Purpose
Hybrid simulation has emerged to increase the practicality of simulation training by combining simulators and standardized patient (SP) that implement realistic clinical environments at a high level. This study aimed to develop a hybrid simulation program focused on case of pediatric cardiac catheterization and to evaluate its effectiveness. Methods: The hybrid simulation program was developed according to the Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model. And deep learning-based analysis program was used to analyze non-verbal communication with SP and applied it for debriefing sessions. To verify the effect of the program, a quasi-experimental study using a random assignment design was conducted. In total, 48 nursing students (n=24 in the experimental group; n=24 in the control group) participated in the study.
Results
Knowledge (F=3.53, p=.038), confidence in clinical performance (F=9.73, p<.001), and communication self-efficacy (F=5.20, p=.007) showed a significant difference in both groups and interaction between time points, and the communication ability of the experimental group increased significantly (t=3.32, p=.003).
Conclusion
Hybrid simulation program developed in this study has been proven effective, it can be implemented in child nursing education. Future research should focus on developing and incorporating various hybrid simulation programs using SP into the nursing curriculum and evaluating their effectiveness.

Citations

• Effect of hybrid simulation-based training on improving nursing students’ patient interaction and suturing skills
  Hossein Mashmool, Mohammad Azim Mahmodi, Zahra Amouzeshi, Toktam Bakhshi
  BMC Medical Education.2026;[Epub]     CrossRef
• Secure and accessible AI in nursing education: A modular agentic chatbot framework comparing ChatGPT-4o with an open-source LLM for chronic wound care
  Necip Gurler, Tuba Sengul, Samet Husnu Bulbul, Dilek Yilmaz Akyaz, Ozgur Guler, Asım Evren Yantac, Emir Bedirhan Aydın, Holly Kirkland-Kyhn
  Nurse Education in Practice.2026; 93: 104789.     CrossRef
• Effectiveness of artificial intelligence in nursing simulation education: A systematic review, meta-analysis and bibliometric visualization analysis
  Xiaoqian Yan, Ziyu Wang, Ou Chen, Yufang Guo
  Nurse Education Today.2026; 167: 107217.     CrossRef
• Development and preliminary evaluation of a procedural performance-oriented back-table setting simulation program for nursing students
  Junmin Park, Eunyoung E. Suh
  The Journal of Korean Academic Society of Nursing .2026; 32(2): 230.     CrossRef
• Enhancing blood transfusion-related competencies through hybrid simulation: Effects on student satisfaction, knowledge acquisition, and clinical transfer of skills
  Sanaa Elmahdaoui, Ghizlan Bouzini, Mohammed Aabdi, Hicham Sbai
  Clinical Simulation in Nursing.2026; 117: 102019.     CrossRef
• Enhancing nurse-parent partnership for NICU nurses by investigating multi-modal learning with a hybrid simulation approach that integrates metaverses and real-world training
  Hee Young Kim, Soon Hyun Myung, In Young Cho
  Nurse Education in Practice.2025; 84: 104294.     CrossRef
• The role of artificial intelligence in shaping nursing education: A comprehensive systematic review
  Jiatian Ma, Jiamin Wen, Ying Qiu, Yuling Wang, Qiao Xiao, Tingting Liu, Dong Zhang, Yangyang Zhao, Zebang Lu, Zhiling Sun
  Nurse Education in Practice.2025; 84: 104345.     CrossRef
• Developing scales for clinical emotional intelligence and clinical competency and initial testing in a randomized controlled trial with hybrid simulation
  Jefferson Garcia Guerrero
  Nurse Education in Practice.2025; 87: 104450.     CrossRef
• Clinical simulation in teaching nursing students: Scoping review
  Daniel Ferreira, Delfina Borges, Maria José Oliveira, Paula Flores, Hélder Cunha, Mafalda Silva
  Athena Health & Research Journal.2025;[Epub]     CrossRef