Background: Nursing students must have adequate knowledge and skills before clinical placement. High-fidelity patient simulation (HFPS) is commonly used to evaluate student learning, but little is known about how students prepare for HFPS. Purpose: To examine self-directed learning (SDL) and self-satisfaction and confidence in learning (SSSCL) during HFPS following a series of activities in the StepUp Learning Tool, a structured preparatory intervention. Methods: This mixed-methods study employed a controlled quantitative design and a qualitative narrative component. The intervention group used the StepUp Learning Tool, while the control group received standard preparatory materials. Results: The intervention group showed significantly greater improvements in SDL ( P < .001) and SSSCL ( P = .018) than the control group post-HFPS. Qualitative feedback from the intervention group supported these findings, indicating that the structured approach better prepared students, enhancing their satisfaction and confidence. Conclusion: Incorporating structured preparatory tools effectively improves nursing students’ SDL, satisfaction, and confidence in HFPS.
Wong et al. (2026) studied this question.