Evaluation of the implementation of clinical simulation as a learning tool: an 18-month experience at a university...

Clinical simulation has become established as a key tool in healthcare education; however, evidence regarding its multidisciplinary implementation in university hospitals, integrating distinct professional profiles into institutional programs, remains limited. The objective of this study was to evaluate the satisfaction and perceived impact of clinical simulation following its structured implementation over 18 months in a university hospital.

An observational, descriptive, cross-sectional study was conducted, corresponding to Level 1 of the Kirkpatrick model. The study included attending physicians, medical residents, nursing staff, and nursing assistants from the Hospital Universitari Consorci Sanitari de Terrassa (Catalonia, Spain) who participated in simulation activities between March 2024 and August 2025. Satisfaction was assessed using the validated Spanish version of the Clinical Simulation Quality and Satisfaction Survey by Durá Ros (14 items, 1-5 Likert scale). A descriptive analysis by professional category and a correlation analysis between age and global satisfaction were performed. The statistical significance level considered for the analysis was set at 5%.

A total of 542 valid questionnaires were analyzed (mean age 37 ± 11 years; 76.9% women). Although all dimensions showed mean scores above 4.5/5, comparative analysis revealed statistically significant differences according to professional profile. The nursing group achieved the highest scores, particularly in activity prioritization (4.97 ± 0.17; p < 0.001) and communication (p = 0.028). Specifically, for overall satisfaction (p = 0.003) and perceived improvement in competencies (p = 0.042), post hoc analysis confirmed significant differences between the nursing group and the TCAE/Other group (adjusted p = 0.030 and adjusted p = 0.036, respectively). No significant correlation was found between age and overall satisfaction (ρ = -0.027; p = 0.52).

The structured implementation of clinical simulation in a university hospital was associated with very high levels of acceptance among professionals from different categories, even in the absence of a dedicated simulation center. The multidisciplinary approach of this study-integrating attending physicians, residents, nurses, and nursing assistants-suggests the transversal utility of simulation in real healthcare teams within hospital continuing education. However, given the cross-sectional design and the focus on Level 1 outcomes, further research using longitudinal or controlled methodologies is required to confirm these findings and to objectively evaluate skill acquisition, transfer to clinical practice, and long-term healthcare impact.