Title : Psychological safety as a mediator in nursing simulation and learning immersion
Abstract:
Background: Simulation-based education depends extensively on students’ intrinsic motivation and active participation, cultivating immersion is essential to maximizing its educational effectiveness. Inadequate psychological safety, even in well-constructed simulations, can inhibit immersion by contributing to persistent anxiety and cognitive overload. This study aimed to analyze the relationships among nursing students’ perceptions of simulation educational practices and their learning immersion and to evaluate whether psychological safety mediates the association between simulation educational practices and learning immersion.
Methods: A cross-sectional survey was conducted with 266 third- and fourth-year nursing students in South Korea. Instruments included the Education Practices Questionnaire–Curriculum (EPQ-C), the Psychological Safety Questionnaire in High Fidelity Simulations, and the Learning Immersion Scale in Simulation (LISS). Data were analyzed using IBM SPSS Statistics 29.0 and Hayes’ PROCESS macro (Model 4).
Results: Both simulation educational practices (B = 0.406, p < .001) and psychological safety (B = 0.165, p < .001) significantly predicted learning immersion. The indirect effect mediated by psychological safety was also significant (B = 0.050, SE = 0.019, 95% CI [0.018, 0.092]), confirming psychological safety serves as a partial mediator between simulation educational practices and learning immersion.
Conclusions: Psychological safety is a critical determinant of students’ engagement and immersion within simulation-based nursing education. Enhancing learner diversity awareness and cultivating an environment that supports confidence and psychological well-being can further promote immersion and improve the educational impact of simulation. Incorporating this approach into simulation design may facilitate more effective teaching-learning frameworks in nursing education.
This work was supported by a Korea Research Foundation grant funded by the Korean Government [MOEHRD, Basic Research Promotion Fund; RS-2025-00517412]
