• Sok Ying Liaw, Albert Scherpbier, Jan-Joost Rethans, and Piyanee Klainin-Yobas.
• Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11 10 Medical Drive 117597, Singapore. nurliaw@nus.edu.sg
• Nurse Educ Today. 2012 Aug 1; 32 (6): e35-9.

BackgroundWith extensive use of simulation in nursing education, researchers around the world are evaluating learning outcomes from simulation. Numerous studies reported the use of knowledge tests and self-reported measures to evaluate simulation outcomes.AimTo determine whether self-reported confidence and knowledge measures are indicators of clinical performance observed in a simulation-based assessment.MethodThirty-one third year nursing students were randomized into intervention and control group. The intervention group received a six hour simulation-based programme in care of a patient with physiological deterioration. Pre and post-tests using knowledge test, confidence scale and simulation-based assessment were conducted immediately before and after the simulation program.ResultsThe intervention group had a significantly higher post-test mean score than the control group for knowledge and clinical performances. Both groups demonstrated a significant improvement on post-test scores from pre-test scores for self-confidence with no significant differences detected among the two groups. Correlation tests indicated no significant correlation between self-confidence and clinical performance, and between knowledge and clinical performance.ConclusionThe study did not provide evidence to support the validity of the knowledge test and self-confidence measures for predicting clinical performance. Most importantly, it revealed potential danger of a simulation-based assessment that could lead toward overestimation of self-confidence.Copyright © 2011. Published by Elsevier Ltd.

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