Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates

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Society’s demand for nurses, particularly male nurses, is rising; nevertheless, the availability of clinical placements for nursing students is insufficient to meet this demand. Simulation has significantly advanced as an educational method for training healthcare personnel. Simulation makes replicating real-life events and honing skills like clinical decision-making and communication. Using simulation as an adjunct or alternative to clinical practice is now under discussion. Simulation is a resource-intensive pedagogical approach, necessitating careful consideration of its organization and implementation to maximize efficiency without undermining learning outcomes. Objective This study aimed to explore simulation as a teaching pedagogy for male undergraduate nursing students in the United Arab Emirates. Method This study adopted a descriptive qualitative approach. The purposive sampling method recruited 43 male students from nursing programs in the University of Sharjah, United Arab Emirates, to participate in the individual interviews. In addition, two focus group discussions were conducted on an online meeting platform. Data analysis was done using thematic analysis. Results In this study, we identified four major themes: 1) Students’ perceptions of simulation, 2) Preparation for realistic situations, 3) Feeling of anxiety and stress, and 4) Theory and practice abilities gaps. Conclusion The study findings indicate that male nursing students received the overall simulation experience well. The study highlights the importance of skilled and encouraging simulation instructors who can provide participants with valuable guidance and feedback for more individualized teaching. Study results provide important new information about how simulation-based learning could improve nursing education and further studies in this field. The findings shed light on the problems that male nursing students have been dealing with for years and highlight efforts to make changes as soon as feasible. It may be helpful to revise the simulation to provide more opportunities for independent problem-solving skills and to incorporate more real-life factors and variables into the scenario. Additionally, developing more individualized approaches to building self-confidence may be helpful, such as providing personalized feedback and guidance based on each student’s strengths and weaknesses. 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F1000Research 2025, 14 :920 ( https://doi.org/10.12688/f1000research.167350.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] Jacqueline Maria Dias https://orcid.org/0000-0001-8873-505X 1 , Mini Sara Abraham 1 , Muhammad Arsyad Subu https://orcid.org/0000-0001-5196-238X 1,2 , [...] Nabeel Al Yateem https://orcid.org/0000-0001-5355-8639 1,2 , Fatma Reefat Ahmed 1 , Raliya Abdourahman Abdillahi 1 , Noof Jamal Saleh 1 , Samira Mohamed Ali 1 , Kowsar Abshir Hashi 1 , Richard Mottershead 3,4 Jacqueline Maria Dias https://orcid.org/0000-0001-8873-505X 1 , Mini Sara Abraham 1 , [...] Muhammad Arsyad Subu https://orcid.org/0000-0001-5196-238X 1,2 , Nabeel Al Yateem https://orcid.org/0000-0001-5355-8639 1,2 , Fatma Reefat Ahmed 1 , Raliya Abdourahman Abdillahi 1 , Noof Jamal Saleh 1 , Samira Mohamed Ali 1 , Kowsar Abshir Hashi 1 , Richard Mottershead 3,4 PUBLISHED 06 Oct 2025 Author details Author details 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates 2 Institute of Health Sciences, Binawan University, Jakarta, Indonesia 3 Sakina, Behavioural Science Institute, SEHA, Al Ain, United Arab Emirates 4 College of Nursing, University of Baghdad, Baghdad, Iraq Jacqueline Maria Dias Roles: Conceptualization, Writing – Original Draft Preparation, Writing – Review & Editing Mini Sara Abraham Roles: Writing – Original Draft Preparation, Writing – Review & Editing Muhammad Arsyad Subu Roles: Writing – Original Draft Preparation, Writing – Review & Editing Nabeel Al Yateem Roles: Writing – Original Draft Preparation, Writing – Review & Editing Fatma Reefat Ahmed Roles: Writing – Original Draft Preparation, Writing – Review & Editing Raliya Abdourahman Abdillahi Roles: Writing – Original Draft Preparation, Writing – Review & Editing Noof Jamal Saleh Roles: Writing – Original Draft Preparation, Writing – Review & Editing Samira Mohamed Ali Roles: Writing – Original Draft Preparation, Writing – Review & Editing Kowsar Abshir Hashi Roles: Writing – Original Draft Preparation, Writing – Review & Editing Richard Mottershead Roles: Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Health Services gateway. Abstract Background The nursing profession is increasingly appealing to male students at the undergraduate level. Society’s demand for nurses, particularly male nurses, is rising; nevertheless, the availability of clinical placements for nursing students is insufficient to meet this demand. Simulation has significantly advanced as an educational method for training healthcare personnel. Simulation makes replicating real-life events and honing skills like clinical decision-making and communication. Using simulation as an adjunct or alternative to clinical practice is now under discussion. Simulation is a resource-intensive pedagogical approach, necessitating careful consideration of its organization and implementation to maximize efficiency without undermining learning outcomes. Objective This study aimed to explore simulation as a teaching pedagogy for male undergraduate nursing students in the United Arab Emirates. Method This study adopted a descriptive qualitative approach. The purposive sampling method recruited 43 male students from nursing programs in the University of Sharjah, United Arab Emirates, to participate in the individual interviews. In addition, two focus group discussions were conducted on an online meeting platform. Data analysis was done using thematic analysis. Results In this study, we identified four major themes: 1) Students’ perceptions of simulation, 2) Preparation for realistic situations, 3) Feeling of anxiety and stress, and 4) Theory and practice abilities gaps. Conclusion The study findings indicate that male nursing students received the overall simulation experience well. The study highlights the importance of skilled and encouraging simulation instructors who can provide participants with valuable guidance and feedback for more individualized teaching. Study results provide important new information about how simulation-based learning could improve nursing education and further studies in this field. The findings shed light on the problems that male nursing students have been dealing with for years and highlight efforts to make changes as soon as feasible. It may be helpful to revise the simulation to provide more opportunities for independent problem-solving skills and to incorporate more real-life factors and variables into the scenario. Additionally, developing more individualized approaches to building self-confidence may be helpful, such as providing personalized feedback and guidance based on each student’s strengths and weaknesses. READ ALL READ LESS Keywords Simulation, male students, baccalaureate, nursing, pedagogy, education, United Arab Emirates. Corresponding Author(s) Richard Mottershead ( [email protected] ) Close Corresponding author: Richard Mottershead Competing interests: No competing interests were disclosed. Grant information: The authors received funding for this research. Dr Jacqueline Maria Dias a TEIG scholar at the University of Sharjah, received the maiden Chancellor's Teaching Excellence and Innovation Grant Winners (TEIG).The Institute of Leadership in Higher Education is pleased to announce the winners of the maiden cycle of the Chancellor's Teaching Excellence and Innovation Grant (TEIG). AED 10, 000/- received for “ Technology enhanced Learning via simulation for Male baccalaureate students in the Maternity course- an innovative teaching pedagogy. https://ilhe.sharjah.ac.ae/en/Pages/grant.aspx The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2025 Maria Dias J et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Maria Dias J, Sara Abraham M, Arsyad Subu M et al. Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.12688/f1000research.167350.2 ) First published: 15 Sep 2025, 14 :920 ( https://doi.org/10.12688/f1000research.167350.1 ) Latest published: 06 Oct 2025, 14 :920 ( https://doi.org/10.12688/f1000research.167350.2 ) Revised Amendments from Version 1 Thank you for your email and comments on our manuscript. We revised our manuscript in response Reviewer Comments: 1. Include interview/FGD guide questions (appendix/supplement). Response: We added and included the interview guide questions (Table 1). 2. Clarify the analytic tools used... Response: Thank you for your comment. This study employed a thematic analysis, adhering to the six data analysis phases described by Braun and Clarke (2006). We employed NVivo 12 as our data management tool, which assists us in coding and identifying themes— thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. (yellow). Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties. 3. Consider sharing an anonymized transcript… Response: Thank you very much for your comment. In this study, reproducibility is achieved by obtaining consistent results through the thematic analysis steps, coding, and conditions. We provided clear, specific, and thorough information about the data products that support our published results, allowing other researchers to replicate the analysis. Additionally, all data are available from the first author or the corresponding author upon reasonable request. 4. Are all the source data… Participant data contains sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. IRB has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author. Thank you for your email and comments on our manuscript. We revised our manuscript in response Reviewer Comments: 1. Include interview/FGD guide questions (appendix/supplement). Response: We added and included the interview guide questions (Table 1). 2. Clarify the analytic tools used... Response: Thank you for your comment. This study employed a thematic analysis, adhering to the six data analysis phases described by Braun and Clarke (2006). We employed NVivo 12 as our data management tool, which assists us in coding and identifying themes— thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. (yellow). Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties. 3. Consider sharing an anonymized transcript… Response: Thank you very much for your comment. In this study, reproducibility is achieved by obtaining consistent results through the thematic analysis steps, coding, and conditions. We provided clear, specific, and thorough information about the data products that support our published results, allowing other researchers to replicate the analysis. Additionally, all data are available from the first author or the corresponding author upon reasonable request. 4. Are all the source data… Participant data contains sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. IRB has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author. See the authors' detailed response to the review by Agussalim Agussalim See the authors' detailed response to the review by Mulyadi Mulyadi READ REVIEWER RESPONSES Introduction Increased knowledge, improved satisfaction with skill performance, and improved critical thinking and self-confidence in the students’ skill set were the goals of the educational outcomes. Nursing education includes both theoretical and practical instruction to educate students in nursing. Developing knowledge and clinical skills depends on the time allotted to teaching and clinical practice and the content of both. Simulation is how we attempt to attain outcomes that closely resemble clinical practice ( Khan et al., 2022 ). It is a nursing instructional strategy that simulates patient care experiences by re-enacting scenarios or real-life circumstances. It offers nursing students and working nurses a secure and regulated setting to develop their clinical expertise. Simulation can help students gain knowledge, hone their clinical reasoning abilities, and become capable of caring for patients and their families in a complicated healthcare setting ( Aebersold, 2018 ). Over time, its technology has advanced significantly, allowing for replicating complex patient scenarios and conditions through high-fidelity manikins and simulated environments ( Herrera-Aliaga & Estrada, 2022 ). In nursing education, simulation allows students to practice in a safe setting. Simulations are valuable because they give students real-world experience and allow them to reflect on their learning while playing various roles ( Haddeland et al., 2021 ). Simulations teach students to share responsibility, encourage one another, give constructive criticism, communicate clearly, and be honest about negative experiences ( Jeffries, 2022 ). In higher education, simulation-based learning substantially contributes to student-centered, collaborative, active, and interprofessional learning ( Glavin, 2009 ). Various sources emphasized the value of simulation as a training method that offers a secure, authentic setting to improve learning and develop nursing abilities, along with how these skills can affect critical thinking, judgment, problem-solving, and self-confidence. Additionally, the experiences of male nursing students exposed to lab training using high-fidelity simulation has been reported earlier by the same authors. Furthermore, simulation has proven to be an effective tool for instruction in nursing as an interactive teaching method ( Khan et al. 2022 ). A study had the same result ( Smith, Jordan, & Li, 2022 ). According to other research, clinical internships and simulation exercises are closely related examples of how practical teaching and learning form the foundation of nursing education ( Dias et al., 2023 ; Ahmed et al., 2025 ). The capacity to identify symptoms, conduct evaluations, and take necessary action was displayed for others to observe and evaluate ( Peachey, 2021 ). Simulation made clinical judgment on subscales, including observing, interpreting, responding, and reflecting ( Ayed et al., 2022 ). However, prior research has concentrated on how students respond to negative emotions when learning through simulation ( Ko & Choi, 2020 ). However, when it comes to encouraging learning, positive emotions work better than negative ones ( Keskitalo & Ruokamo, 2021 ). The students experienced positive and negative emotions during the simulation ( Salo et al., 2025 ). Teachers should therefore be mindful of the stressors in the simulation scenario, such as sensitivity in interpersonal interactions, unfamiliarity with new learning methods, the weight of being observed, and dread of evaluation ( Ko & Choi, 2020 ). More male nursing students are enrolling in educational institutions in the United Arab Emirates ( Subu et al., 2022 ). However, the number of real-world training opportunities available for these students is not keeping up with the increasing demand. Simulation as a teaching pedagogy is essential to integrate nursing students into the field and provide them with the necessary skills ( Rattani et al., 2020 ). The maternal health course has presented several difficulties as male students register in nursing programs. In addition, because of cultural restrictions that prevent them from entering the maternity hospital, nursing faculty find it challenging to locate suitable practice opportunities in obstetrics for male baccalaureate nursing students due to the conservative Arab culture. Students were given simulated experiences to gain the skills required for the course, such as maternal health, to overcome these cultural barriers to clinical learning and guarantee that they met the maternal course competencies. Study purpose In the Gulf region, few clinical settings can give bachelor male nursing students thorough, profound, and high-quality hands-on learning experiences in maternity care, where patients’ needs are complex and hospital stays are brief, limiting male students’ opportunities. Simulation is utilized to improve students’ clinical fundamental competencies while navigating through significant issues due to societal and cultural concerns. Understanding the unique experiences that male nursing students face during simulation is important. This study aimed to explore simulation as a teaching pedagogy for male undergraduate nursing students. The findings will benefit clinical practice in identifying nursing students’ experiences in the healthcare setting and improve teaching strategies to help shape and enhance future curricula. Methods Design This study used a descriptive qualitative approach to explore simulation as a teaching pedagogy for male undergraduate nursing students in the United Arab Emirates. Qualitative research methods are regularly used in healthcare professions research and nursing research. Qualitative studies were employed to enhance comprehension and elucidate human experience. In qualitative research, data is gathered through interviews and is methodically collected and analyzed. The interview questions can be found in Table 1 . It investigates the meanings of social phenomena in which people perceive circumstances ( Grossoehme, 2014 ), focusing on examining how people understand their experiences and the meaning they give them. Table 1. Interview questions. Question number Interview question Probe 1 How would you describe your overall experience during the maternity practicum labs? What stood out the most to you? 2 What were your feelings and thoughts on the first day of your maternity practicum? Were you nervous, excited, or unsure? 3 How did your feelings change by the last day of the practicum? What had improved or become more comfortable? 4 Can you share a positive experience you had during your maternity practicum? What made it a good experience? 5 Can you describe a negative or challenging experience during the practicum? How did you handle it? 6 What was the most difficult part of your experience in the maternity lab or clinical setting? Skills, communication, environment, etc. 7 As this was your first exposure to maternity care, what specific fears or anxieties did you experience? Were any of these related to gender, confidence, or knowledge? 8 Did participating in the maternity practicum affect your daily life or your mental/emotional health? If so, how? N/A 9 What specific challenges did you face as a male student in the maternity practicum setting? Interaction with patients, acceptance by staff, cultural barriers, etc. 10 What advice would you give to a second-year male student who will soon enter the maternity practicum? What do you wish you had known beforehand? 11 How were you able to apply maternity theory learned in class during your practicum or simulation sessions? Can you give specific examples? 12 Would you consider working in the maternity department in the future? Why or why not? Did your practicum influence this decision? 13 How did simulation activities in the sim labs prepare you for real-life maternity clinical experiences? What scenarios or skills were most helpful? Settings and participants This study was conducted in the nursing program at the University of Sharjah, United Arab Emirates. The study population was undergraduate nursing students. The purposive sampling method recruited thirty-two male students from nursing programs to participate in the individual face-to-face interviews. According to Charmaz (2006) , 25 participants in a qualitative study are more than enough to reach data saturation. In addition, two focus group discussions were conducted on an online meeting platform (Microsoft Teams). The first focus group involved six participants from the fourth year, and the second had five participants from the third year. In this study, there are 43 student participants in total. This study’s inclusion criteria are male nursing students at the University of Sharjah who completed the maternity practicum courses in year three. Students also must speak English and be willing to participate in the research. The exclusion criteria were the students who did not complete the simulation component. Bridging students and transfer students were also excluded. Data collection This study employed semi-structured interviews as the primary data collection method. Richards and Morse (2007) assert that a semi-structured interview is a recognized technique for data collection in qualitative research, facilitating constructive interactions with participants and enabling them to express their thoughts, experiences, attitudes, and beliefs. After we received approval from the REC University of Sharjah, we contacted each potential male participant via email or phone. We approached potential