# Drama-based simulations in first aid education: psychometric validation of a student assessment tool in school settings

## TL;DR

This study validates a tool for assessing student performance in drama-based first aid simulations in Greek schools.

## Contribution

The study adapts and validates the SPRS-S for school-aged students in Greece using psychometric methods.

## Key findings

- The Greek version of SPRS-S showed a unidimensional structure and high reliability.
- Three distinct performance profiles were identified using clustering analysis.
- The tool is stable across demographic subgroups and suitable for structured feedback in role-playing simulations.

## Abstract

Drama-based simulations and role-playing are increasingly integrated into school-based first aid education, as they enable students to rehearse emergency response skills within controlled and realistic environments. Despite their pedagogical value, the systematic assessment of simulated patient performance in school contexts remains underdeveloped, particularly for younger populations. This study aimed to adapt and psychometrically validate the Standardized Patient Performance Rating Scale - Student Version (SPRS-S) for use in first aid training with school-aged students in Greece.

The study included 332 students aged 10-16 years (160 boys, 172 girls) and three first aid instructors. The scale underwent translation and back-translation procedures to ensure linguistic equivalence and contextual appropriateness within the Greek educational setting. Construct validity was examined through exploratory and confirmatory factor analyses, while internal consistency was assessed using reliability indices. In addition, an unsupervised computational intelligence clustering algorithm was implemented to classify simulated patient performance into distinct profiles.

Factor analyses confirmed a unidimensional structure with satisfactory reliability coefficients. The Greek version of the SPRS-S demonstrated clarity, internal coherence, and measurement stability across demographic subgroups. The clustering analysis identified three distinct performance profiles among simulated patients, providing additional interpretive depth regarding role enactment quality.

The validated Greek version of the SPRS-S constitutes a psychometrically robust instrument for evaluating simulated patient performance in school-based first aid education. Its application supports structured feedback processes and strengthens the pedagogical use of role-playing simulations. The findings support the systematic evaluation of drama-based health education and extend assessment practices to school-aged populations.