BMC Med Educ 2026 Jul 09; doi: 10.1186/s12909-026-09883-4.

Development and evaluation of a digital simulation tool for teaching gynecological cytology: a pilot study with nursing students.

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BACKGROUND: Training in gynecological cytology within nursing education presents challenges, including limited opportunities for practical experience and a lack of empirically evaluated educational tools. Digital simulation may offer a structured and safe approach to support learning, learner engagement, and practical preparation. This study aimed to develop and evaluate PapSim, a digital simulation tool for teaching gynecological cytology to nursing students. METHODS: A pilot educational study was conducted with 40 second-year nursing students following a theoretical session on gynecological cytology. Participants engaged with the PapSim prototype in a supervised laboratory setting. Emotional engagement was assessed using a structured questionnaire based on the Pleasure Framework. Participants rated each emotional dimension on a six-point (0-5) ordinal response scale. Quantitative data were analyzed descriptively and through Spearman's rank correlation analysis. Qualitative responses were examined using thematic content analysis. RESULTS: Higher mean scores were observed in the categories of Simulation (4.63), Discovery (4.60), and Exploration (4.48), indicating strong engagement with immersive and task-oriented dimensions. Lower scores were reported in Danger (0.78) and Subversion (1.23), reflecting perceptions of safety and appropriateness. Significant positive correlations were identified between Discovery and Competition (ρ = 0.69, p < 0.001), as well as between sensory and empathic dimensions. Qualitative findings reinforced participants' perceptions of realism, cognitive stimulation, and spontaneous peer interaction during the simulation. CONCLUSIONS: The PapSim prototype was positively perceived and well accepted by nursing students, supporting its use as a complementary educational tool for teaching gynecological cytology. Further studies involving larger and more diverse samples are warranted to evaluate educational outcomes.

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