Effects of MAES© versus traditional clinical simulation on nursing students' satisfaction, self-confidence, and educational practices

Abstract

Background Simulation-based learning is widely used in nursing education to foster active learning and clinical competence. MAES (c) is an innovative, learner-centered simulation methodology that integrates problem-based learning, collaborative scenario design, and reflective practice. However, evidence comparing MAES (c) with traditional clinical simulation remains scarce. This study aimed to compare the effects of the Self-Learning Methodology in Simulated Environments (MAES (c)) and traditional clinical simulation on nursing students' satisfaction, self-confidence in learning, and perceptions of educational practices. Methods A randomized controlled experimental study was conducted among fourth-year nursing students enrolled in nursing courses at a university in T & uuml;rkiye during the 2025 to 2026 academic year. A total of 88 students completed the study and were assigned to either the MAES (c) group (n = 46) or the traditional clinical simulation group (n = 42). Data were collected using the Student Satisfaction and Self-Confidence in Learning Scale, the Educational Practices Questionnaire, and the Subjective Impact and Satisfaction with MAES (c) Methodology Questionnaire. Data were analyzed using the Mann-Whitney U test and chi-square test. Results Students in the MAES (c) group exhibited significantly higher self-confidence in learning than those in the traditional clinical simulation group (U = 1199.0, p = .042, r = 0.241). No significant differences were observed between the groups in satisfaction with learning or perceptions of educational practices (p > .05). Students reported highly positive perceptions of the MAES (c) methodology, with the highest rating for teamwork enhancement and motivation. Conclusions Both simulation methodologies were effective in promoting positive educational outcomes. However, MAES (c) demonstrated an advantage in improving students' self-confidence in learning. These findings indicate that learner-centered simulation approaches, such as MAES (c), enhance students' active engagement and perceived competence throughout the learning process.