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Background <p>Infection prevention and control (IPC) is essential in healthcare settings, yet evidence on simulation-based learning (SBL) for nursing education in low- and middle-income countries remains limited. This study reports the first experience in Tunisia of integrating a procedural simulation unit focused on Ventilator-Associated Pneumonia (VAP) prevention into the nursing curriculum.</p> Methods <p>A quasi-experimental pre–post study was conducted at the Higher Institute of Nursing Sciences of Tunis (ISSIT). Final-year nursing students (<i>N</i> = 109) participated in three procedural simulation workshops based on Kolb’s Experiential Learning Theory. Students’ knowledge and procedural skills were assessed using structured pre- and post-tests based on international guidelines. Additionally, the quality of the instructional process was evaluated using the Debriefing Assessment for Simulation in Healthcare – Student Version (DASH-SV). Data were analyzed using McNemar’s test for paired samples and Cohen’s d for effect size.</p> Results <p>At baseline, nursing students demonstrated substantial gaps in knowledge regarding VAP prevention and IPC principles; notably, incorrect response rates exceeded 50% for most items. Following the simulation workshops, significant improvements were observed across all assessed domains (<i>p</i> &lt; 0.001). Overall scores increased substantially, with all students achieving a post-test score of at least 10/20, and 66.7% scoring ≥ 15/20. The DASH-SV revealed a high quality of debriefing (Mean global score: 6.85 ± 0.14/7), with a “ceiling effect” observed for instructor effectiveness and psychological safety.</p> Conclusion <p>Simulation-based learning effectively improved nursing students’ IPC knowledge and procedural skills, demonstrating its feasibility for integration into nursing curricula in resource-limited settings. The high DASH scores confirm that a structured and psychologically safe learning environment was successfully established. This study provides a replicable model for future curriculum development to bridge the gap between theory and clinical practice in Tunisia.</p> Clinical trial number <p>Not applicable.</p>

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Pioneering infection prevention and control education through simulation-based learning: impact on knowledge and skills in nursing students in Tunisia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月24日

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  • Samia Khabouchi,
  • Saida Sakhri,
  • Hallouma Ben Fredj,
  • Zohra Benezzine,
  • Sonia Ben Ali,
  • Habiba Mamlouk,
  • Emna Mseddi,
  • Ahmed Zaiem,
  • Alia Jebri

摘要

Background

Infection prevention and control (IPC) is essential in healthcare settings, yet evidence on simulation-based learning (SBL) for nursing education in low- and middle-income countries remains limited. This study reports the first experience in Tunisia of integrating a procedural simulation unit focused on Ventilator-Associated Pneumonia (VAP) prevention into the nursing curriculum.

Methods

A quasi-experimental pre–post study was conducted at the Higher Institute of Nursing Sciences of Tunis (ISSIT). Final-year nursing students (N = 109) participated in three procedural simulation workshops based on Kolb’s Experiential Learning Theory. Students’ knowledge and procedural skills were assessed using structured pre- and post-tests based on international guidelines. Additionally, the quality of the instructional process was evaluated using the Debriefing Assessment for Simulation in Healthcare – Student Version (DASH-SV). Data were analyzed using McNemar’s test for paired samples and Cohen’s d for effect size.

Results

At baseline, nursing students demonstrated substantial gaps in knowledge regarding VAP prevention and IPC principles; notably, incorrect response rates exceeded 50% for most items. Following the simulation workshops, significant improvements were observed across all assessed domains (p < 0.001). Overall scores increased substantially, with all students achieving a post-test score of at least 10/20, and 66.7% scoring ≥ 15/20. The DASH-SV revealed a high quality of debriefing (Mean global score: 6.85 ± 0.14/7), with a “ceiling effect” observed for instructor effectiveness and psychological safety.

Conclusion

Simulation-based learning effectively improved nursing students’ IPC knowledge and procedural skills, demonstrating its feasibility for integration into nursing curricula in resource-limited settings. The high DASH scores confirm that a structured and psychologically safe learning environment was successfully established. This study provides a replicable model for future curriculum development to bridge the gap between theory and clinical practice in Tunisia.

Clinical trial number

Not applicable.