Ghada Khawand Ayle

Title: The influence of simulation based training on the development of critical thinking and on the sense of self efficacy related to appropriate behaviors in complex clinical situations: A descriptive correlational study among nursing students in beirut

Abstract

In contemporary clinical settings, especially when practitioners face complex situations, the quality and safety of care depend greatly on nurses’ ability to think critically and on their confidence to act (Gagnon and Roberge, 2012). According to Bandura (1997), self-efficacy is a major determinant of clinical performance: high levels speed up the acquisition of technical skills, strengthen clinical judgment, and lower the risk of mistakes. Initial training should therefore cultivate environments that nurture both critical thinking and self-efficacy, preparing practitioners to make safe, well-reasoned decisions. High-fidelity simulation is a well-validated pedagogical strategy: exposing learners to realistic clinical scenarios followed by structured debriefing simultaneously enhances critical analysis and self-confidence (Cant and Cooper, 2017). However, in Lebanon, few studies have examined how simulation jointly influences critical thinking and self-efficacy; this thesis aims to address that gap. The study employs a quasi-experimental design involving 120 second- and third-year students at two Lebanese universities. Quantitative data on critical thinking and self-efficacy were collected before and after a simulation-based training program. Mean critical-thinking scores rose from 27.85 ± 6.29 to 37.68 ± 2.65 (t = -14.62; p < 0.001), while self-efficacy scores increased from 27.68 ± 6.47 to 37.28 ± 2.70 out of 40 (t = -14.11; p < 0.001). A strong correlation emerged between gains in self-efficacy and improvements in critical thinking (r = 0.823; p < 0.001). These findings demonstrate that, even in resource-limited settings, simulation sessions significantly and simultaneously strengthen critical thinking and self-efficacy. Systematically integrating simulation into nursing curricula would therefore boost future professionals’ confidence, refine their clinical judgment, and ultimately enhance patient safety and overall care quality.