participant personally and face-to-face. Prior to participation, all students received a clear explanation of the study’s objectives, procedures, and their rights as participants. Written informed consent was obtained from all participants. We interviewed each participant at their college at the University of Sharjah. Study participants who consented to partake were invited, and we elucidated the study’s objective along with the schedule and location of each interview. All interviews were conducted with the participants’ consent in the nursing program at the University of Sharjah. Individual interviews were audiotaped using a tape recorder with participants’ consent, and each interview lasted 40 to 50 minutes. As a triangulation, we conducted two focus group discussions on an online meeting platform (Microsoft Teams) to ensure consistency and obtain more participant feedback. Triangulation employs many approaches or data sources in qualitative research to thoroughly understand phenomena ( Patton, 1999 ). Triangulation is a qualitative research approach for validating findings by synthesizing data from many sources ( Carter et al., 2014 ). The first focus group involved six participants from the fourth year, and the second had five participants from the third year. Each discussion lasted approximately 35 minutes. One experienced supervisor (JD, the leading researcher) organized the FGD sessions with two groups. Data analysis This study adopted a thematic analysis and adhered to the six data analysis phases described by Braun and Clarke (2006) ( Figure 1 ). In this qualitative study, we employed NVivo 12 as our data management tool, which assists us in coding and identifying themes—thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. The thematic analysis objective is to identify data patterns pertinent to the study’s purpose. Phase one (phase familiarization) involved verbatim transcriptions of every interview. This study conducted all the FGDs and interviews in English. Figure 1. Phases of thematic analysis ( Braun & Clarke, 2006 ). At this stage, notes were taken as a beginning point. We created initial codes in step two by performing line-by-line coding, marking, and assigning codes to essential information from the raw data. In the third phase, known as ‘searching for themes,’ all codes are input into a different spreadsheet, where all authors assess and discuss them to find and classify similar codes into themes. In step four, we review the themes to determine their validity in terms of internal homogeneity. Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties to maintain transparency and clarity. During our analysis, the authors meet to review all coding and reach consensus. Regular meetings are held throughout the process to review the data and implement any necessary adjustments. To ensure the themes relate to the data and make the themes and their connections more straightforward, we reviewed all the data again in phase five (defining and naming themes). Our findings are presented in a document generated in the last phase (phase six, creating the report). Braun and Clarke (2006) state that the writing moved from data summaries to analytical tales. Ethical consideration The University of Sharjah’s Research Ethics Committee (REC) REC-23-02-27-02-S approved this research project. Participants received a thorough explanation of the research prior to the interview. Every student participating in the study was aware of its purpose and methodology. Prior to each interview, we gave each participant signed informed consent. They received guarantees regarding the study’s secrecy and anonymity. Students who participated in the study were informed that it was entirely voluntary and that they might leave at any moment. Furthermore, their grades were unaffected by their involvement in this study. To ensure that every participant felt at ease and secure, we chose interview settings for this study that could offer seclusion and silence. Furthermore, none of the participants in this study were paid directly for their time. Study rigor A participant’s private information disclosed to a researcher is considered confidential. There are restrictions on when and how it can be shared with a third party. Without their explicit consent, study participants were guaranteed that their data would remain anonymous. Keeping a person’s name apart from their involvement in a study is known as anonymity, and no names were used in this study. Each participant was assigned A random alpha-numeric code so that no one could associate a transcription with a specific participant (P1 for Participant 1). A password-protected private computer was used to download the digitally recorded interviews. Researchers should always be the only ones handling the interview material, including the recordings and transcriptions. All private information and documents were secured in the University of Sharjah’s chief researcher’s office. Data were stored for five years after the study ended, and then the material was destroyed (tapes were demagnetized and transcriptions were shredded). Results In this study, forty-three male students, aged between 19 and 23, participated. All verbatim transcripts from the interviews were thoroughly read and extensively discussed with all authors. Two focus group interviews were conducted in a virtual meeting for the study. Six students participated in the first FGD in the fourth year, while the second FGD included five participants from the third year. The interviews’ audio recordings were fully transcribed, and transcripts of the interviews were checked against written summaries of the contributions made by each interviewer. After reviewing the transcripts, we identified four major themes: 1) Students’ perceptions of simulation, 2) Preparation for realistic situations, 3) Feeling of anxiety and stress, and 4) Theory and practice abilities gaps. Theme 1: Students’ perceptions of simulation Subtheme: Practice in the same way with realistic situations The study participants stated that even if they know what must be done, they must get the contact nurse’s permission before acting in real-world practice settings. They practice in the simulation much like in actual clinical settings. … I believe it is great that this course is about nursing care. The fact that it makes sense for us has, I believe, been evident throughout the instruction. If the simulations in the training had taken place in the department… It would have been practiced similarly in realistic situations, like in a similar experience. (FGD 1, member 1). Similarly, a participant said in an interview that he practices with simulation in the same way as with realistic situations in health settings. In my opinion, the course’s connection to nursing care is fantastic. It has become evident throughout the instruction that it makes sense for us. Things would have been different if we had taken a simulation course set in a hospital. Since we mimicked these scenarios, we encountered numerous things that raised our level of knowledge and confidence while we were there [clinical placement] (Interview, participant 17) Subtheme: Improve knowledge and skills The male students said the simulation enhanced their understanding of equipment best practices and procedures. Their practical skills were strengthened as they gained confidence and increased awareness of the tools and neonatal care procedures. One student thought back to how, prior to the simulation, he had no idea how to practice using the chart. Before the simulation, I had no idea how to use resuscitation equipment or score the baby prior to the physical activity. After arriving here for the simulation, I learned how to operate this equipment. It improved my knowledge and skills… I have no fear of anything related to the realities of caring for a patient (FGD 2, member 3). Similar to the statement above, another participant said: …. I was nervous to utilize it when I first saw it in a clinical setting, but after practicing with a simulation, I became more comfortable with it. I was also able to use it and successfully perform resuscitation on a neonate when I returned to the clinical area. It will enable us to conduct many more procedures effectively (Interview, participant 26). Subtheme: Increased self-confidence The students, who had never done such things before, greatly appreciated learning about clinical procedures and more complex difficulties outside the clinical context. In addition to lowering their anxiety of making mistakes in secure learning settings, the students felt that the simulation increased their confidence, which is essential for clinical practice and professional life. … The simulation enhances our confidence and prepares us psychologically and physically for practice. Because the simulation represents the reality of what we do in clinical settings, I felt more confident and gained more experience during the scenario… (FGD 1, member 5). The students indicated that simulation exercises improved their confidence and capacity to perform in clinical settings. Because of the simulation, students said they felt more confident and performed better. … Because simulation speeds up processes, it has increased my confidence and performance in the clinical setting. I was not confident in my practice before, but going to the simulation sessions, where we practice a lot, has given me more self-assurance (Interview, participant 22). Subtheme: Improve communication skills Male students also discussed how they learned that effective communication is essential to managing neonatal emergencies. They believed requesting help during the simulation promoted interprofessional interaction, communication, and teamwork. My ability to communicate effectively in the clinical setting has improved through simulation. I am sufficiently knowledgeable to interact with other colleagues while performing my tasks once the situation occurs in the clinical setting. ask for help … (FGD 2, member 2). Theme 2: Preparation for realistic situations Based on the interview, the male students’ knowledge increased following the simulation course, and their comprehension of women’s difficulties broadened, which will help them in practical circumstances. … Yes, excellent. Being a married man, this course taught me a lot about women and pregnancy, and once I am done, I will be able to support my wife throughout her pregnancy (Interview, participant 15). Everybody will have