Impact of High-Fidelity Simulation and OSCE on Stress, Academic Performance, and Well-Being in Nursing Students.

Introduction: High-fidelity simulation and Objective Structured Clinical Examinations (OSCEs) are essential tools in nursing education, designed to enhance clinical and non-technical competencies. However, these high-pressure activities can induce significant stress, potentially impacting students' performance and well-being. Methods: The study involved 53 third-year nursing students from a single university. Data collection included demographic, psychological, and academic variables, measured through validated tools such as the Perceived Stress Scale and Zung Self-Rating Depression Scale. Physiological and academic performance data from OSCEs were also analysed. Statistical analyses included correlation tests, multiple regression, and ANOVA to identify relationships and group differences. Results: Results indicated significant physiological stress activation during simulations and OSCEs. However, stress did not adversely affect overall academic performance, suggesting that resilience and coping strategies mitigated the impact of acute stress. Students with better sleep quality and higher levels of physical activity reported lower stress levels, better academic grades, and greater adaptability to complex situations. These findings emphasize the role of healthy habits in moderating the effects of stress in high-demand academic contexts. Conclusion: This study highlights the need to integrate stress management strategies, such as mindfulness and breathing techniques, into nursing curricula. Promoting sleep hygiene and regular physical activity can enhance students' resilience and preparedness for professional challenges. Future research should include longitudinal and multicentric studies to explore these relationships further and assess the long-term effectiveness of interventions.