Zhang Baoya

Hainan Vocational University of Science and Technology

Abstract：

The transition from theoretical knowledge to safe clinical practice in nursing education relies heavily on the acquisition of both technical competencies and non-technical skills (NTS). In high-stakes healthcare environments, non-technical skills—encompassing situational awareness, clinical decision-making, teamwork, and communication—are critical determinants of patient safety.While high-fidelity simulation (HFS) has been widely adopted as a pedagogical tool, the exact mechanisms and pathways through which HFS influences the development of NTS in nursing students remain insufficiently quantified. This study constructs and validates a structural equation model (SEM) to explore the influence paths of HFS on NTS, specifically examining the mediating roles of clinical self-efficacy and reflective debriefing. Based on an empirical analysis of simulated survey data from 345 undergraduate nursing students, the findings reveal that HFS design exhibits a significant positive direct effect on NTS (β = 0.32, p < 0.01). More importantly, the cultivation of NTS is heavily dependent on indirect pathways; clinical self-efficacy and reflective debriefing serve as parallel mediators, accounting for 64% of the total effect variance. The integration of structured feedback paradigms, such as the 3C guided feedback model, within the HFS framework significantly accelerates cognitive scaffolding. These results provide actionable insights for nursing educators to optimize simulation-based curricula by prioritizing psychological safety and structured reflection, thereby bridging the translational gap between academic training and complex clinical realities.

Key Words：

high-fidelity simulation; non-technical skills; nursing education; structural equation modeling; path analysis; self-efficacy