infant issues because their families will always have neonates. Once we are all married, you will apply the knowledge from the maternity course in certain circumstances, particularly in emergency scenarios or real life (FGD 2, member 4). Subtheme: Integrating theory into practice Through interactions and criticism with facilitators and other students, the students felt that the simulation session was essential to improving their critical thinking and reasoning skills. This critical thinking and introspection benefited the development of clinical knowledge and abilities. I experience… A simulation can help you learn about your weaknesses, how each person engaged in the scenario, and integrate a theory into clinical practice. You are also asked why you did this, which aids with memory recall. Therefore, I had more opportunities to gain theory and knowledge in the clinical practice (FGD 1, member 3). Students found simulation essential to integrating and applying their theoretical knowledge to clinical practice. During the simulation, they believed the facilitators improved their knowledge and abilities by encouraging them to think critically and reason more. Through observation and logic, simulation has enhanced our understanding and application of any care we offer. Simulation can also enhance our reasoning skills (Interview, participant 29). Subtheme: More practice time in simulation labs The students lamented the lack of simulation laboratories throughout the maternity course, making it difficult to do well on the OSCE tests. They would only retain the checklist information without understanding what it meant. The second issue is the lengthy time between practice and the exam. I request that the doctor give the students more than one to two labs or more than two weeks to repeat the experience because we knew then, but now we have forgotten. They [instructors] only gave us two labs and the exams, which is insufficient (Interview, participant 29). Even though we had the checklist step by step, they could not fully comprehend it during the OSCE examination. We need more time to practice in the labs so they can be familiar with the procedure, which would help them in the OSCE examination (FGD 1, member 4). Theme 3: Feeling of anxiety and stress During the simulation, the male students felt anxiety and stress due to cultural and religious factors. Some felt stress and anxiety because other students or instructors would evaluate them. Yes, I am stressed and uncertain… the measurement procedures were carried out during the simulation. I also had a fear of touching the babies because we are boys, and that anything could happen to the baby (FGD 1, member 6). Theme 4: Theory and practice abilities gaps The discrepancy between the knowledge acquired in theoretical training and its application in a clinical context is known as the theory-practice gap. The misalignment between the theoretical portion and the simulation labs caused some participants to feel inept. It inhibited them from applying their skills or acquiring new ones on the clinical days. In simulation, my problem is the gap between lab training and the OSCE exam. I did nothing except the assessment tool and went home after that. The theory and practice in the lab, the gap is there… (Interview, participant 18). At the beginning of the course, we only took the basics in the lab, and there was a long gap between clinical labs and my clinical practices, so it was not much of a surprise for me… (FGD 2, member 4). Discussion In this study, we found that male participants generally had a positive perception of the objectives and information provided during the simulation. These results suggest that the simulation design provided a supportive learning environment, with participants feeling that their needs were recognized and that support was available on time. The male student participants felt the support provided was effective in helping them learn and problem-solve during the simulation. Using simulation as a teaching tool can help by giving students realistic chances to participate in learning activities that call for making their own clinical decisions and seeing the outcomes of their answers in a secure setting ( Newton & Krebs, 2020 ; Saifan et al., 2021 ). Faculty can detect knowledge and education gaps through simulation, and students can remark on what happened during the simulation experience ( Ali & Musallam, 2018 ; Gantt et al., 2018 ). Simulation has increased nursing students’ confidence, which was not previously known in the literature ( Malya et al., 2025 ). According to earlier studies, simulation helped nursing students become more competent and confident by providing them with safe practice ( Khan et al., 2022 ; Dias et al., 2024a ). Given that pre-service education frequently lacks opportunities for practical experience, these findings are novel and pertinent, indicating that simulation can boost students’ confidence in providing first neonatal care ( Khan et al., 2022 ; Al Gharibi and Arulappan, 2020 ; Bailey & Emory, 2022 ). It is crucial to impart information and competence to students during their education ( Kruk et al., 2018 ). To prepare students to become competent professionals who can improve the quality of neonatal care in settings with a high neonatal mortality rate, it is essential to use simulation to increase their procedural confidence ( Khan et al., 2022 ; Tjoflåt, Koyo, & Bø, 2021 ; Dias et al., 2024b ). Furthermore, during simulation practice, students’ physiological stress and anxiety levels rise, which may impact their performance in real-world scenarios and simulations ( O’Regan, Ekelund, & Watterson, 2022 ). Simulation is important since it prepares for realistic situations. Simulation allows nursing faculty to replicate the clinical environment, immersing students in a nonthreatening, guided learning experience. Our findings indicated that most male students indicated that simulation is a way to prepare for realistic situations in clinical settings. Salo et al. (2025) believe that better instruction and greater student satisfaction in simulation-based learning can result from acknowledging and treating students’ emotions. To achieve the optimal learning results, nursing students must improve their practical competence and be ready to work in relationships with people who have not had exposure to the maternal health setting. The study participants indicated that the simulation experience was supportive and provided feedback. Also, the simulation was well-designed to provide participants with the necessary support and feedback to learn and apply new skills effectively in real situations in clinical settings. According to research, simulation can help students gain clinical reasoning abilities and knowledge while preparing them to provide patient and family care in a complicated healthcare setting ( Aebersold, 2018 ). Following best practice recommendations is necessary for simulation to effectively replace or supplement traditional clinical experiences ( Newton & Krebs, 2020 ). Nursing students saw simulation as a helpful way to prepare for and enhance clinical practice ( Furuheim & Lindenskov, 2025 ). Research on the emotional experiences of nursing students during simulation has shown that they go through a range of coexisting and fluctuating feelings, such as pleasurable and unpleasant ( Salo et al., 2025 ; Madsgaard et al., 2022 ). However, most research has been on how nursing students respond to negative emotions when learning through simulation ( Ko & Choi, 2020 ). Our results showed that several students experienced stress and anxiety during simulation exercises. Emotions also impact how information is encoded, retrieved, and used to solve problems ( LeBlanc & Posner, 2022 ). According to Caloca-Amber et al. (2024) , emotional control, tension, worry, and self-assurance can impact learning outcomes, knowledge, and abilities. Unpleasant feelings like tension and worry interfere with students’ ability to study ( Salo et al., 2025 ; Amimaruddin & Ruditaldris, 2022 ). Proper preparation, including outlining the learning objectives, can increase psychological safety and lessen students’ fear, improving their educational experiences ( Somerville et al., 2023 ). According to Roh and Jang (2017) , students frequently feel stressed during simulations, vulnerable, and at high risk of making mistakes or coming off as insufficient. Effective learning requires addressing this problem, and simulation is essential. The students felt the stress of being watched and assessed by facilitators and observers. According to studies, students experience stress and anxiety when participating in a simulation ( Tosterud et al., 2020 ). Since emotions greatly influence learning, it is critical to examine nursing students’ feelings during simulation ( Madsgaard et al., 2022 ). Students can be better prepared for problems in the workplace, and a supportive learning environment can be created by acknowledging and treating their emotions. Training professionals with emotional intelligence can help them become well-prepared ( Ahn et al., 2023 ). According to He et al. (2024) , students’ subjective emotions are crucial in perceiving and engaging with their learning environment. The students’ past experiences and knowledge should be the foundation for this. Through carefully thought-out briefings, the facilitator can lower stress levels by acquainting students with the simulation room, the simulator’s capabilities, and the facilitator’s expected role throughout the simulation. A thorough briefing can avoid misunderstandings during the simulation ( Rattani, 2020 ). Simulation-based learning can be stressful and challenging, impacting learning ( LeBlanc & Posner, 2022 ). It elicits strong student emotions ( Behrens et al., 2021 ). With various professional groups and patients, students take on various responsibilities and engage in collaborative learning ( MacLean et al., 2019 ). In this situation, group skills and emotional control are crucial. Simulations elicit both positive feelings (like surprise and attention) and negative emotions (like dread and anxiety) in nursing students, according to other studies ( Madsgaard et al., 2022 ). In a simulated environment, students who experience less anxiety might perform better clinically ( Al-Ghareeb, McKenna, & Cooper, 2019 ). Positive simulation progress experiences heighten positive emotions like confidence, serenity, and a sense of