Title:
Development and validation of the Simulation Learning Effectiveness Scale for nursing students.

Abstract:
To develop and validate the Simulation Learning Effectiveness Scale, which is based on Bandura's social cognitive theory.
A simulation programme is a significant teaching strategy for nursing students. Nevertheless, there are few evidence-based instruments that validate the effectiveness of simulation learning in Taiwan.
This is a quantitative descriptive design.
In Study 1, a nonprobability convenience sample of 151 student nurses completed the Simulation Learning Effectiveness Scale. Exploratory factor analysis was used to examine the factor structure of the instrument. In Study 2, which involved 365 student nurses, confirmatory factor analysis and structural equation modelling were used to analyse the construct validity of the Simulation Learning Effectiveness Scale.
In Study 1, exploratory factor analysis yielded three components: self-regulation, self-efficacy and self-motivation. The three factors explained 29·09, 27·74 and 19·32% of the variance, respectively. The final 12-item instrument with the three factors explained 76·15% of variance. Cronbach's alpha was 0·94. In Study 2, confirmatory factor analysis identified a second-order factor termed Simulation Learning Effectiveness Scale. Goodness-of-fit indices showed an acceptable fit overall with the full model (χ /df (51) = 3·54, comparative fit index = 0·96, Tucker-Lewis index = 0·95 and standardised root-mean-square residual = 0·035). In addition, teacher's competence was found to encourage learning, and self-reflection and insight were significantly and positively associated with Simulation Learning Effectiveness Scale. Teacher's competence in encouraging learning also was significantly and positively associated with self-reflection and insight. Overall, theses variable explained 21·9% of the variance in the student's learning effectiveness.
The Simulation Learning Effectiveness Scale is a reliable and valid means to assess simulation learning effectiveness for nursing students.
The Simulation Learning Effectiveness Scale can be used to examine nursing students' learning effectiveness and serve as a basis to improve student's learning efficiency through simulation programmes. Future implementation research that focuses on the relationship between learning effectiveness and nursing competence in nursing students is recommended.