Clinical simulation as a teaching-learning methodology in the management of pressure injuries
DOI:
https://doi.org/10.35699/2237-5864.2025.57364Keywords:
nursing education, nursing, pressure ulcer, clinical simulation, nursing careAbstract
Objective: To evaluate the influence of clinical simulation as an educational strategy on the knowledge of undergraduate Nursing students regarding the assessment, prevention, and management of pressure injuries. Methodology: A quasi-experimental study was conducted in May 2023 with undergraduate Nursing students. A simple random sample of 20 students was selected. The study was carried out in three stages: 1) pre-test; 2) implementation of the intervention (clinical simulation); and (3) post-test. For both the pre- and post-tests, a validated instrument was used: the Pressure Ulcer Knowledge Test by Caliri and Pieper. Descriptive analysis and repeated measures Student's t-test were performed. A significance level of 5% (p<0.05) was adopted. Results: Most participants were female (90%) and aged between 20 and 26 years. After the educational intervention, knowledge levels about pressure injuries significantly increased (p<0.001), with notable improvements in identifying preventive strategies, such as the use of protective creams (from 45% to 85%) and proper repositioning in bed (from 10% to 55%). Conclusion: The study assessed the influence of clinical simulation on the enhancement of Nursing students’ knowledge regarding the assessment, classification, prevention, and treatment of pressure injuries. The findings indicated that the strategy employed effectively promoted the development of essential competencies for nursing practice, contributing to the training of future professionals.
Downloads
References
ALSHAHRANI, Bassam; SIM, Jenny; MIDDLETON, Rebekkah. Nursing interventions for pressure injury prevention among critically ill patients: a systematic review. Journal of Clinical Nursing, v. 30, n. 15-16, p. 2151-2168, 2021. DOI: https://doi.org/10.1111/jocn.15709. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/jocn.15709. Acesso em: 3 mai. 2025. DOI: https://doi.org/10.1111/jocn.15709
ARAÚJO, Paula Roberta Silva; DE SOUSA SANTANA, Breno; DA SILVA NOGUEIRA, Jane Walkíria; DA SILVA MAGRO, Marcia Cristina. Simulação clínica na retenção tardia de conhecimento e autoconfiança de profissionais de enfermagem: estudo quase-experimental. Cogitare Enferm, Curitiba, v. 27, p. e81568, 2022. DOI: https://doi.org/10.5380/ce.v27i0.81568. Disponível em: https://revistas.ufpr.br/cogitare/article/view/81568. Acesso em: 05 mai. 2025. DOI: https://doi.org/10.5380/ce.v27i0.81568
ARIBURNU, Özlem; KORKMAZ, Fatoş. Nursing students' perceptions and experiences in pressure injury risk assessment: a qualitative study. Nurse Education in Practice, v. 79, p. 104039, 2024. DOI: https://doi.org/10.1016/j.nepr.2024.104039. Disponível em: https://www.sciencedirect.com/science/article/pii/S1471595324001689?via%3Dihub. Acesso em: 10 mai. 2025. DOI: https://doi.org/10.1016/j.nepr.2024.104039
