ผลของการเตรียมความพร้อมก่อนฝึกปฏิบัติด้วยสถานการณ์จำลองโดยใช้ผู้ป่วยมาตรฐานต่อการคิดวิเคราะห์และการตัดสินใจทางคลินิกของนิสิตพยาบาล

Suphaphon Udomluck; Poonsap Soparat*; Sophanna Chatlueng; Wilaiporn  Homtong; Pichayada Siriyawanit

Authors

Suphaphon Udomluck Nation University, Faculty of Nursing
Poonsap Soparat* Faculty of Nursing, Nation University
Sophanna Chatlueng Nation University, Faculty of Nursing
Wilaiporn Homtong Nation University, Faculty of Nursing
Pichayada Siriyawanit Nation University, Faculty of Nursing

Keywords:

Preclinical preparation, Standardized patient, Analytical thinking, Clinical decision-making, Nursing students

Abstract

Analytical thinking and clinical decision-making are essential competencies for preclinical nursing preparation. This two-group pretest–posttest quasi-experimental study aimed to (1) compare analytical-thinking and clinical decision-making scores before and after instruction within the control and experimental groups and (2) compare pretest, posttest, and change scores between two groups. Fifty-three second-year nursing students were purposively recruited and matched by prior achievement. After three withdrawals, 50 participants remained (25 per group). The experimental group received standardized-patient simulation, whereas the control group received lecture plus case analysis. The combined tests yielded Kuder–Richardson 20 reliability coefficients of .73 and .70. Wilcoxon signed-rank and Mann–Whitney U tests were used. Analytical thinking improved in the control (Z=−2.50, p<.01) and experimental groups (Z=−3.45, p<.001), with large effects (r=.50 and .69). Clinical decision-making improved only in the experimental group (Z=−2.05, p<.05), with a moderate effect (r=.41). The clinical decision-making change was greater in the experimental group (U=207.50, Z=−2.05, p<.05), with a small effect (r=.29), whereas analytical-thinking change did not differ (U=221.00, Z=−1.84, p>.05; r=.26). Standardized-patient simulation may strengthen clinical decision-making during preclinical preparation.

References

Burrell, S. A., Ross, J. G., Byrne, C., & Heverly, M. (2023). The effects of a simulation-based experience with standardized participants on learning and clinical decision-making related to nursing management of oncologic emergencies. Journal of Cancer Education, 38(3), 870–878. https://doi.org/10.1007/s13187-022-02199-z

Flanagan, O. L., & Cummings, K. M. (2023). Standardized patients in medical education: A review of the literature. Cureus, 15(7), e42027. https://doi.org/10.7759/cureus.42027

Jeffries, P. R. (2021). The NLN Jeffries simulation theory (2nd ed.). Wolters Kluwer. https://nln.lww.com/The-NLN-Jeffries-Simulation-Theory/p/9781975185046

Lasater, K. (2007). Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education, 46(11), 496–503. https://doi.org/10.3928/01484834-20071101-04

Leetheera, T., Sirited, P., & Somjarit, M. (2025). Integrating standardized patients to enhance practical training in health sciences. Ramathibodi Medical Journal, 48(1), e267786. https://he02.tci-thaijo.org/index.php/ramajournal/article/view/267786 (in Thai)

Loubbairi, S., Lahlou, L., Amechghal, A., & Nassik, H. (2025). The impact of simulation on the development of critical thinking and reflection among nursing and medical students: A systematic review. Korean Journal of Medical Education, 37(2), 187–202. https://doi.org/10.3946/kjme.2025.334

Ma, J., Lee, Y., & Kang, J. (2023). Standardized patient simulation for more effective undergraduate nursing education: A systematic review and meta-analysis. Clinical Simulation in Nursing, 74, 19–37. https://doi.org/10.1016/j.ecns.2022.10.002

Naummasing, K., Permpoonputtana, K., Wangkawan, T., Jaidee, P., Prasomsri, N., & Thichanpiang, P. (2025). Translation and content validity testing of the Thai version of the KIDSCREEN-52 for children and adolescents. Procedia of Multidisciplinary Research, 3(10), 52. https://so09.tci-thaijo.org/index.php/PMR/article/view/7726 (in Thai)

Rattanapanyakorn, F., & Deeprasert, A. (2024). The Effect of case-based learning on critical thinking of nursing students. Journal of The Royal Thai Army Nurses, 25(3), 112–120. https://he01.tci-thaijo.org/index.php/JRTAN/article/view/269037 (in Thai)

Saghafi, F., Blakey, N., Guinea, S., & Levett-Jones, T. (2024). Effectiveness of simulation in nursing students’ critical thinking scores: A pre-/post-test study. Clinical Simulation in Nursing, 89, 101500. https://doi.org/10.1016/j.ecns.2023.101500

Sakulrungjalas, T., Chaiyaratana, C., & Tiwaree, C. (2023). Effectiveness of teaching program to develop the critical thinking skills among nursing students. The Journal of Faculty of Nursing Burapa University. 31(1),17-29. https://he02.tci-thaijo.org/index.php/Nubuu/article/view/260681 (in Thai)

Silva, G. O., Oliveira-Kumakura, A. R. S., Silva, J. L. G., & Carvalho, E. C. (2022). Effect of simulation on stress, anxiety, and self-confidence in nursing students: Systematic review with meta-analysis and meta-regression. International Journal of Nursing Studies, 133, 104282. https://doi.org/10.1016/j.ijnurstu.2022.104282

Sinthuchai, S., Sanghuachang, W., Khunpinit, K., & Phakhapatchpirom, P. (2025). Effectiveness of debriefing for meaningful learning in high-fidelity simulation-based learning on clinical reasoning and clinical decision making of nursing students: A mixed-methods research. Journal of Health and Nursing Research, 41(3), 60–71. https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/280646 (in Thai)

Srisaard, B. (2017). Basic research (10th ed.). Bangkok: Suweereyasan. (in Thai)

Stenseth, H. V., Steindal, S. A., Solberg, M. T., Ølnes, M. A., Sørensen, A. L., Strandell-Laine, C., Olaussen, C., Farsjø Aure, C., Pedersen, I., Zlamal, J., Gue Martini, J., Bresolin, P., Linnerud, S. C. W., & Nes, A. A. G. (2025). Simulation-based learning supported by technology to enhance critical thinking in nursing students: Scoping review. Journal of Medical Internet Research, 27, e58744. https://doi.org/10.2196/58744

Thailand Nursing and Midwifery Council. (2022). Nursing and midwifery strategic plan, 2022–2026. Thailand Nursing and Midwifery Council. https://www.tnmc.or.th/images/userfiles/files/NM%20Strategic%20Plan.pdf (in Thai)

Watson, G., & Glaser, E. M. (1964). Watson–Glaser critical thinking appraisal. Psychological Corporation.

Yotsurin, P., Tancharoen, P., Tipwan, N., & Jamroenwong, N. (2024). Effectiveness of transformative learning for critical thinking among second-year nursing students in principles and techniques of nursing practice. Journal of Nursing and Public Health Research, 4(2), e265377. https://he02.tci-thaijo.org/index.php/jnphr/article/view/265377 (in Thai)