The effects of video-based simulation in Collaborative Learning in a Student-led Global Classroom (CLSGC) program on non-technical skills among undergraduate nursing students in three regions: A mixed-methods study.

Background: Global nursing shortages and increasing cultural diversity in healthcare necessitate the development of culturally sensitive nurses. Intercultural learning and exchange programs have been shown to enhance nursing students' intercultural knowledge, cultural awareness, and sensitivity. However, non-technical skills such as communication, leadership, and teamwork are less emphasized in existing programs, despite their importance in facilitating adaptation to clinical contexts and ensuring patient safety across different ethnic groups. Objective: This study aims to evaluate the effectiveness of a Collaborative Learning in a Student-led Global Classroom (CLSGC) program that employs video-based learning and student-led debriefings to enhance non-technical skills, and to explore the experiences of undergraduate nursing student participants from three different regions. Methods: Seventy-eight nursing students from the Hong Kong Polytechnic University, Malmo University, and La Trobe University participated in the program. The program included three webinars on teamwork, communication skills, and leadership, facilitated through student-led discussions and video simulations. Data were collected using the Team Strategies and Tools to Enhance Performance and Patient Safety Teamwork Attitudes Questionnaire, and qualitative methods including focus groups and reflective journals. A paired t-test and manifest content analysis were used to analyze the quantitative and qualitative data, respectively. Results: The quantitative results indicated significant improvements in the students' attitudes towards teamwork, communication, and leadership. The qualitative data shed light on the students' learning experiences, highlighting the value of cultural exchanges in exploring the importance of non-technical skills in practice, and the effectiveness of the program structure. Conclusions: The CLSGC program effectively improved nursing students' non-technical skills and enriched their clinical practice. Integrating simulation-based learning and student-led debriefing sessions to enhance nursing students' knowledge and attitudes towards teamwork, communication, and leadership is recommended in nursing education. Continuous exposure to simulation should be part of nursing education to reinforce the significance of non-technical skills in practice.