGregorio","year":"2025","journal-title":"Clin. Simul. Nurs."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101777","DOI":"10.1016\/j.ecns.2025.101777","article-title":"Healthcare Simulation Standard of Best Practice\u00ae: Prebriefing preparation and briefing","volume":"105","author":"Persico","year":"2025","journal-title":"Clin. Simul. Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ecns.2021.08.009","article-title":"Healthcare Simulation Standards of Best Practice\u00ae: Simulation design","volume":"58","author":"Watts","year":"2021","journal-title":"Clin. Simul. Nurs."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101778","DOI":"10.1016\/j.ecns.2025.101778","article-title":"Healthcare Simulation Standards of Best Practice\u00ae: Professional integrity","volume":"105","author":"Xavier","year":"2025","journal-title":"Clin. Simul. Nurs."},{"key":"ref_6","first-page":"e08","article-title":"Clinical simulation in health education: A systematic review","volume":"41","year":"2023","journal-title":"Investig. Educ. Enferm."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"106270","DOI":"10.1016\/j.nedt.2024.106270","article-title":"The effect of simulation-based learning on nursing students\u2019 clinical decision-making skills: Systematic review and meta-analysis","volume":"140","year":"2024","journal-title":"Nurse Educ. Today"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"15","DOI":"10.5455\/aim.2021.29.15-20","article-title":"Simulation in clinical nursing education","volume":"29","author":"Koukourikos","year":"2021","journal-title":"Acta Inform. Medica"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2147\/JHL.S496266","article-title":"Exploring the impact of transformational and transactional style of leadership on nursing care performance and patient outcomes","volume":"16","author":"Alsharawneh","year":"2024","journal-title":"J. Healthc. Leadersh."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s41077-024-00288-1","article-title":"Global consensus statement on simulation-based practice in healthcare","volume":"9","author":"Armstrong","year":"2024","journal-title":"Adv. Simul."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1177\/01939459221114079","article-title":"Nurse managers\u2019 leadership, patient safety, and quality of care: A systematic review","volume":"45","author":"Lee","year":"2023","journal-title":"West. J. Nurs. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"344","DOI":"10.18295\/squmj.4.2021.007","article-title":"Use of simulation in teaching nursing leadership and management course: An integrative review","volume":"21","author":"Labrague","year":"2021","journal-title":"Sultan Qaboos Univ. Med. J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Costa, P., Sousa, J.P., Nascimento, T., Cruchinho, P., Nunes, E., Gaspar, F., and Lucas, P. (2025). Leadership development in undergraduate nursing students: A scoping review. Nurs. Rep., 15.","DOI":"10.3390\/nursrep15050160"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.2147\/AMEP.S477309","article-title":"Nursing students\u2019 satisfaction and self-confidence with simulation-based learning and its associations with simulation design characteristics and educational practices","volume":"15","author":"Zedini","year":"2024","journal-title":"Adv. Med. Educ. Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/SIH.0000000000000150","article-title":"Reporting guidelines for health care simulation research: Extensions to the CONSORT and STROBE statements","volume":"11","author":"Cheng","year":"2016","journal-title":"Simul. Healthc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2105\/AJPH.94.3.361","article-title":"Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND Statement","volume":"94","author":"Lyles","year":"2004","journal-title":"Am. J. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ecns.2021.08.013","article-title":"Healthcare Simulation Standards of Best Practice\u00ae: Outcomes and objectives","volume":"58","author":"Miller","year":"2021","journal-title":"Clin. Simul. Nurs."},{"key":"ref_18","unstructured":"Jeffries, P.R. (2012). Simulation in Nursing Education: From Conceptualization to Evaluation, National League for Nursing. [2nd ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.mnl.2021.12.003","article-title":"Nurse leaders: Transforming interprofessional relationships to bridge healthcare quality and safety","volume":"20","author":"Stucky","year":"2022","journal-title":"Nurse Lead."},{"key":"ref_20","unstructured":"Almeida, R.G.S. (2016). Simula\u00e7\u00e3o Cl\u00ednica: Valida\u00e7\u00e3o de Instrumentos de Ensino-Aprendizagem Para a L\u00edngua Portuguesa. [Doctoral Dissertation, Universidade de S\u00e3o Paulo]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1590\/0104-1169.0472.2643","article-title":"Validation to Portuguese of the Scale of Student Satisfaction and Self-Confidence in Learning","volume":"23","author":"Almeida","year":"2015","journal-title":"Rev. Lat.-Am. Enferm."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1590\/0104-0707201500004570014","article-title":"Validation for the Portuguese language of the Simulation Design Scale","volume":"24","author":"Almeida","year":"2015","journal-title":"Texto Contexto\u2014Enferm."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s41077-021-00175-z","article-title":"Translation of the Debriefing Assessment for Simulation in Healthcare in Portuguese and cross-cultural adaptation for Portugal and Brazil","volume":"6","author":"Couto","year":"2021","journal-title":"Adv. Simul."},{"key":"ref_24","unstructured":"IBM Corp (2025, November 30). IBM SPSS Statistics for Windows, Available online: https:\/\/www.ibm.com\/products\/spss-statistics."},{"key":"ref_25","unstructured":"Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates. [2nd ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"326","DOI":"10.3928\/01484834-20120409-02","article-title":"Using debriefing for meaningful learning to foster development of clinical reasoning in simulation","volume":"51","author":"Dreifuerst","year":"2012","journal-title":"J. Nurs. Educ."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1097\/SIH.0b013e3182620228","article-title":"Debriefing Assessment for Simulation in Healthcare: Development and psychometric properties","volume":"7","author":"Rudolph","year":"2012","journal-title":"Simul. Healthc."},{"key":"ref_28","unstructured":"Center for Medical Simulation (2010). Debriefing Assessment for Simulation in Healthcare (DASH)\u00a9: Student Version, Short Form, Center for Medical Simulation."},{"key":"ref_29","first-page":"e20230414","article-title":"Nursing students\u2019 perception: Escape room use in teaching leadership skills","volume":"77","author":"Rached","year":"2024","journal-title":"Rev. Bras. Enferm."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Wojcieszek, A., Kurowska, A., Wr\u00f3bel, A., Bodys-Cupak, I., Kami\u0144ska, A., and Majda, A. (2025). Analysis of high-fidelity simulation effects and their connection with educational practices in early nursing education. BMC Nurs., 24.","DOI":"10.1186\/s12912-025-03077-x"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"23779608231194403","DOI":"10.1177\/23779608231194403","article-title":"Effect of High-Fidelity Simulation on Self-Satisfaction and Self-Confidence Among Nursing Students","volume":"9","author":"Toqan","year":"2023","journal-title":"SAGE Open Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1590\/1982-0194201600054","article-title":"Valida\u00e7\u00e3o para a l\u00edngua portuguesa do Educational Practices Questionnaire (Student Version)","volume":"29","author":"Almeida","year":"2016","journal-title":"Acta Paul. DE Enferm."},{"key":"ref_33","unstructured":"(2026, June 08). Clinical Simulation in Nursing. Guide for Authors. ScienceDirect. Available online: https:\/\/www.sciencedirect.com\/journal\/clinical-simulation-in-nursing\/publish\/guide-for-authors."},{"key":"ref_34","unstructured":"(2026, June 08). STROBE Statement. STROBE Checklists. Available online: https:\/\/www.strobe-statement.org\/checklists\/."}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/8\/271\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:04:23Z","timestamp":1785834263000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/8\/271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":34,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["nursrep16080271"],"URL":"https:\/\/doi.org\/10.3390\/nursrep16080271","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]}}}