Abstract
Emergency nursing is a high-pressure specialty requiring rapid decision-making, technical proficiency, and effective teamwork; however, traditional clinical training often limits opportunities to practice rare or high-risk scenarios. Simulation-based training has emerged as a promising educational approach to enhance emergency nurses’ knowledge, technical skills, and confidence; moreover, it provides a safe and controlled environment for skill acquisition. This study aims to evaluate the effectiveness of simulation-based training on emergency nurses’ knowledge and skills at PIMS Hospital Islamabad and to assess its impact on confidence, clinical performance, and transferability to real-world settings. A positivist research philosophy is adopted in this study, as objective to measurement and empirical evidence are emphasized was adopted, involving 40 practicing emergency nurses who participated in structured high-fidelity and in situ simulation sessions. Pre- and post-tests, skill assessments, and self-efficacy questionnaires were administered; furthermore, observational data were collected to measure practical performance improvements. Data were analyzed using descriptive statistics, paired t-tests, and thematic analysis for qualitative feedback. Findings indicate significant improvements in knowledge scores, technical skills such as airway management and trauma resuscitation, and non-technical skills including communication, teamwork, and situational awareness. Nurses reported increased confidence in handling high-pressure emergencies; moreover, in situ simulations facilitated the effective transfer of skills to actual clinical practice. Simulation-based training effectively enhances both technical and non-technical competencies of emergency nurses; furthermore, it builds confidence and supports real-world performance in high-acuity settings. It is suggested that simulation programs be integrated into regular professional development, include periodic refresher sessions, and adopt inter-professional approaches to maximize team-based performance and long-term skill retention.