Preliminary evaluation of the impact of a simulation-based training program on needlestick injuries among nursing...

Needlestick injuries (NSIs) pose a significant occupational threat to nursing students. This study aimed to evaluate the impact of a simulation-based training (SBT) program for NSI prevention among nursing students using the Kirkpatrick model.

A quasi-experimental, one-group pre-test/post-test study was conducted with 206 nursing students from a government college in Eastern India. The participants underwent a two-day blended SBT program that incorporated didactic sessions and scenario-based simulations with debriefing using Rapid Cycle Deliberate Practice. Outcomes were evaluated across four Kirkpatrick levels: reaction (satisfaction), learning (knowledge and self-reported practices), behavior (observed practices), and results (NSI incidence). Data were collected at baseline, immediately post-intervention, and at one- and three-month follow-ups.

The mean satisfaction score was high (17.6 ± 2.8/20). Knowledge scores significantly improved from 13.6 ± 3.4 to 16.0 ± 2.9 (mean difference: 2.4; 95% CI: 1.90-2.90; p < 0.001; d = 0.78). Self-reported practice scores showed a large increase from 13.3 ± 1.7 to 17.3 ± 3.0 (mean difference: 4.0; 95% CI: 3.54-4.46; p < 0.001; d = 1.20). The observed behavior scores at three months were 16.1 ± 2.0 (n = 108). The number of reported NSI exposures fell from 48 (23.3%) in the year before training to 6 (2.9%) in the three months after training (an 87.5% relative reduction). Given the unequal recall periods (12 months vs. three months), this reduction should be considered exploratory. Attitude scores also showed significant and sustained improvements from baseline to three months (p < 0.01).

The SBT program was associated with improvements in knowledge, self-reported practices, attitudes, and observed behaviors; it was well accepted and accompanied by a reduction in reported NSIs. However, the lack of a control group and the single-center design limit causal inference. Incorporating SBT into nursing education appears promising for enhancing occupational safety; however, multicenter controlled trials are needed to establish causal evidence.