Cardiopulmonary physical examination is a fundamental nursing skill that is essential for the early recognition of patient problems and safe clinical decision-making. Nursing students often experience difficulties in developing competence and confidence in performing cardiac and pulmonary assessment skills during their early clinical education.
This quasi-experimental study aims to compare the effects of simulation-based training and standardized patient-based training on first-year nursing students' cardiopulmonary physical examination outcomes. The study will evaluate knowledge, clinical skill performance, learning satisfaction, self-confidence, and anxiety levels before and after the educational interventions.
Participants will be first-year nursing students enrolled in a health assessment course. Students will be assigned to either a simulation-based training group or a standardized patient-based training group. Data will be collected using knowledge tests, skill assessment checklists, satisfaction and self-confidence scales, and anxiety measures. The findings are expected to contribute to evidence-based nursing education by identifying effective teaching strategies for improving cardiopulmonary assessment competence among nursing students.
First-year nursing students enrolled in the Nursing Department of the Faculty of Health Sciences during the 2025-2026 academic year.
Enrolled in the Health Assessment I and II courses for the first time.
Willing to participate and able to provide written informed consent.
Agree to attend all educational sessions, including theoretical instruction and practical training.
Previous formal training in cardiopulmonary physical examination (e.g., summer school, certification course, or equivalent training).
Transfer students admitted through horizontal or vertical transfer programs.
Receiving ongoing psychological or psychiatric treatment for a diagnosed mental health condition, particularly anxiety-related disorders.
Withdrawal of informed consent at any stage of the study.
Parallel
Simulation-Based Training
BehavioralSimulation-based training designed to improve nursing students' cardiopulmonary physical examination knowledge, skills, satisfaction, self-confidence, and clinical preparedness through structured practice using a nursing simulation manikin.
Standardized Patient-Based Training
BehavioralStandardized patient-based training designed to improve nursing students' cardiopulmonary physical examination knowledge, skills, satisfaction, self-confidence, and clinical preparedness through structured interactions with trained standardized patients.
Cardiopulmonary Physical Examination Skill Performance
Clinical skill performance scores obtained using a 27-item cardiopulmonary physical examination skills checklist. The checklist assesses students' performance in communication, vital signs assessment, inspection, palpation, cardiac auscultation, and pulmonary auscultation. Each item is scored on a 3-point scale (0 = not performed, 1 = performed incorrectly or incompletely, 2 = performed correctly and completely). Total scores range from 0 to 54, with higher scores indicating greater competence in cardiopulmonary physical examination skills.
Cardiopulmonary Physical Examination Knowledge
Knowledge scores obtained from a 25-item multiple-choice test assessing theoretical knowledge related to cardiopulmonary physical examination. Scores range from 0 to 100, with higher scores indicating greater knowledge.
Student Satisfaction With Learning
Learning satisfaction scores measured using the Student Satisfaction and Self-Confidence in Learning Scale developed by the National League for Nursing (NLN). Higher scores indicate greater satisfaction with the learning experience.
Self-Confidence in Learning
Self-confidence scores measured using the Self-Confidence subscale of the Student Satisfaction and Self-Confidence in Learning Scale. Higher scores indicate greater confidence in performing cardiopulmonary assessment skills.
State Anxiety Level
State anxiety scores measured using the State-Trait Anxiety Inventory (STAI). Higher scores indicate greater anxiety
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