Impact of moulage-based simulation on nursing students’ recognition of physical violence: a randomised controlled trial

Background: Violence against women is a global public health and human rights issue with profound physical and psychological consequences. Simulation-based learning may help nursing students recognize signs of violence. This study examined whether physical violence indicators created on a standardized patient using moulage improve nursing students’ recognition of violence and their related attitudes, knowledge, satisfaction, self-efficacy, and communication skills. Methods: A randomized controlled pretest–posttest design was conducted with 55 fourth-year nursing students allocated to a moulage group (n = 28) and a control group (n = 27). The data collection tools included the “Demographic Information Form”, “ISKEBE Attitude Scale for Violence Against Women,” “Communication Skills Assessment Form”, “Nurses’ and Midwives’ Recognition of Signs of Violence Against Women Form”, “Modified Simulation Effectiveness Tool”, “Student Satisfaction and Self-Efficacy Scale in Learning,” and “Moulage Evaluation Questionnaire.” Data analysis involved calculating frequency, mean, standard deviation, chi-square tests, the Mann-Whitney U test, and the Wilcoxon Signed Ranks Test. Results: The demographic data of the moulage and control groups were similar. Recognition of violence indicators was significantly higher in the moulage group (19.75 ± 2.78) than in the control group (16.38 ± 3.63; p < 0.05). The communication skills of the students in the moulage group had an average score of 5.35 ± 0.48 for the effective communication subscale, while the average score for the therapeutic communication subscale was 4.55 ± 2.91. Additionally, the moulage group reported greater satisfaction with current learning (51.85 ± 6.66) and higher self-efficacy (29.21 ± 4.26, p = 0.006) than the control group. The mean Modified simulation effectiveness tool score was 68.42 ± 20.87, indicating a positive perception of learning effectiveness. No significant between-group difference was found for attitudes (ISKEBE). Conclusion: Moulage-supported simulation enhanced recognition of physical violence indicators, satisfaction, self-efficacy, and communication-related outcomes. The integration of these methods is recommended in future educational programs. Clinical registration: The study is registered on ClinicalTrials.gov. ID: NCT06982017 (date: 2024-05-20).