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Background: Although the demand for virtual simulation learning is increasing to substitute clinical practicum, there are a lack of studies that identify the relationships among learning flow, cognitive load, and clinical reasoning skills in virtual simulation learning. Methods: This study was a cross-sectional survey with 148 nursing students who completed virtual simulation learning as a substitution for clinical practicum during the COVID-19 pandemic. Participants completed a web-based self-administered questionnaire. Data were analyzed using multiple regression analysis to identify the mediating effects of cognitive load on the relationship between learning flow and clinical reasoning skills. Results: Learning flow and cognitive load were significant predictors of clinical reasoning skills. Cognitive load mediated the relationship between learning flow and clinical reasoning skills. Conclusion: Simulation educators should apply best-practice standards by enhancing learning flow and cognitive load to achieve clinical reasoning skills in virtual simulation learning.

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BackgroundThe word "geop" is a unique Korean term commonly used to describe fright, fear and anxiety, and similar concepts. The purpose of this pilot study is to examine the correlation between the Numeric Rating Scale (NRS) score of geop and three different questionnaires on pain perception.MethodsPatients aged 20 to 70 years who visited our outpatient pain clinics were evaluated. They were requested to rate the NRS score (range: 0-100) if they felt geop. Next, they completed questionnaires on pain perception, in this case the Korean version of the Pain Sensitivity Questionnaire (PSQ), the Pain Catastrophizing Scale (PCS), and the Pain Anxiety Symptoms Scale (PASS). The correlations among each variable were evaluated by statistical analyses.ResultsThere was no statistically significant correlation between the NRS score of geop and the PSQ score (r = 0.075, P = 0.5605). The NRS score of geop showed a significant correlation with the PCS total score (r = 0.346, P = 0.0063). Among the sub-scales, Rumination (r = 0.338, P = 0.0077) and Magnification (r = 0.343, P = 0.0069) were correlated with the NRS score of geop. In addition, the NRS score of geop showed a significant correlation with the PASS total score (r = 0.475, P = 0.0001). The cognitive (r = 0.473, P = 0.0002) and fear factors (r = 0.349, P = 0.0063) also showed significant correlations with the NRS score of geop.ConclusionsThis study marks the first attempt to introduce the concept of "geop." The NRS score of geop showed a moderate positive correlation with the total PCS and PASS score. However, further investigations are required before the "geop" concept can be used practically in clinical fields.