# Contributions of Clinical Simulation to Group Cohesion: A Quasi-Experimental Study

## TL;DR

This study shows that clinical simulation improves group cohesion among nursing students, potentially enhancing teamwork and communication.

## Contribution

The study provides evidence that clinical simulation is associated with increased group cohesion in nursing student teams.

## Key findings

- Clinical simulation significantly increased group cohesion with moderate to large effect sizes.
- The task-oriented dimension of group cohesion showed the greatest improvement after simulation.
- Findings suggest clinical simulation enhances collaboration and commitment in student teams.

## Abstract

(1) Background: The complexity of today’s healthcare system requires the formation of highly cohesive work teams that guarantee safe and high-quality care. Clinical simulation has become established as a pedagogical strategy capable of promoting the collaborative skills of teams of students and healthcare professionals. The objective of this study was to analyze the influence of learning through clinical simulation on group cohesion in nursing student teams. (2) Methods: A pre–post quasi-experimental study without a control group was conducted with final-year nursing students using the short Spanish version of the Group Environment Questionnaire, validated for nursing students. This questionnaire was administered twice, before and after participation in clinical simulation sessions. (3) Results: Clinical simulation significantly increased group cohesion in most items and in all dimensions with moderate to large effect sizes (r > 0.5). The Group Integration-Task (GI-T) dimension showed the greatest improvement after clinical simulation. Although causal relationships cannot be established, the results suggest an association between exposure to clinical simulation and increased group cohesion. (4) Conclusions: Clinical simulation was associated with significant improvements in both task-oriented and social dimensions of group cohesion among nursing students. These findings suggest that clinical simulation may enhance collaboration, communication, and commitment to shared goals within student teams. Future studies including control groups are needed to confirm these associations and further explore the impact of clinical simulation on team performance in both student and healthcare professional contexts.