Student-designed primary care role-play simulation with Plus/Delta debriefing: A quasi-experimental pretest-posttest study in pre-licensure nursing education Galarreta-Aperte, Sergio Gómez-Torres, Piedad Rúger-Navarrete, Azahara Gómez Urquiza, José Luis García Oliva, Sofía Ramón-Arbués, Enrique Membrive Jiménez, María José Debriefing Nursing education Primary care Role-play Simulation Funding for open access charge: University of Granada/CBUA. 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." 2026-03-18T09:50:59Z 2026-03-18T09:50:59Z 2026-03-13 journal article Published version: S. Galarreta-Aperte et al. / Teaching and Learning in Nursing 00 (2026) 1-7. https://doi.org/10.1016/j.teln.2026.02.015 https://hdl.handle.net/10481/112234 10.1016/j.teln.2026.02.015 eng http://creativecommons.org/licenses/by-nc-nd/4.0/ open access Attribution-NonCommercial-NoDerivatives 4.0 Internacional Elsevier