Perceived Simulation Design Quality, Educational Effectiveness, Satisfaction, and Self-Confidence in a...

Background: Early recognition and management of burns are essential, yet access to technologically complex simulation may be limited in resource-constrained educational settings. Methods: We developed a resource-conscious simulation scenario for the initial management of adult burns, established its content validity, and evaluated its implementation across three Brazilian public universities. Nine experts assessed content validity, and post-intervention evaluation included 48 nursing students. Perceived simulation design quality, perceived educational effectiveness, satisfaction, and self-confidence were measured. Results: The scenario demonstrated adequate content validity (S-CVI/Ave = 0.86). Median scores were 4.60/5.0 for design quality, 2.63/3.0 for perceived educational effectiveness, 4.80/5.0 for satisfaction, and 4.38/5.0 for self-confidence. Perceived design quality correlated positively with perceived effectiveness (ρ = 0.557; 95% CI 0.317-0.731), satisfaction (ρ = 0.711; 95% CI 0.529-0.831), and self-confidence (ρ = 0.612; 95% CI 0.390-0.767; all p < 0.001). After adjustment for age, region, and previous simulation experience, each one-point increase in design rating remained associated with a 0.43-point increase in perceived effectiveness (95% CI 0.17-0.69; p = 0.002). Conclusions: Higher perceived design quality was associated with more favourable self-reported educational outcomes. The scenario was implemented across three institutions, but its effects on knowledge and clinical performance require further evaluation.