The Impact of Situation Simulation and Reflection Training on the Work Conscientiousness of Nursing Students: A Quasi-experimental Study
Authors: Mozaffari Zahra , Hekmati Pour Nafiseh , Naderkhani Razieh 
Published: January 2025

Background: Work conscientiousness refers to an ethical attitude towards assigned tasks. Teaching ethical principles and values using modern educational methods, such as situation simulation and reflection, can foster the sustainable learning of ethical issues among nursing students. Objectives: This study aimed to compare the effectiveness of situation simulation and reflection training in improving the work conscientiousness of nursing students at Islamic Azad University in Golestan province. Methods: This quasi-experimental study employed a pre-test-post-test design with a control group and included 75 nursing students (semesters 7 and 8) at the Islamic Azad University in Golestan province in 2023. Participants were selected through cluster sampling. To achieve this, three faculties from different regions in Golestan province were chosen by drawing lots. For randomization, sealed envelopes containing letters representing three groups—(X: The situation simulation group), (Y: The reflection group), and (O: The control group)—were used to assign group membership to the university branches: Situation simulation (Aliabadkatol Branch), reflection (Gonbadkavous Branch), and control (Azadshahr Branch). Subsequently, participants were selected using convenience sampling from students who met the inclusion criteria. The participants in the two intervention groups attended seven 30-minute sessions of either situation simulation or reflection training (once a week). In contrast, the participants in the control group did not receive any intervention. All participants in the three groups completed the Work Conscientiousness Scale from Costa and McCrae’s (1992) NEO Personality Inventory both before and after the intervention. Data were analyzed using SPSS-24 software, applying independent samples t-tests, paired samples t-tests, chi-square tests, Fisher’s exact tests, and analysis of covariance (ANCOVA) at a significance level of P < 0.05. Results: The majority of participants in the three groups were female students aged 20 to 25 years. The mean conscientiousness scores before the intervention for students in the situation simulation, reflection, and control groups were 33.92 ± 6.53, 36.88 ± 9.72, and 36.96 ± 8.02, respectively. The corresponding scores after the intervention were 50.96 ± 4.11, 42.08 ± 5.88, and 36.16 ± 8.6, respectively, indicating a significant difference among the three groups in terms of conscientiousness (P < 0.05). The ANCOVA, after controlling for the pre-test effect, revealed a significant difference between the intervention and control groups (P < 0.01; η² = 0.72). This suggests that 72% of the post-intervention changes in conscientiousness were attributable to the impact of the situation simulation training interventions. Conclusions: Both situation simulation and reflection interventions effectively improve the work conscientiousness of nursing students. However, as demonstrated in this study, the situation simulation intervention is more effective in enhancing work conscientiousness. Therefore, nursing managers, planners, and educators are encouraged to incorporate diverse training programs to promote moral values and enhance the work conscientiousness of nurses and nursing students.