Creating a culture of safety is of the utmost importance in healthcare settings today. The World Health Organization (WHO) states that more than three million deaths occur on a yearly basis due to unsafe care, with around 50% of those deaths classified as being preventable (WHO, 2023). Song and Kim (2023) report that nearly 53% of recent nurse graduates are involved in a medical error within their first year of practice. Therefore, experiences that create a culture of safety must be brought into the nursing curriculum and analyzed to assess the efficacy of teaching methods by the instructors and the student's learning ability. Safety can be taught by various methods, including class instruction, simulation (especially in a safe and student-centered environment), and clinical practice scenarios that bring patient safety to the forefront. The research question for this study was, "How does a room of errors simulation with first-semester nursing students affect their awareness of healthcare safety concerns?" A pre/post-test design was used to compare students' maturation in their ability to recognize errors throughout the first semester of the nursing program. The investigators expected to see statistically significant maturational levels of identifying key safety components in patient care through their first semester of the nursing program.

The students in this study were exposed to multiple courses in their first semester of nursing school. These courses include Foundations of Nursing Practice and Clinical, Health Assessment Across the Lifespan and Lab, Skills Lab, Pathophysiology, and Professional Development. These courses all teach foundational nursing knowledge, skills, and attitudes that prepare students to provide safe, quality care at the bedside. Elements of patient safety are threaded throughout all courses. In addition to the room of errors, the clinical course consisted of a phlebotomy clinical, flu drive, nursing home clinical, and two simulations focused on communication, education, and end-of-life.