BOBBINK, Paul; GSCHWIND, Géraldine; CHARBONNEAU, Lucie; GUESX, Carole; CHABAL, Laurent; PROBST, Sebastian. Nursing students’ knowledge on pressure injuries following a blended-learning unit: a quasi-experimental study. Advances in Skin & Wound Care, v. 36, n. 12, p. 636-641, 2023. DOI: https://doi.org/10.1097/ASW.0000000000000066. Disponível em: https://journals.lww.com/aswcjournal/fulltext/2023/12000/nursing_students__knowledge_on_pressure_injuries.4.aspx. Acesso em: 10 mai. 2025. DOI: https://doi.org/10.1097/ASW.0000000000000066
BORTOLATO-MAJOR, Carina; MANTOVAN, Maria de Fátima; FELIX, Jorge Vinícius Cestari; BOOSTEL, Radamés; SILVA, Ângela Taís Mattei da; CARAVACA-MORERA, Jaime Alonso. Avaliação do debriefing na simulação clínica em enfermagem: um estudo transversal. Revista Brasileira de Enfermagem, Brasília, v. 72, n. 3, p. 788-794, 2019. DOI: https://doi.org/10.1590/0034-7167-2018-0103. Disponível em: https://www.scielo.br/j/reben/a/DRHMC77PzkzK9fMhyG8cdQz/?lang=en. Acesso em: 27 dez. 2024. DOI: https://doi.org/10.1590/0034-7167-2018-0103
CAMPOI, Ana Laura Mendes; ENGEL, Rosana Huppes; STACCIARINI, Thaís Santos Guerra; CORDEIRO, Aldenora Laísa Paiva de Carvalho; MELO, Adriana Feliciana; REZENDE, Marina Pereira. Educação permanente para boas práticas na prevenção de lesão por pressão: quase-experimento. Revista Brasileira de Enfermagem, Brasília, v. 72, p. 1646-1652, 2019. DOI: http://dx.doi.org/10.1590/0034-7167-2018-0778. Disponível em: https://www.scielo.br/j/reben/a/k8TLfjT3htdFfVc9NG3T3jq/?lang=en. Acesso em: 2 jan. 2025. DOI: https://doi.org/10.1590/0034-7167-2018-0778
CHAO, Wei; WU, Yu-Hsiu; HSU, Ming-Hui; CHU, Ching-Hui. Effectiveness of immersive teaching strategies on pressure injury: Impact on nurses' knowledge, attitudes and self-efficacy- A partially randomized participant preference (PRPP) controlled trial. Nurse Education in Practice, v. 82, p. 104237, 2025. DOI: https://doi.org/10.1016/j.nepr.2024.104237. Disponível em: https://www.sciencedirect.com/science/article/pii/S1471595324003664?via%3Dihub. Acesso em: 10 mai. 2025. DOI: https://doi.org/10.1016/j.nepr.2024.104237
CORREIA, Ana Suelen Barros; SANTOS, Isadora Batista de Carvalho. Lesão por pressão: medidas terapêuticas utilizadas por profissionais de enfermagem. Revista Brasileira de Ciências da Saúde, João Pessoa, v. 23, n. 1, p. 33-42, 2019. DOI: https://doi.org/10.22478/ufpb.2317-6032.2019v23n1.36793. Disponível em: https://periodicos.ufpb.br/index.php/rbcs/article/view/36793-p4. Acesso em: 3 jan. 2025. DOI: https://doi.org/10.22478/ufpb.2317-6032.2019v23n1.36793
CUKLJEK, Snjezana; REZIC, Slađana; FICKO, Sanja Ledinski; HOSNJAK, Ana Marija; SMREKAE, Martina; LJUBAS, Ana. Croatian nurses' and nursing students' knowledge about pressure injury prevention. Journal of tissue Viability, v. 31, n. 3, p. 453-458, 2022. DOI: https://doi.org/10.1016/j.jtv.2022.04.008. Disponível em: https://www.sciencedirect.com/science/article/pii/S0965206X22000468?via%3Dihub#section-cited-by. Acesso em: 5 jan. 2025. DOI: https://doi.org/10.1016/j.jtv.2022.04.008
EUROPEAN PRESSURE ULCER ADVISORY PANEL; NATIONAL PRESSURE INJURY ADVISORY PANEL; PAN PACIFIC PRESSURE INJURY ALLIANCE. Prevention and treatment of pressure ulcers/injuries: clinical practice guideline. The international guideline. HAESLER, Emily (ed.). EPUAP/NPIAP/PPPIA, 2019. Disponível em: https://internationalguideline.com/2019. Acesso em: 2 jan. 2025.
