Development and evaluation of a digital simulation tool for teaching gynecological cytology: a pilot study with...

Training in gynecological cytology within nursing education presents challenges, including limited opportunities for practical experience and a lack of empirically evaluated educational tools. Digital simulation may offer a structured and safe approach to support learning, learner engagement, and practical preparation. This study aimed to develop and evaluate PapSim, a digital simulation tool for teaching gynecological cytology to nursing students.

A pilot educational study was conducted with 40 second-year nursing students following a theoretical session on gynecological cytology. Participants engaged with the PapSim prototype in a supervised laboratory setting. Emotional engagement was assessed using a structured questionnaire based on the Pleasure Framework. Participants rated each emotional dimension on a six-point (0-5) ordinal response scale. Quantitative data were analyzed descriptively and through Spearman's rank correlation analysis. Qualitative responses were examined using thematic content analysis.

Higher mean scores were observed in the categories of Simulation (4.63), Discovery (4.60), and Exploration (4.48), indicating strong engagement with immersive and task-oriented dimensions. Lower scores were reported in Danger (0.78) and Subversion (1.23), reflecting perceptions of safety and appropriateness. Significant positive correlations were identified between Discovery and Competition (ρ = 0.69, p < 0.001), as well as between sensory and empathic dimensions. Qualitative findings reinforced participants' perceptions of realism, cognitive stimulation, and spontaneous peer interaction during the simulation.

The PapSim prototype was positively perceived and well accepted by nursing students, supporting its use as a complementary educational tool for teaching gynecological cytology. Further studies involving larger and more diverse samples are warranted to evaluate educational outcomes.