Simulation-based and clinical training in undergraduate nuclear medicine education: evaluation of competency outcomes...

Simulation-based training (SBT) has emerged as a structured educational strategy to support safe transition into clinical imaging practice. In nuclear medicine technology (NMT), where high-risk procedures require precision and adherence to radiation protection standards, variability in clinical-based training (CBT) exposure may affect skill acquisition. Evidence evaluating structured simulation integration within undergraduate nuclear medicine education remains limited. This study aimed to evaluate performance outcomes associated with SBT and CBT using a structured OSCE framework to assess competency acquisition, procedural performance, and radiation safety preparedness among undergraduate nuclear medicine students.

A comparative educational evaluation was conducted involving two undergraduate NMT cohorts from separate institutions in Riyadh, Saudi Arabia (SBT, n = 30; CBT, n = 30). Students underwent a structured four-station objective structured clinical examination (OSCE) in a controlled hot laboratory environment assessing theoretical knowledge, radiopharmaceutical dose preparation, dose calibrator operation, and radiation safety management. Normality of the data was assessed using the Shapiro-Wilk test, and homogeneity of variances was evaluated using Levene's test. Independent-samples t-tests with Welch's correction were used to compare group means between SBT and CBT groups. For variables where assumptions were violated, the non-parametric Mann-Whitney U test was applied. Bonferroni correction was applied to account for multiple comparisons (p < 0.0125).

Students trained using simulation demonstrated higher mean scores across all OSCE stations compared with clinically trained peers. Statistically significant differences were observed in stations 2, 3, and 4 (all p < 0.001), favoring the SBT group and remaining significant after Bonferroni correction. Higher mean performance was also observed in theoretical knowledge; however, this difference was not statistically significant.

Simulation-based training was associated with higher mean performance across assessed competencies, with statistically significant differences observed in practical and safety-related OSCE stations (stations 2-4). While no significant difference was observed in theoretical knowledge, these findings suggest that structured simulation may enhance procedural readiness and reinforce radiation safety behaviors in undergraduate nuclear medicine education when integrated alongside clinical training.