FULBROOK, Paul; LAWRENCE, Petra; MILES, Sandra. Australian nurses' knowledge of pressure injury prevention and management: a cross-sectional survey. Journal of Wound Ostomy & Continence Nursing, v. 46, n. 2, p. 106-112, 2019 DOI: http://dx.doi.org/10.1097/WON.0000000000000508. Disponível em: https://journals.lww.com/jwocnonline/fulltext/2019/03000/australian_nurses__knowledge_of_pressure_injury.5.aspx. Acesso em: 3 jan. 2025. DOI: https://doi.org/10.1097/WON.0000000000000508
GOUVEIA, Marcela Ferroni. Debriefing como ferramenta auxiliadora no raciocínio diagnóstico de estudantes de enfermagem. 2020. 113 f. Dissertação (Mestrado Profissional em Ciências da Saúde) – Universidade Federal de Viçosa, Viçosa, 2020. Disponível em: https://locus.ufv.br/handle/123456789/28438. Acesso em: 06 nov.2024.
INACSL STANDARDS COMMITTEE; MCMAHON, Eileen; JIMENEZ, Fabiola A.; LAWRENCE, Karen; VICTOR, Janet. Healthcare Simulation Standards of Best PracticeTM Evaluation of Learning and Performance. Clinical Simulation in Nursing, v. 58, p. 54-56, 2021. DOI: https://doi.org/10.1016/j.ecns.2021.08.016. Disponível em: https://www.sciencedirect.com/science/article/pii/S1876139921001031?via%3Dihub. Acesso em: 4 jan. 2025. DOI: https://doi.org/10.1016/j.ecns.2021.08.016
KARA, Hava; ARIKAN, Fatma; KAHYAOGLU, Ali. Student nurse knowledge of and attitudes toward pressure injury prevention: how sufficient is undergraduate education? Advances in Skin & Wound Care, v. 34, n. 9, p. 473-480, 2021. DOI: https://doi.org/10.1097/01.ASW.0000767332.40833.28. Disponível em: https://journals.lww.com/aswcjournal/abstract/2021/09000/student_nurse_knowledge_of_and_attitudes_toward.4.aspx?context=latestarticles. Acesso em: 6 jan. 2025. DOI: https://doi.org/10.1097/01.ASW.0000767332.40833.28
LIOCE, Lori; MEAKIM, Colleen H.; FEY, Mary K.; CHMIL, Joyce Victor; MARIANI, Bette; ALINIER, Guillaume. Standards of best pratice: Simulation standard IX: Simulation design. Clinical Simulation in Nursing, v. 11, n. 6, p. 309-315, 2015. DOI: http://dx.doi.org/10.1016/j.ecns.2015.03.005. Disponível em: https://www.sciencedirect.com/science/article/pii/S1876139915000250?via%3Dihub. Acesso em: 01 jun.2024. DOI: https://doi.org/10.1016/j.ecns.2015.03.005
MIYAZAKI, Margareth Yuri; CALIRI, Maria Helena Larcher; SANTOS, Claudia Benedita dos. Conhecimento dos profissionais de enfermagem sobre prevenção da úlcera por pressão. Revista Latino-Americana de Enfermagem, Ribeirão Preto, v. 18, n. 6, p. 1203-1211, 2010. DOI: https://doi.org/10.1590/S0104-11692010000600022. Disponível em: https://www.scielo.br/j/rlae/a/NGzrXTcmJf4SbNNhVmCQzGS/?lang=en. Acesso em: 5 jan. 2025.