competence, which are thought to affect learning positively. On the other hand, students who felt like they had failed at simulations experienced negative emotions such as stress, worry, fear, despair, and uneasiness. This made them doubt their ability to perform in the future and was thought to have a detrimental effect on their learning ( Behrens et al., 2021 ). Positive emotions are generally better at fostering learning than negative ones ( Keskitalo & Ruokamo, 2021 ). Simulations have emerged as a helpful tool for practicing the application of academic information in real-world skill-use scenarios. The ability of nursing students to integrate classroom knowledge and apply it to clinical practice must be strengthened by nursing instructors. Thus, the theory-practice gap in education may be closed by repeatedly using simulation games and virtual simulation to approximate theory-based teaching practices ( Dias et al., 2023 ). In nursing education, the theory-practice gap is a significant issue. Nurse educators frequently find it challenging to incorporate theoretical knowledge into their lessons. Educators or mentors may either not know which theoretical knowledge student educators have learned, or their priorities for teaching are inconsistent with the knowledge learned in university. Commonly employed in the simulation phase, pedagogical techniques like debates, reflections, critical thinking, and reasoning are underutilized in many low-income higher health education institutions ( Bø et al., 2022 ; Tjoflåt, Koyo & Bø, 2021 ). The gap between theory and practice, a lack of resources, and a lack of experience with the medical environment are some of the many challenges nursing students have in the clinical context ( Panda et al., 2021 ). Li et al. (2022) assert that simulation-based education is a practical pedagogical approach for nursing students. A secure and regulated framework provides students an intense clinical setting for skill development and experiential learning ( Tamilselvan et al., 2023 ). This educational method fosters the development of several competences, including knowledge, skills, interprofessional collaboration, critical thinking, empathy, and a passion for learning ( Rattani, 2020 , Tamilselvan et al., 2023 ). Furthermore, students can implement the concepts acquired in intricate and demanding scenarios ( Chernikova et al., 2020 ). A recent meta-analysis revealed that simulation enhances nursing students’ knowledge acquisition more effectively than computer-based simulation. In nursing education, the combination of simulation and computer-based simulation is the most prevalent blended learning methodology (student stressors). Combining theoretical knowledge with practical skills is crucial for patient care, and simulation discussions promote students’ reflection, critical thinking, and reasoning ( Bailey & Emory, 2022 ). The study results showed that participants believed simulation is about preparing for real life and realistic situations. The simulation sessions helped students handle emergency obstetric situations and prepared them for upcoming events ( Khan et al., 2023 ). The study also identified several new issues that will be considered, such as the gap between theoretical knowledge and practical abilities and the need for more practice time in simulation labs. Simulation-based learning methods are becoming increasingly popular in nursing education to mimic real-life conditions ( Somerville et al., 2023 ). They can offer an alternative to realistic and real-life situations in clinical encounters ( Leighton et al., 2021 ). Simulation helps students adapt to professional occupations and prepares them for real-life situations ( Mishra, Hemlata & Trivedi, 2023 ). Students in this study reported that simulation aided their skill development and knowledge transfer during neonatal resuscitation. These findings consistently show that simulation enhances practicing proficiency, skills, and confidence ( Alalhareth & Howarth, 2020 ; Mishra, Hemlata, & Trivedi, 2023 ). The study’s findings support the idea that simulation is an effective teaching strategy that can help students put theory into practice ( Wong & Kowitlawakul, 2020 ). In addition, during neonatal emergencies, such as breathing difficulties after birth, effective communication was enabled through calls, shouts for help, interactions, and role allocation—skills essential for successful interprofessional teamwork ( Khan et al., 2023 ). These scenarios’ actions are consistent with earlier research showing that simulation enhances students’ teamwork and communication skills ( Hustad et al., 2019 ). Limitation It is important to recognize the limitations of the current investigation. This study was conducted at a single nursing school in the United Arab Emirates. The findings might not be as applicable to other nursing programs in this setting. Another limitation of this qualitative study was the small sample size, which might not accurately reflect the general population. Future research should therefore get beyond these restrictions by employing quantitative techniques, greater sample sizes, longer study durations, and other study locations. Conclusion and recommendation The study findings indicate that male nursing students received the overall simulation experience well. However, it can be ameliorated by promoting active learning and integrating simulation-based learning with clinical practice. The study highlights the importance of skilled and encouraging simulation instructors who can provide participants with valuable guidance and feedback and the need for more individualized teaching. These results provide important new information about how simulation-based learning could improve nursing education and further studies in this field. Furthermore, the findings shed light on the problems that male nursing students have been dealing with for years and highlight efforts to make changes as soon as feasible. Based on the study results, it may be helpful to revise the simulation to provide more opportunities for independent problem-solving skills and to incorporate more real-life factors and variables into the scenario. Developing more individualized approaches to building self-confidence may be helpful, such as providing personalized feedback and guidance based on each student’s strengths and weaknesses. Incorporating more opportunities for reflection and self-assessment may also help build self-confidence. Data availability The data generated and analyzed during this study are not publicly available due to ethical and confidentiality considerations, as outlined by the Ethics Committee of the Office of the Vice Chancellor for Research & Graduate Studies at the University of Sharjah, UAE. Participant data contain sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. The Institutional Review Board (IRB) has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author Dr. Richard Mottershead [email protected] . 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PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 15 Sep 2025 ADD YOUR COMMENT Comment Author details Author details 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates 2 Institute of Health Sciences, Binawan University, Jakarta, Indonesia 3 Sakina, Behavioural Science Institute, SEHA, Al Ain, United Arab Emirates 4 College of Nursing, University of Baghdad, Baghdad, Iraq Jacqueline Maria Dias Roles: Conceptualization, Writing – Original Draft Preparation, Writing – Review & Editing Mini Sara Abraham Roles: Writing – Original Draft Preparation, Writing – Review & Editing Muhammad Arsyad Subu Roles: Writing – Original Draft Preparation, Writing – Review & Editing Nabeel Al Yateem Roles: Writing – Original Draft Preparation, Writing – Review & Editing Fatma Reefat Ahmed Roles: Writing – Original Draft Preparation, Writing – Review & Editing Raliya Abdourahman Abdillahi Roles: Writing – Original Draft Preparation, Writing – Review & Editing Noof Jamal Saleh Roles: Writing – Original Draft Preparation, Writing – Review & Editing Samira Mohamed Ali Roles: Writing – Original Draft Preparation, Writing – Review & Editing Kowsar Abshir Hashi Roles: Writing – Original Draft Preparation, Writing – Review & Editing Richard Mottershead Roles: Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The authors received funding for this research. Dr Jacqueline Maria Dias a TEIG scholar at the University of Sharjah, received the maiden Chancellor's Teaching Excellence and Innovation Grant Winners (TEIG).The Institute of Leadership in Higher Education is pleased to announce the winners of the maiden cycle of the Chancellor's Teaching Excellence and Innovation Grant (TEIG). AED 10, 000/- received for “ Technology enhanced Learning via simulation for Male baccalaureate students in the Maternity course- an innovative teaching pedagogy. https://ilhe.sharjah.ac.ae/en/Pages/grant.aspx The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (2) version 2 Revised Published: 06 Oct 2025, 14:920 https://doi.org/10.12688/f1000research.167350.2 version 1 Published: 15 Sep 2025, 14:920 https://doi.org/10.12688/f1000research.167350.1 Copyright © 2025 Maria Dias J et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Maria Dias J, Sara Abraham M, Arsyad Subu M et al. Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.12688/f1000research.167350.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 06 Oct 2025 Revised Views 0 Cite How to cite this report: Benfatah M. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r421782 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-421782 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 04 Nov 2025 Mohamed Benfatah , Hassan First University of Settat, Settat, Morocco Approved VIEWS 0 https://doi.org/10.5256/f1000research.188736.r421782 Summary: This manuscript presents a descriptive qualitative study exploring the experiences of male undergraduate nursing students using simulation-based learning at the University of Sharjah, UAE. Forty-three students participated through individual interviews and two online focus groups. Thematic analysis revealed ... Continue reading READ ALL Summary: This manuscript presents a descriptive qualitative study exploring the experiences of male undergraduate nursing students using simulation-based learning at the University of Sharjah, UAE. Forty-three students participated through individual interviews and two online focus groups. Thematic analysis revealed four main themes: (1) students’ perceptions of simulation, (2) preparation for realistic situations, (3) feelings of anxiety and stress, and (4) theory-practice gaps. The authors report that simulation enhances knowledge, practical skills, communication, self-confidence, and integration of theory into practice, while also revealing challenges such as anxiety, limited lab time, and gaps between theory and practice. Overall, the manuscript is well-written, comprehensive, and provides novel insights into the experiences of male nursing students in a culturally specific context. Simulation is positioned as a valuable pedagogical tool for bridging clinical training gaps. Evaluation of Key Aspects Originality and Relevance: Strengths: The study addresses a clear gap in nursing education research, particularly the experiences of male students in maternity and neonatal simulation training in a culturally conservative environment. The topic is timely and relevant to educators seeking alternative methods to supplement clinical placements. Areas for Improvement: None significant. The manuscript is original and contributes to the field. Methodology: Strengths: The study uses an appropriate qualitative design with semi-structured interviews and focus groups. Thematic analysis following Braun & Clarke’s six-phase approach is appropriate, and the use of NVivo 12 for coding adds rigor. Ethical considerations are well-addressed. Weaknesses / Points to Address: Sampling Clarification: The text mentions 32 participants in interviews but 43 in total; a clear table or figure summarizing participant distribution across interviews and focus groups would improve clarity. Interview Guide Transparency: Although Table 1 includes questions, providing the full interview and focus group guide in a supplementary appendix would enhance reproducibility. Reflexivity Statement: The authors do not discuss their positionality or potential biases as researchers, which is important in qualitative research to ensure credibility. A brief statement on the researchers’ background, relationship with participants, and steps taken to minimize bias should be added. Data Analysis and Rigor: Strengths: Thematic analysis is described in detail. Steps to resolve coding disagreements are explained, and triangulation with focus groups increases credibility. Data storage, confidentiality, and ethical considerations are thorough. Weaknesses / Points to Address: Codebook and Theme Validation: Consider including an anonymized excerpt of the codebook or examples of coding to illustrate transparency. This is optional but strengthens reproducibility. Data Saturation: The authors mention that 25 participants are enough per Charmaz (2006). It would strengthen the manuscript to explicitly state how saturation was confirmed during analysis. Results: Strengths: The results are well-organized into four main themes with subthemes, supported by participant quotes. The findings align with the study objective and provide clear insight into students’ experiences. Weaknesses / Points to Address: Some quotes are repeated or paraphrased multiple times, which can be condensed for clarity. Consider a table summarizing the themes, subthemes, and representative quotes; this improves readability for journal reviewers and readers. Discussion: Strengths: The discussion contextualizes findings within existing literature, highlighting the positive effects of simulation on skills, confidence, and communication. Cultural and gender-specific challenges are acknowledged. Weaknesses / Points to Address: Some parts of the discussion are repetitive, particularly when addressing stress, anxiety, and theory-practice gaps. Condensing and synthesizing these points will improve clarity. Consider explicitly linking recommendations (e.g., increasing lab time, individualized feedback) to the literature and study findings in a concise table or paragraph. Limitations: Clearly stated (single institution, small sample). Consider adding a comment on potential social desirability bias in interviews, especially as students were discussing sensitive experiences. Conclusion and Recommendations: Clear and actionable recommendations are provided. Ensure the conclusion explicitly states how findings contribute to advancing nursing education, particularly for male students in culturally restricted contexts. References: Current references appear appropriate and recent. Ensure all references are correctly formatted according to the journal guidelines. Specific Points that Must Be Addressed to Ensure Scientific Soundness: Issue Recommendation Participant distribution clarity: Provide a table showing total participants, interviews, and focus groups to remove ambiguity. Interview/FGD guide transparency: Include full interview and focus group guide as supplementary material. Reflexivity: Add a brief statement on researcher positionality, potential bias, and mitigation strategies. Saturation: Explicitly describe how data saturation was assessed. Coding transparency: Consider including a sample of coding or excerpts from the codebook. Repetitive quotes: Condense similar quotes to improve readability. Discussion clarity: Synthesize repetitive points on anxiety, stress, and theory-practice gaps; link recommendations directly to findings. Additional Constructive Suggestions: Adding a visual summary (e.g., table or figure) of themes and subthemes with representative quotes. Consider highlighting gender- and culture-specific insights in a separate paragraph to strengthen the manuscript’s unique contribution. Minor language edits for conciseness and clarity, particularly in Results and Discussion, will enhance readability. Overall Assessment: This manuscript is scientifically sound, original, and relevant. With minor clarifications and revisions—particularly around methodology transparency, reflexivity, and condensation of repetitive text it will be suitable for indexing in journal. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Nursing education, simulation-based learning, clinical pedagogy, qualitative research methods in healthcare education. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Benfatah M. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r421782 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-421782 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Agussalim A. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r420842 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-420842 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Nov 2025 Agussalim Agussalim , Makassar Health Polytechnic, Makassar, Indonesia Approved VIEWS 0 https://doi.org/10.5256/f1000research.188736.r420842 No further comments ... Continue reading READ ALL No further comments from my end Competing Interests: No competing interests were disclosed. Reviewer Expertise: Nursing in Medical surgical Research I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Agussalim A. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r420842 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-420842 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 05 Nov 2025 Dr. Richard Mottershead , College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates 05 Nov 2025 Author Response Dear Dr. Agussalim, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for proving your peer-review for our article. ... Continue reading Dear Dr. Agussalim, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for proving your peer-review for our article. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Dear Dr. Agussalim, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for proving your peer-review for our article. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 05 Nov 2025 Dr. Richard Mottershead , College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates 05 Nov 2025 Author Response Dear Dr. Agussalim, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for proving your peer-review for our article. ... Continue reading Dear Dr. Agussalim, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for proving your peer-review for our article. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Dear Dr. Agussalim, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for proving your peer-review for our article. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Mulyadi M. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r421780 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-421780 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 03 Nov 2025 Mulyadi Mulyadi , Sam Ratulangi University, , Manado,, Indonesia Approved VIEWS 0 https://doi.org/10.5256/f1000research.188736.r421780 Thank you for the opportunity to review this manuscript, title: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates I have provided the following feedback which I believe will ... Continue reading READ ALL Thank you for the opportunity to review this manuscript, title: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates I have provided the following feedback which I believe will strengthen the manuscript. Abstract: The conclusion is meaningful but could be more focused on the main research theme. It would be helpful if the authors emphasized how their findings contribute to nursing education, especially in enhancing simulation learning experiences for male nursing students. Highlighting this connection would make the study’s message clearer and more impactful for readers. Methods: The interview questions can be found in Table 1 . The interview guide is clear, but the authors should explain the theoretical or empirical basis used to develop it. This would strengthen the study’s methodological rigor and ensure alignment with the research objectives. Study rigor The authors provide clear ethical safeguards for confidentiality and data security. To further strengthen this section, a brief explanation of how trustworthiness and methodological rigor, such as credibility, transferability, dependability, and confirmability, were ensured would enhance the study’s transparency and robustness Results and Discussion: The results are clearly presented. However, mentioning the number of subthemes identified under each main theme would improve the clarity and completeness of the findings. The third theme, “Feelings of Anxiety and Stress,” lacks subthemes and is supported by only one participant quote (out of forty-three male students). While not all themes require subthemes, this limited evidence may not adequately capture the participants’ overall experiences. The authors are encouraged to provide additional supporting data or reconsider whether this theme should stand alone. