الفهرس 
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Abstract
Clinical teaching is a hallmark of nursing education. It is pivotally important in the development of competency in clinical practice. Simulation is a highly effective instructional strategy for developing clinical skills which include cognitive, technical and behavioral skills. The use of simulation in nursing education evolved through several stages of sophistication, from using oranges to practice intramuscular and subcutaneous injections to the more complex use of sophisticated computerized high fidelity patient simulators. There are many simulation based learning methods that can be used to teach different nursing concepts which are role play, case study, standardized patients, virtual reality, simulation games, computer & web based programs and simulators. Simulators can be classified according to the level of fidelity (low, moderate and high fidelity).
Different methods of simulation can be used for teaching all learning domains. In relation to, cognitive domain, it can be used for developing student’s critical thinking, problem solving, clinical reasoning and decision making skills. It also used to improve students’ theoretical application and their knowledge acquisition and retention. Concerning, psychomotor domain, simulation provides students with a safe and controlled environment free from distraction and interruption to practice skills and perform patient care. It is also important to improve students’ skills acquisition and mastering them. Regarding, affective domain, it is used for helping students to develop self-confidence, self-efficacy, teamwork and communication skills as well as decrease their level of anxiety and stress in the clinical setting and improve their learning satisfaction . In addition, simulation is considered as an excellent tool to measure students’ competency in the application of knowledge and technical skills. It also used to evaluate students’ critical thinking, team building and clinical judgment skills.
The current study aimed to identify opinions of nursing students about usefulness of simulation as a clinical teaching strategy.
The study followed a descriptive exploratory research design. It was carried out at eight Nursing Departments which are using simulation as a clinical teaching strategy at the Faculty of Nursing, Damanhour University. These departments were namely, Critical Care and Emergency Nursing, Pediatric Nursing, Psychiatry and Mental Health Nursing, Obstetric and Gynecological Nursing, Medical-Surgical Nursing, Geriatric Nursing, Community Health Nursing and Nursing Administration Departments. The subjects of this study were 415 nursing students who were enrolled at the previously mentioned 8 nursing departments during the second semester of the academic year 2014-2015.
One tool was used by the researcher for the purpose of data collection:
Tool: Opinions of nursing students about usefulness of simulation as a clinical teaching strategy questionnaire. This tool was developed by the researcher using relevant literatures to identify nursing students’ opinions about usefulness of simulation as a clinical teaching strategy. It comprised four parts:
Part 1:
Students’ profile, it included data about students’ socio-demographic and academic data as age, sex, academic department and academic year.
Part II:
This part included 19 questions in relation to nursing students’ opinions regarding their previous experience with simulation as a clinical teaching strategy. (3 questions in relation to learning objectives, 2 questions with respect to content, 2 questions regarding equipment and supplies, 5 questions concerning learning environment and 6 questions in relation to teacher and students relationship.). In addition to the last question which concerned with methods of simulation based learning and included sub items in relation to each method. The students responded by choosing yes (1) or No (0). This part was scored as follows: <50% Weak, 50% -< 75% Good, 75% and more Very Good.
Part III:
This part included 16 questions in relation to the following domains; cognitive domain, 5 questions concerning (knowledge acquisition and retention, critical thinking, problem solving and decision making skills), psychomotor domain, 4 questions as (skill acquisition and mastering it, safe and controlled environment to practice skills and perform patient care), affective domain, 4 questions regarding (self- confidence, communication skills, team work, decreasing level of anxiety and stress in the clinical setting) and 3 questions in relation to evaluation purposes as (evaluating students’ competency in the application of knowledge and technical skills and evaluating students’ critical thinking, team building and clinical judgment skills.
Part IV:
It included 2 open-ended questions; the first question related to problems facing students during implementation of simulation and the second question related to their recommendations regarding using of simulation.
A pilot study was carried out on approximately 5% of the total number of the study subjects. The results of the pilot study revealed that the tool was clear and applicable.
The structured questionnaire was distributed to nursing students in the second term of the academic year (2014-2015) in each academic year in the clinical area to collect data after explaining the aim of the study.
Main findings of the present study were the follow:
Students’ exposure to simulation methods and their impression about them:
Role-play:
• While all the students in the 2nd year and the majority of the students in the 3rd and the 4th years (97.2% and 93.0% respectively) were exposed to role-play as a clinical teaching strategy, only about one tenth (9.5%) of the 1st year students were found to be exposed to it.
• The students in all academic years had positive experience from using the role-play method with a total mean percent score of (80.5%).
Case study:
• All the students in the 1st year were exposed to case study method. As compared to the majority of the students in the 2nd, the 3rd and the 4th years (97.9%, 95.8% and 97.2% respectively).
• The students in all academic years had positive experience from using the case study method with a total mean percent score of (77.4%).
Simulation on simulators:
• Majority of the students in the 1st, the 2nd and the 3rd years (96.2%, 97.9% and 95.2% respectively) were exposed to simulators, this as compared to all the students in the 4th year.
• Slightly more than half of the students (51.2%) in all academic years ensured that simulators were not working efficiently.
• The students in all academic years had positive experience from using simulators with a total mean percent score of (62.2%).
Variety of simulation methods as simulation games, standardized patients, virtual reality and computer & web based programs:
• The majority of the students in all academic years assured that they had not been exposed to simulation games, standardized patients, virtual reality and computer & web based programs (92.8%, 99.8%, 99.3% and 87.7% respectively).
• The students in all academic years had no experience about variety of simulation methods as simulation games, standardized patients, virtual reality and computer & web based programs with a total mean percent score of (5.1%).
Students’ opinions regarding use of simulation as a clinical teaching strategy:
Firstly, learning objectives
• The students in all academic years had positive impression about learning objectives with a mean percent score of (81.2%)