MORAES, Juliano Teixeira; BORGES, Eline Lima; LISBOA, Cristiane Rabelo; CORDEIRO, Danieli Campos Olímpio; ROSA, Elizabeth Geralda; ROCHA, Neilian Abreu. Conceito e classificação de lesão por pressão: atualização do National Pressure Ulcer Advisory Panel. Revista de Enfermagem do Centro-Oeste Mineiro, Divinópolis, v. 6, n. 2, p. 2292-2306, 2016. DOI: https://doi.org/10.19175/recom.v6i2.1423. Disponível em: http://www.seer.ufsj.edu.br/recom/article/view/1423. Acesso em: 5 jan. 2025. DOI: https://doi.org/10.19175/recom.v6i2.1423
OLIVEIRA, Saionara Nunes; MASSAROLI, Aline; MARTINI, Jussara Gue; RODRIGUES, Jeferson. From theory to practice, operating the clinical simulation in Nursing teaching. Revista brasileira de Enfermagem, Brasília, v. 71, n. 4, p. 1791-1798, 2018. DOI: https://doi.org/10.1590/0034-7167-2017-0180. Disponível em: https://www.scielo.br/j/reben/a/FWHYc86T6S7sRXWwhRKVNZR/?lang=en. Acesso em: 3 jan. 2025. DOI: https://doi.org/10.1590/0034-7167-2017-0180
RABEH, Soraia Assad Nasbine; PALFREYMAN, Simon; SOUZA, Camilla Borges Lopes; BERNARDES, Rodrigo Magri; CALIRI, Maria Helena Larcher. Cultural adaptation of the Pieper-Zulkowski pressure ulcer knowledge test for use in Brazil. Revista Brasileira de Enfermagem, Brasília, v. 71, n. 4, p. 1977-1984, 2018. DOI: https://doi.org/10.1590/0034-7167-2017-0029. Disponível em: https://www.scielo.br/j/reben/a/dZwLkNNkJXcPbXbH93JLRRq/?lang=en. Acesso: 5 jan. 2025. DOI: https://doi.org/10.1590/0034-7167-2017-0029
SILVA, Renan Diego Boletti; PEREIRA, Maria Gorete Nicolette; ROCCO, Kelen Mitie Wakassugui de; OLIVEIRA, Thaisa Mariela Nascimento de; MARTINS, Eleine Aparecida Penha. Simulação clínica como estratégia de ensino-aprendizagem para profissionais e estudantes de enfermagem: revisão integrativa. Brazilian Journal of Implantology and Health Science, Macapá, v. 5, n. 4, p. 58-77, 2023. DOI: https://doi.org/10.36557/2674-8169.2023v5n4p58-77. Disponível em: https://bjihs.emnuvens.com.br/bjihs/article/view/373. Acesso em: 28 dez. 2024. DOI: https://doi.org/10.36557/2674-8169.2023v5n4p58-77
SOUZA, Gleyce Siqueira Santos de; SANTOS, Laurice Alves dos; CARVALHO, Alessandro Monteiro; COSTA, Pedrina Maria Nascimento Araújo; SILVA, Taniel Lopes da. Prevenção e tratamento de lesão por pressão na atualidade: revisão de literatura. Research, Society and Development, v. 10, n. 17, p. 1-10, 2021. DOI: https://doi.org/10.33448/rsd-v10i17.23945. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/23945. Acesso em: 3 jan. 2025. DOI: https://doi.org/10.33448/rsd-v10i17.23945
TYERMAN, Joanna; LUCTJKAR-FLUDE, Monica; GRAHAM, Linda; COFFEY, Sheila; OLSEN-LYNCH, Erin. A systematic review of health care presimulation preparation and briefing effectiveness. Clinical Simulation in Nursing, v. 27, p. 12-25, 2019. DOI: https://doi.org/10.1016/j.ecns.2018.11.002. Disponível em: https://www.sciencedirect.com/science/article/pii/S1876139918302020?via%3Dihub. Acesso em: 3 jan. 2025. DOI: https://doi.org/10.1016/j.ecns.2018.11.002
Published
Issue
Section
License
Copyright (c) 2025 Jéssica Caroline Louzada Vieira, Lídia Miranda Brinati, Talita da Conceição de Oliveira Fonseca, Patrícia de Oliveira Salgado

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal retain the copyright and grant the journal the right of first publication, with the work simultaneously licensed under the Creative Commons Attribution License which allows the sharing of work with acknowledgment of authorship and initial publication in this journal.
Authors are authorized to take additional contracts separately, for non-exclusive distribution of the version of the work published in this journal (e.g. publish in institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
Open access policy:
Revista Docência do Ensino Superior is an Open Access journal, which means that all content is available free of charge, at no cost to the user or their institution. Users may read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other legal purpose, without seeking prior permission from the publisher or author, provided they respect the license to use the Creative Commons used by the journal. This definition of open access is in line with the Budapest Open Access Initiative (BOAI).

