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Nursing education, trauma and emergency nursing I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Mulyadi M. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r421780 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-421780 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 05 Nov 2025 Dr. Richard Mottershead , College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates 05 Nov 2025 Author Response Dear Dr. Mulyadi, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for providing your peer-review for our article. Your ... Continue reading Dear Dr. Mulyadi, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for providing your peer-review for our article. Your insight was very useful and if will certainly consider your recommendations for our future publications. So often, we are constrained by the word-limit of the journals we publish within. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Dear Dr. Mulyadi, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for providing your peer-review for our article. Your insight was very useful and if will certainly consider your recommendations for our future publications. So often, we are constrained by the word-limit of the journals we publish within. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 05 Nov 2025 Dr. Richard Mottershead , College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates 05 Nov 2025 Author Response Dear Dr. Mulyadi, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for providing your peer-review for our article. Your ... Continue reading Dear Dr. Mulyadi, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for providing your peer-review for our article. Your insight was very useful and if will certainly consider your recommendations for our future publications. So often, we are constrained by the word-limit of the journals we publish within. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Dear Dr. Mulyadi, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for providing your peer-review for our article. Your insight was very useful and if will certainly consider your recommendations for our future publications. So often, we are constrained by the word-limit of the journals we publish within. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 15 Sep 2025 Views 0 Cite How to cite this report: Agussalim A. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.184457.r414848 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v1#referee-response-414848 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 23 Sep 2025 Agussalim Agussalim , Makassar Health Polytechnic, Makassar, Indonesia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.184457.r414848 Summary of the Article This study, “Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates” (Dias et al., 2025), investigates the experiences of male nursing students with simulation-based ... Continue reading READ ALL Summary of the Article This study, “Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates” (Dias et al., 2025), investigates the experiences of male nursing students with simulation-based learning in a context where clinical placements, especially in maternity care, are limited due to cultural barriers. Using a descriptive qualitative design, the authors conducted semi-structured interviews with 32 male nursing students and two focus groups (11 additional participants), for a total of 43 students. Data were analyzed using Braun and Clarke’s six-phase thematic analysis framework. Four themes were identified: (1) Students’ perceptions of simulation (e.g., improved skills, self-confidence, and communication), (2) Preparation for realistic situations, (3) Feelings of anxiety and stress, and (4) Theory–practice gaps. The authors conclude that simulation is a valuable and well-received pedagogy for male students, though improvements are needed in lab time, individualized feedback, and integration with clinical practice. Evaluation Against Review Questions 1. Is the work clearly and accurately presented and does it cite the current literature? Yes. The manuscript is clearly structured (IMRaD), with transparent reporting of objectives, methods, results, and discussion. The literature cited is current, including very recent studies (2022–2025), and covers both global and regional perspectives. Some reliance on the authors’ own prior work is noted, but this does not overshadow the breadth of references. 2. Is the study design appropriate and is the work technically sound? Yes. The descriptive qualitative design is entirely appropriate for the research aim of exploring experiences and perceptions. The sampling strategy, data collection methods, and analytic approach are sound. Rigor is addressed through triangulation, ethical safeguards, and anonymization. The main technical limitation is that the study is confined to one institution, which restricts transferability, but this is acknowledged. 3. Are sufficient details of methods and analysis provided to allow replication by others? Partly. The methodology is generally well described, including sampling, data collection, and thematic analysis steps. However, some details are missing: The interview and focus group guides (or at least example questions) are not provided, making it difficult to replicate the data collection exactly. The software or tools used for data analysis are not specified (e.g., NVivo, Atlas.ti, or spreadsheets). It is not clear how disagreements in coding were handled (e.g., consensus meetings, inter-rater reliability checks). Recommendation: The authors should include an appendix with the interview guide, clarify whether any qualitative analysis software was used, and describe how coder agreement was reached. This would significantly strengthen transparency and replicability. 4. If applicable, is the statistical analysis and its interpretation appropriate? Not applicable. As a qualitative study, no statistical analysis is required. Thematic analysis is appropriate and correctly applied, with adequate use of participant quotations to support interpretation. 5. Are all the source data underlying the results available to ensure full reproducibility? Partly. The raw interview and FGD transcripts are not publicly available due to confidentiality concerns, but the authors provide a controlled access pathway for qualified researchers via ethics approval. This is standard practice in qualitative research involving sensitive personal data. Recommendation: The current data availability statement is acceptable, but the authors could improve transparency by providing an anonymized sample transcript or coding framework in supplementary material. This would give readers a clearer sense of the raw data without breaching confidentiality. 6. Are the conclusions drawn adequately supported by the results? Yes. The conclusions align well with the identified themes and are supported by direct quotations from participants. Recommendations (e.g., individualized feedback, integration of simulation with clinical practice) logically follow from the findings. The limitations are acknowledged, which keeps the conclusions appropriately cautious. Overall Strengths Timely and relevant focus on male nursing students in a cultural context with clinical placement restrictions. Clear and logical structure with transparent reporting of ethical considerations. Use of triangulation (interviews + FGDs) and thematic analysis strengthens trustworthiness. Engagement with very recent literature makes the study well-situated in current debates. Overall Limitations & Required Revisions Interview/FGD guide not included → Must be added (appendix or supplementary file). Analysis software not specified and coder agreement process unclear → Should be clarified. Data availability → While full transcripts cannot be shared, providing an anonymized sample transcript or coding framework would strengthen reproducibility. Final Recommendation The manuscript is scientifically sound, clearly presented, and contributes valuable insights into simulation-based pedagogy for male nursing students. However, minor revisions are required to strengthen methodological transparency and reproducibility: Include interview/FGD guide questions (appendix/supplement). Clarify analytic tools used and how coding disagreements were resolved. Consider sharing an anonymized transcript excerpt or coding framework to enhance reproducibility. With these revisions, the paper will meet high scientific and reporting standards. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Nursing in Medical surgical Research I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Agussalim A. Reviewer Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.184457.r414848 ) The direct URL for this report is: https://f1000research.com/articles/14-920/v1#referee-response-414848 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 27 Sep 2025 Dr. Richard Mottershead , Sakina, Behavioural Science Institute, SEHA, Al Ain, United Arab Emirates 27 Sep 2025 Author Response Dear editor and reviewers, Thank you for your email and comments on our manuscript. We revised our manuscript in response to the reviewers' comments and concerns. Our revisions and comments ... Continue reading Dear editor and reviewers, Thank you for your email and comments on our manuscript. We revised our manuscript in response to the reviewers' comments and concerns. Our revisions and comments are highlighted in yellow throughout the manuscript. Please see our responses below. Reviewer Comments: The manuscript is scientifically sound, clearly presented, and contributes valuable insights into simulation-based pedagogy for male nursing students. However, minor revisions are required to strengthen methodological transparency and reproducibility: 1. Include interview/FGD guide questions (appendix/supplement). Response: Thank you so much for your comment. We added and included the interview guide questions in the appendix. 1. How would you describe your overall experience during the maternity practicum labs? ( Probe: What stood out the most to you?) 2. What were your feelings and thoughts on the first day of your maternity practicum? (Probe: Were you nervous, excited, or unsure?) 