Evaluating the Effect of Simulation-Based Handover Training and Its Predictors: A Quasiexperimental Study

This study aimed primarily to evaluate the effect of simulation-based handover training on nurses' perceived handover competency (PC). A secondary aim was to identify demographic and psychological factors that predict nurses' perceived handover competency.

A single-group, quasi-experimental, pretest-posttest design was adopted.

Using cluster sampling and purposive sampling, 558 qualified, English-proficient nurses were recruited from 29 hospitals in Hong Kong. A 4-h simulation-based training on the CARE protocol was delivered. Validated instruments with high reliability (overall Cronbach's α = 0.954) measured perceived competency and four psychological factors immediately pre- and post-intervention. The primary objective, assessing changes in perceived handover competency (PC), was analyzed using paired-samples t-tests. The second objective, exploring the predictors of PC, was evaluated using Pearson's correlation and ordinary least squares (OLS) regression. Ethical approval and written consent were obtained. Reporting followed the TREND statement.

The simulation-based training demonstrated a large positive effect on nurses' perceived handover competency (Cohen's d = 1.198, p < 0.001). Staff position (F = 3.813) and age group (F = 3.204) were the only demographic factors associated with significant increases in PC, with registered nurses and nurses aged 30-34 years showing the greatest gains. Perceived competency correlated strongly with resilience (r = 0.920, p < 0.001). Baseline demographic and professional factors explained only 1.8% of the variance in perceived competency (R² = 0.018, p > 0.05), whereas internal psychological factors increased the explained variance to 76.5% (R² = 0.765, p < 0.001). Resilience (β = 0.376, p < 0.001) and intention to complete handover (β = 0.320, p < 0.001) were the strongest predictors.

Simulation-based training is a highly effective intervention for enhancing nursing handover competency. Perceived handover competency was mainly predicted by internal psychological attributes rather than professional factors. Educational programs must prioritize soft skills, specifically resilience, to optimize clinical communication.

For nurse education, the findings indicate that communication training should shift from purely technical training to integrating resilience-building strategies and psychological skills. In clinical practice, nurse leaders should implement ongoing mentorship and feedback to help nurses fully internalize handover protocols. Regarding healthcare policy and management, the findings indicate that hospital administrators should design separate training tracks tailored to the different experience levels of junior and senior nurses, maximizing the growth potential of each group.