title: "Clinical simulation as a learning tool in undergraduate nursing: Validation of a questionnaire".
abstract: BACKGROUND
  Clinical simulation allows both students and professionals to perform their clinical practice in a safe environment, facilitating the standardization of contents and promoting the integration of theoretical knowledge into the clinical practice.
  
  
  OBJECTIVE
  To design and validate in Spanish the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation, instrument created to assess the nursing students' satisfaction with the use of clinical simulation in training.
  
  
  METHODS
  The scale items were developed from a review of the literature. Content validity was established by an expert panel. This questionnaire was validated by 150 nursing students in the second year of the Bachelor Degree in Nursing at a Spanish university during the academic year 2013/2015. Lawshe formula was used to determine its validity, while for the construct validity a factor analysis was conducted using the principal component and Varimax rotation. Cronbach Alpha was used to determine internal consistency.
  
  
  RESULTS
  The questionnaire developed presents satisfactory internal consistency (alpha 0.857). The factorial analysis indicated a structure of eight principal components that explain the 62.85% of the total variance explained, and in turn each subscale presented acceptable internal consistency. Frequency analysis results show a satisfaction degree higher than 80%, emphasizing "the realism of the cases" (98.7%), that "many benefits are obtained as clinical simulation relates theory to practice" (98.7%), "priorities are established "(97.4%)," errors are corrected after debriefing" (93.4%), and "communication and teamwork improved" (90%).
  
  
  CONCLUSIONS
  The scale designed and validated on high-fidelity clinical simulation in the Spanish population is satisfactory and adequate. Nursing students at the University of Cantabria (Spain) reported a high satisfaction degree with clinical simulation, confirming its usefulness in the teaching–learning process.
authors.affiliation: Department of Nursing, University of Cantabria, Santander, Spain. Electronic address: alconear@unican.es.
authors.forename: Ana Rosa
authors.initials: AR
authors.lastname: Alconero-Camarero
authors.affiliation: Cantabrian Health Service, Santander, Cantabria, Spain.
authors.forename: Alexandra Gualdrón
authors.initials: AG
authors.lastname: -Romero
authors.affiliation: Department of Nursing, University of Cantabria, Santander, Spain.
authors.forename: Carmen María
authors.initials: CM
authors.lastname: Sarabia-Cobo
authors.affiliation: Virtual Hospital Valdecilla, Clinical Simulation, Santander, Spain.
authors.forename: Alejandro Martinez-
authors.initials: AM
authors.lastname: Arce
mesh_terms: D004508:Education, Nursing, Baccalaureate; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D010549:Personal Satisfaction; D011594:Psychometrics; D000066908:Simulation Training / Q000379:methods*; D013030:Spain; D013338:Students, Nursing / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult
keywords: Clinical simulation; Decision making; Nursing students; Teamwork