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Background: Recent technological advancements have enabled multi-user virtual environments that can provide safe and interactive training opportunities for healthcare providers. This study aims to develop a multi-user virtual simulation program for metacognition and evaluate the students' satisfaction, clinical judgment, and nursing competencies. Methods: Mixed methods was used. A virtual reality simulation program based on an existing curriculum model and experiential learning theory was developed. The five scenarios were evaluated for content validity and tested for pilot. A total of 57 senior nursing students participated. Clinical judgment and nursing competencies were scored, and interviews were conducted with focus groups. Results: Total scores for nursing competency before and after the simulation program were 243.6(29.82) and 264.0(34.53), respectively, with a significant increase of 20.4 ( t = 4.690, p < .001) post-session. Total scores for clinical judgment ranged from 22.2 to 32.0 (out of 44 maximum possible points). Overall, most of the participants were able to achieve their learning outcomes through the program. Conclusions:The findings suggest that the use of virtual simulation is effective in enhancing nursing competence by enhancing metacognition.

Background: The Simulation Effectiveness Tool (SET) frequently is used to assess perceived learning and confidence in simulation. However, few studies have reported the validity of the tool. This study assessed the reliability and validity of the SET. Method: This retrospective analysis evaluated the tool using 568 cases conducted at three nursing schools. Results: A two-factor model showed reasonable fit indices. The fit statistics for the two-factor structure were: χ 2 , 152.98 ( df = 53, p < .001); comparative fit index, 0.94; root mean square error of approximation, 0.05 (range, 0.04 to 0.06); and standardized root mean square residual, 0.04. In addition, weak convergence was identified between the confidence in the SET and responding in the Lasater rubric. Conclusion: The psychometric properties of the study indicate the SET has demonstrated acceptable evidence of validity and reliability to measure simulation effectiveness in Korean nursing students. The use of this instrument for brief simulation education is recommended. [ J Nurs Educ . 2020;59(4):186–193.]

Aim To develop a comprehensive, hands‐on assessment tool for assessing health in children under five in underserved regions. Design Methodological study design and usability testing were used. Sample Eight nurses working at two health posts and 261 children under five living in the migrant villages participated in the study. Measurement The developed tool was evaluated using 10 items of a questionnaire based on the honeycomb model of Morville (2004). Community nurses administered the questionnaire then followed with a focus group interview after completing a child health exam using the developed tool. Data were collected during July 2017. Results The Hands‐on Assessment Tool for Child Health is composed of developmental screening, identification of risk factors and clinical signs, growth measurement, diagnostic tests and interpretation of each subdomain, and final impressions. Management strategies include parent education, resource networking, referral to a paediatrician, and follow‐up plans. Usability testing revealed high scores on the facets “valuable,” “useful,” “desirable,” and “findable.” Conclusions Considering the demand for hands‐on tools in underserved regions, the developed tool can provide nurses with resources for competent management of child assessment, interpretation, and nurses' intervention strategies, fortified with clinical judgement processes.