Effects of a Simulation-based Program on Self-Directed Learning Ability, Metacognition and Clinical Competence in a Nursing Student

시뮬레이션 교육이 간호대학생의 자기주도 학습능력, 메타인지, 임상수행능력에 미치는 효과

  • Received : 2015.07.21
  • Accepted : 2015.10.08
  • Published : 2015.10.31


The purpose of this study was to identify the effect of simulation-based program on self-directed learning ability, metacognition and clinical competence for nursing students. The subjects were 88 students enrolling in the simulation-based practice. Simulation-based program included team based pre-discussion, taking a simulation and being debriefed during 12 weeks. After the subjects had participated in the simulation-based program, they showed statistically significant higher self-directed learning ability(t=4.270, p<.001), metacognition(t=4.435, p<.001) than before. However, there was no significant change in clinical competence. Therefore, facility of self-directed learning ability, metacognition and clinical competence for nursing students needs to develop and operate more systematic simulation-based program.


Supported by : 청주대학교 보건의료과학연구소


  1. W. S. Lee, K. C. Cho, S. H. Yang, Y. S. Roh, G. Y. Lee, "Effects of problem-based learning combined with simulation on the basic nursing competency of nursing students", Journal of Korean Academy of Fundamentals of Nursing, Vol.16, No.1, pp.64-72, 2009.
  2. Korean Accreditation Board of Nursing Education. Purpose of nursing education accreditation, 2012 Available From: (accessed December 3, 2012).
  3. Y. S. Roh, E. S. Cho, W. S. Lee, "Analysis of main instructional design factors for simulation integrated PBL nursing courses", The Journal of Educational Information and Media, Vol.16, No.1, pp.125-143, 2010.
  4. Y. A. Song, Y. J. Son, "Effects of simulation-based practice education for core skill of maternity nursing", Korean Parent-Child Health Journal, Vol.16, No.1, pp.37-44, 2013.
  5. A. Lathrop, B. Winningham, L. VandeVusse, "Simulation-based learning for midwives: background and pilot implementation", Journal of Midwifery & Women's Health, Vol.52, No.5, pp.492-498, 2007. DOI:
  6. P. R. Jeffries, "A framework for designing, implementing, and evaluation simulations used as teaching strategies in nursing", Nursing Education Perspectives, Vol.26, No.1, pp.96-103, 2005.
  7. G. Kocaman, A. Dicle, A. L. Ugur, "A longitudinal analysis of the self-directed learning readiness level of nursing students enrolled in a problem-based curriculum", The Journal of nursing education, Vol.48, No.5, pp.286-290, 2009.
  8. J. H. Choi, J. H. Jeong, "The effect of readiness to self-directed learning on nursing practice competence", Journal of Korean Clinical Nursing Research, Vol.17, No.1, pp.16-26, 2011.
  9. M. R. Song, E. M. Kim, S. J. Yu, "Aanalysis on the competency of nursing students' basic nursing skills", International Journal of Contents, Vol.12, No.6, pp.390-401, 2012. DOI:
  10. M. Y. Jho, M. O. Chae, "Impact of self-directed learning ability and metacognition on clinical competence among nursing students", The Journal of Korean academic society of nursing education, Vol.20, No.4, pp.513-522, 2014. DOI:
  11. P. R. Pintrich, D. A. F. Smith, T. Garcia, W. J., McKeachie, A manual for the use of the motivated strategies for learning questionnaire (MSLQ). Washington, DC: Office of Educational Research and Improvement, 1991.
  12. M. H. Kang, Y. H. Song, S. H. Park, "Relationships among metacognition, flow, interactions and problem solving ability in web-based problem based learning", Journal of Research Institute of Curriculum Instruction, Vol.12, No.1, pp.293-315, 2008.
  13. H. R. Kim, E. Y. Choi, H. Y. Kang, "Simulation module development and team competency evaluation", Journal of Korean Academy of Fundamentals of Nursing, Vol.18, No.1, pp.392-400, 2011.
  14. C. M. Lee, H. S. So, Y. K. Kim, J. E, Kim, M. J. An, "The effects of high fidelity simulation-based education on clinical competence and confidence in nursing students: A aystematic review", International Journal of Contents, Vol.14, No.10, pp.850-861, 2014. DOI:
  15. M. S. Lee, S. W. Hahn, "Effect of simulation-based practice on clinical performance and problem solving process for nursing students", The Journal of Korean academic society of nursing education, Vol.17, No.2, pp.226-234, 2011.
  16. Korean Educational Developmental Institute, A study on the developmental of life-skills: Communication, problem solving, and self-directed learning. Seoul: Korean Educational Developmental Institute, 2003.
  17. W. M. Yi, Effect of metacognition and flow level in learning through educational computer game on problem solving ability, Unpublished master's thesis, Korea National University of Education, ChungBuk, 2004.
  18. P. M. Schwirian, "Evaluating the performance of nurse: a multidimensional approach", Nursing Research, Vol.27, No.6, pp.347-351, 1978. DOI:
  19. W. H. Lee, C. J. Kim, J. S. Yoo, H.K. Hur, K. S. Kim, S. M. Lim, "Development of clinical competency measurement tool for student", Journal Nursing Science, Vol.13, No.1, pp.17-29, 1990.
  20. M. S. Choi, A study on the relationship between teaching effectiveness of clinical nursing education and clinical competency in nursing students, Unpublished master's thesis, Ewha Womans University, Seoul, 2005.
  21. H. Y. Jun, Y. I. Cho, K. E. Park, J. M. Kim, "Effect of human patient simulator-based education on self-directed learning and collective efficacy", International Journal of Contents, Vol.12, No.5, pp.293-302, 2012. DOI:
  22. Y. I. Han, "Effects of nursing simulation-based practice education on learning outcomes and classes experience in nursing students", The Korean Journal of Health Service Management, Vol.18, No.1, pp.135-150, 2014. DOI:
  23. H. J. Choi, "The effects of PBL on the metacognition, critical thinking and problem solving process of nursing students", Journal of Korean Academy Nursing, Vol.34, No.5, pp.712-721, 2004.
  24. Y. J. Oh, H. Y. Kang, "Metacognition, learning flow and problem solving ability in nursing simulation learning", Journal of Korean Academy of Fundamentals of Nursing, Vol.20, No.3, pp.239-247, 2013. DOI:
  25. B. J. Zimmerman, D. H. Schunk, Self-regulated learning and academic achievement: Theory, research, and practice. New York: Springer Verlag, 1989. DOI:
  26. S. O. Kim, S. Y. Pak, "Effects of High-Fidelity Simulation-Based Training of Nursing Students according to their Learning Styles", International Journal of Contents, Vol.13, No.11, pp.1046-1057, 2013. DOI: