Effects of theory-based education versus simulation-based training on knowledge and skills in managing shortness of breath among university health volunteers
Downloads
Background: First aid skills for respiratory emergencies, particularly shortness of breath, are crucial for university health volunteers who often serve as the first responders. However, theory-based learning alone is not always adequate for developing practical competencies.
Objectives: This study aims to evaluate the effectiveness of theoretical education compared to the combination of theory and simulation in enhancing the knowledge and skills of university health volunteers in managing cases of shortness of breath.
Methods: A quasi-experimental pre-posttest design was conducted among 40 student volunteers of the Indonesian Red Cross Volunteer Corps (KSR-PMI), aged 18-20 years, who were equally assigned to a theory-only group or a theory-plus-simulation group. The intervention consisted of two 45-minute sessions. Knowledge and skills were assessed before and after the intervention. Data were analyzed using the Wilcoxon Signed Rank Test and the Mann–Whitney U Test with a significance level of α = 0.05.
Results: Knowledge significantly improved in both groups (p < 0.05), with no significant difference between them (p = 0.204). Skill performance improved markedly in the simulation group, increasing from 0% to 100%, compared with only 20% in the theory-only group (p < 0.001).
Conclusions: While theoretical education effectively enhances knowledge, it is insufficient for developing practical skills. Integrating simulation-based training significantly improves psychomotor competence and better prepares university health volunteers to manage respiratory emergencies.
Alharbi, A., Nurfianti, A., & Mullen, R. F. (2024). The effectiveness of simulation-based learning (SBL) on students’ knowledge and skills in nursing programmes: A systematic review. BMC Medical Education, 24, Article 1099. https://doi.org/10.1186/s12909-024-06080-z
Ardoin, T., Gantt, R., & Wallace, C. (2020). Impact of high-fidelity simulation on airway management skills among emergency medicine trainees. Advances in Simulation, 5, 15. https://doi.org/10.1186/s41077-020-00128-w
Brill, S. E., & Wedzicha, J. A. (2014). Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease. International journal of chronic obstructive pulmonary disease, 1241-1252. https://doi.org/10.2147/COPD.S41476
Brooks, D., et al. (2018). Oxygen therapy for acutely ill medical patients: A clinical practice guideline. The Lancet Respiratory Medicine, 6 (12), 1020–1031. https://doi.org/10.1016/S2213-2600(18)30225-9
Clary, E. G., Snyder, M., & Stukas, A. A. (2021). The gendered pathways into giving and volunteering: Similar or distinct? Nonprofit and Voluntary Sector Quarterly, 50(2), 302–321. https://doi.org/10.1177/08997640211057408
Cook, D. A., Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hamstra, S. J. (2011). Technology-enhanced simulation for health professions education: A systematic review and meta-analysis. JAMA, 306(9), 978–988. https://doi.org/10.1001/jama.2011.1234
DeVellis, R. F. (2017). Scale development: Theory and applications (4th ed.). SAGE Publications.
Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4. https://doi.org/10.11648/j.ajtas.20160501.11
Jones, A. T., Thomas, R. K., & Hughes, P. D. (2022). Response time and clinical outcomes in emergency medical situations: key indicators of patient safety. Emergency Medicine Journal, 39(3), 154-160.
Kim, H., Lee, J., & Park, J. (2021). Air pollution, smoking, and respiratory health outcomes: Associations with dyspnea and chronic pulmonary disease. Environmental Health Perspectives, 129(2), 027003. https://doi.org/10.1289/EHP7953
McGaghie, W. C., Issenberg, S. B., Cohen, E. R., Barsuk, J. H., & Wayne, D. B. (2014). A critical review of simulation-based medical education research: 2003–2009. Medical Education, 44(1), 50–63. https://doi.org/10.1111/j.1365-2923.2009.03547.x
Mohammadi, M., Karimi, S., & Asghari, M. (2016). Prevalence of asthma and respiratory symptoms among university students in Urmia, Iran. Journal of Asthma and Allergy, 9, 67–74. https://doi.org/10.2147/JAA.S102859
Morris, N. R., & Adams, L. (2020). Dyspnea: Mechanisms, measurement, and management. Respiratory Medicine, 166, 105940. https://doi.org/10.1016/j.rmed.2020.105940
O’Driscoll, B. R., Howard, L. S., Earis, J., & Mak, V. (2017). BTS guideline for oxygen use in adults in healthcare and emergency settings. Thorax, 72(Suppl 1), ii1–ii90. https://doi.org/10.1136/thoraxjnl-2016-209729
Oermann, M. H., & Hays, J. C. (2019). Writing for Publication in Nursing (4th ed.). New York, NY: Springer. https://doi.org/10.1891/9780826147219
Parshall, M. B., Schwartzstein, R. M., Adams, L., Banzett, R. B., Manning, H. L., Bourbeau, J., Calverley, P. M. A., Gift, A. G., Harver, A., Lareau, S. C., & O’Donnell, D. E. (2012). An official American Thoracic Society statement: Update on the mechanisms, assessment, and management of dyspnea. American Journal of Respiratory and Critical Care Medicine, 185(4), 435–452. https://doi.org/10.1164/rccm.201111-2042ST
Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Wolters Kluwer Health.
Santrock, J. W. (2019). Life-span development (17th ed.). McGraw-Hill Education.
Sharma, R., & Gupta, A. (2019). Effectiveness of first aid training in educational institutions: a study in india. Journal of Public Health Education, 6(3), 45– 51.
Smith, J. R., Clark, M. T., & Adams, H. W. (2021). Simulation-based oxygenation training: enhancing clinical skills for respiratory emergencies. Journal of Clinical Simulation, 20(2), 87-95.
Smith, J. R., Turner, L. K., & Roberts, D. A. (2020).The role of campus health teams in medical emergencies. Journal of American College Health, 68(5), 456–463. https://doi.org/10.1080/07448481.2019.1706532
Smith, R. J., & Jones, T. P. (2021). The Lower Respiratory Tract: Function and Gas Exchange Mechanisms in the Human Lungs. Journal of Pulmonary Research, 19(2), 112–121.
Tan, S. Y., Leong, L. W., & Tan, H. H. (2021). Simulation-based training for cardiopulmonary resuscitation in southeast asia: a 30% improvement in skill proficiency. Journal of Medical Training and Simulation, 10(4), 98- 106.
Tawfik, D. S., Profit, J., Morgenthaler, T. I., Sood, A., & Peters, A. S. (2020). Simulation-based education to improve patient safety: A systematic review. Medical Education, 54(1), 32–46. https://doi.org/10.1111/medu.13975
Taylor, S. L., Mitchell, M., & Roberts, T. P. (2022). First aid training for students: Increasing awareness and response time to campus emergencies. International Journal of Emergency Medicine, 15(1), 34. https://doi.org/10.1186/s12245-022-00410-3
Weile, J., Nebsbjerg, M. A., Ovesen, S. H., Paltved, C., & Ingeman, M. L. (2021). Simulation-based team training in time-critical clinical presentations in emergency medicine and critical care: a review of the literature. Advances in Simulation, 6, 3. https://doi.org/10.1186/s41077-021-00154-4
World Health Organization. (2022). Clinical guidelines for oxygen therapy: Principles and best practices. World Health Organization.
World Health Organization. (2023). Respiratory diseases: Global death statistics and impact on public health. World Health Organization.
Copyright (c) 2025 Agus Nur Wahyuda, Marji Marji, Nurnaningsih Herya Ulfah, Anita Sulistyorini

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.




