Effects of Concept Mapping and AI Dialogue on Flow and Learning Outcomes in Simulation-Based Learning

Pediatric nursing knowledge will be assessed using a test covering fever management for an infant with febrile seizures, chest physiotherapy for a child with pneumonia, and nursing care for a child with epilepsy. Scores range from 0 to 100, with higher scores indicating greater pediatric nursing knowledge. The change score will be calculated as the post-intervention score minus the baseline score.

Critical thinking disposition will be assessed using a 6-item questionnaire adapted by Lin et al. from Chai et al. Each item is rated from 1 to 5. Total scores range from 6 to 30, with higher scores indicating a greater tendency to evaluate information, consider different perspectives, and use logical and analytical thinking. The change score will be calculated as the post-intervention score minus the baseline score.

Self-reported communication competence will be assessed using the 8-item Communication Competence Scale developed by Li (2013) for nursing students. The scale assesses communication with patients and family members, including initiating communication, establishing therapeutic relationships, using verbal and nonverbal communication, identifying key information, active listening, recognizing emotions, providing health guidance, and organizing communication content. Each item is rated from 1 to 5. Total scores range from 8 to 40, with higher scores indicating greater self-reported communication competence. The change score will be calculated as the post-intervention score minus the baseline score.

Learning self-efficacy will be assessed using the 8-item self-efficacy subscale of the Motivated Strategies for Learning Questionnaire. Each item is rated from 1 to 5. Total scores range from 8 to 40, with higher scores indicating greater confidence in successfully completing the learning tasks. The change score will be calculated as the post-intervention score minus the baseline score.

Flow experience will be assessed using an 8-item questionnaire based on the Flow Experience Scale developed by Pearce et al. The questionnaire assesses perceived control, involvement, enjoyment, immersion, interest, altered perception of time, curiosity, and understanding of the learning activity. Each item is rated from 1 to 5. Total scores range from 8 to 40, with higher scores indicating a greater level of flow experience. The change score will be calculated as the post-intervention score minus the baseline score.

Perceived achievement of the learning objectives will be assessed using a researcher-developed 15-item questionnaire covering fever management (4 items), chest physiotherapy (6 items), and epilepsy care (5 items). Each item is rated from 1 to 5. Total scores range from 15 to 75, with higher scores indicating greater perceived achievement of the learning objectives.

Students' experiences with the learning approach will be explored through semi-structured interviews. The interviews will examine perceived differences from previous learning methods, advantages, learning gains, areas requiring improvement, willingness to use the approach again, and willingness to recommend the approach to students and instructors. Interview recordings will be transcribed and analyzed using thematic analysis. Findings will be reported as themes and subthemes describing students' learning experiences.