Student-designed primary care role-play simulation with Plus/Delta debriefing: A quasi-experimental pretest-posttest study in pre-licensure nursing education

Abstract

Background: Clinical simulation is widely used in nursing education but is less frequently implemented in pri-mary care contexts.

Aim: To examine pre-post changes in knowledge and student satisfaction after a student-designed primary-care role-play simulation with Plus/Delta debriefing.

Methods: Quasi-experimental pretest-posttest study without a control group in a pre-licensure nursing course. Knowledge was assessed with a 12-item test completed before the first and after the final session (n = 103 paired). Satisfaction was collected after the activity (n = 73). Wilcoxon signed-rank tests (effect size r) and Spearman correlations were used.

Results: Knowledge scores increased from pre- to post-test (p < .001; r = .519). Lower baseline scores were associated with larger gains (r = -.447; p < .001), suggesting potential ceiling effects. Among respondents, 91.7% reported being satisfied/very satisfied.

Conclusions: A learner-designed primary-care simulation paired with Plus/Delta debriefing was associated with higher knowledge scores and high satisfaction. Controlled and longitudinal studies are warranted to confirm effectiveness and examine skill transfer."