3. How did your feelings change by the last day of the practicum? (Probe: What had improved or become more comfortable?) 4. Can you share a positive experience you had during your maternity practicum? (Probe: What made it a good experience?) 5. Can you describe a negative or challenging experience during the practicum? (Probe: How did you handle it?) 6. What was the most difficult part of your experience in the maternity lab or clinical setting? (Probe: Skills, communication, environment, etc.) 7. As this was your first exposure to maternity care, what specific fears or anxieties did you experience? (Probe: Were any of these related to gender, confidence, or knowledge?) 8. Did participating in the maternity practicum affect your daily life or your mental/emotional health? If so, how? 9. What specific challenges did you face as a male student in the maternity practicum setting? (Probe: Interaction with patients, acceptance by staff, cultural barriers, etc.) 10. What advice would you give to a second-year male student who will soon enter the maternity practicum? (Probe: What do you wish you had known beforehand?) 11. How were you able to apply maternity theory learned in class during your practicum or simulation sessions? (Probe: Can you give specific examples?) 12. Would you consider working in the maternity department in the future? Why or why not? (Probe: Did your practicum influence this decision?) 13. How did simulation activities in the lab prepare you for real-life maternity clinical experiences? (Probe: What scenarios or skills were most helpful?) 2. Clarify the analytic tools used and how coding disagreements were resolved. Response: Thank you for your comment. This study employed a thematic analysis, adhering to the six data analysis phases described by Braun and Clarke (2006). We employed NVivo 12 as our data management tool, which assists us in coding and identifying themes— thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. (highlighted in yellow). Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties to maintain transparency and clarity. During our analysis, the authors meet to review all coding and reach consensus. Regular meetings are held throughout the process to review the data and implement any necessary adjustments. 3. Consider sharing an anonymized transcript excerpt or coding framework to enhance reproducibility. Response: Thank you very much for your comment. In this study, reproducibility is achieved by obtaining consistent results through the thematic analysis steps, coding, and conditions. We provided clear, specific, and thorough information about the data products that support our published results, allowing other researchers to replicate the analysis. Additionally, all data are available from the first author or the corresponding author upon reasonable request. 4. Are all the source data underlying the results available to ensure full reproducibility? Response: Thank you. Participant data contains sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. The Institutional Review Board (IRB) has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author, Dr. Richard Mottershead. Dear editor and reviewers, Thank you for your email and comments on our manuscript. We revised our manuscript in response to the reviewers' comments and concerns. Our revisions and comments are highlighted in yellow throughout the manuscript. Please see our responses below. Reviewer Comments: The manuscript is scientifically sound, clearly presented, and contributes valuable insights into simulation-based pedagogy for male nursing students. However, minor revisions are required to strengthen methodological transparency and reproducibility: 1. Include interview/FGD guide questions (appendix/supplement). Response: Thank you so much for your comment. We added and included the interview guide questions in the appendix. 1. How would you describe your overall experience during the maternity practicum labs? ( Probe: What stood out the most to you?) 2. What were your feelings and thoughts on the first day of your maternity practicum? (Probe: Were you nervous, excited, or unsure?) 3. How did your feelings change by the last day of the practicum? (Probe: What had improved or become more comfortable?) 4. Can you share a positive experience you had during your maternity practicum? (Probe: What made it a good experience?) 5. Can you describe a negative or challenging experience during the practicum? (Probe: How did you handle it?) 6. What was the most difficult part of your experience in the maternity lab or clinical setting? (Probe: Skills, communication, environment, etc.) 7. As this was your first exposure to maternity care, what specific fears or anxieties did you experience? (Probe: Were any of these related to gender, confidence, or knowledge?) 8. Did participating in the maternity practicum affect your daily life or your mental/emotional health? If so, how? 9. What specific challenges did you face as a male student in the maternity practicum setting? (Probe: Interaction with patients, acceptance by staff, cultural barriers, etc.) 10. What advice would you give to a second-year male student who will soon enter the maternity practicum? (Probe: What do you wish you had known beforehand?) 11. How were you able to apply maternity theory learned in class during your practicum or simulation sessions? (Probe: Can you give specific examples?) 12. Would you consider working in the maternity department in the future? Why or why not? (Probe: Did your practicum influence this decision?) 13. How did simulation activities in the lab prepare you for real-life maternity clinical experiences? (Probe: What scenarios or skills were most helpful?) 2. Clarify the analytic tools used and how coding disagreements were resolved. Response: Thank you for your comment. This study employed a thematic analysis, adhering to the six data analysis phases described by Braun and Clarke (2006). We employed NVivo 12 as our data management tool, which assists us in coding and identifying themes— thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. (highlighted in yellow). Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties to maintain transparency and clarity. During our analysis, the authors meet to review all coding and reach consensus. Regular meetings are held throughout the process to review the data and implement any necessary adjustments. 3. Consider sharing an anonymized transcript excerpt or coding framework to enhance reproducibility. Response: Thank you very much for your comment. In this study, reproducibility is achieved by obtaining consistent results through the thematic analysis steps, coding, and conditions. We provided clear, specific, and thorough information about the data products that support our published results, allowing other researchers to replicate the analysis. Additionally, all data are available from the first author or the corresponding author upon reasonable request. 4. Are all the source data underlying the results available to ensure full reproducibility? Response: Thank you. Participant data contains sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. The Institutional Review Board (IRB) has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author, Dr. Richard Mottershead. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 27 Sep 2025 Dr. Richard Mottershead , Sakina, Behavioural Science Institute, SEHA, Al Ain, United Arab Emirates 27 Sep 2025 Author Response Dear editor and reviewers, Thank you for your email and comments on our manuscript. We revised our manuscript in response to the reviewers' comments and concerns. Our revisions and comments ... Continue reading Dear editor and reviewers, Thank you for your email and comments on our manuscript. We revised our manuscript in response to the reviewers' comments and concerns. Our revisions and comments are highlighted in yellow throughout the manuscript. Please see our responses below. Reviewer Comments: The manuscript is scientifically sound, clearly presented, and contributes valuable insights into simulation-based pedagogy for male nursing students. However, minor revisions are required to strengthen methodological transparency and reproducibility: 1. Include interview/FGD guide questions (appendix/supplement). Response: Thank you so much for your comment. We added and included the interview guide questions in the appendix. 1. How would you describe your overall experience during the maternity practicum labs? ( Probe: What stood out the most to you?) 2. What were your feelings and thoughts on the first day of your maternity practicum? (Probe: Were you nervous, excited, or unsure?) 3. How did your feelings change by the last day of the practicum? (Probe: What had improved or become more comfortable?) 4. Can you share a positive experience you had during your maternity practicum? (Probe: What made it a good experience?) 5. Can you describe a negative or challenging experience during the practicum? (Probe: How did you handle it?) 6. What was the most difficult part of your experience in the maternity lab or clinical setting? (Probe: Skills, communication, environment, etc.) 7. As this was your first exposure to maternity care, what specific fears or anxieties did you experience? (Probe: Were any of these related to gender, confidence, or knowledge?) 8. Did participating in the maternity practicum affect your daily life or your mental/emotional health? If so, how? 9. What specific challenges did you face as a male student in the maternity practicum setting? (Probe: Interaction with patients, acceptance by staff, cultural barriers, etc.) 10. What advice would you give to a second-year male student who will soon enter the maternity practicum? (Probe: What do you wish you had known beforehand?) 11. How were you able to apply maternity theory learned in class during your practicum or simulation sessions? (Probe: Can you give specific examples?) 12. Would you consider working in the maternity department in the future? Why or why not? (Probe: Did your practicum influence this decision?) 13. How did simulation activities in the lab prepare you for real-life maternity clinical experiences? (Probe: What scenarios or skills were most helpful?) 2. Clarify the analytic tools used and how coding disagreements were resolved. Response: Thank you for your comment. This study employed a thematic analysis, adhering to the six data analysis phases described by Braun and Clarke (2006). We employed NVivo 12 as our data management tool, which assists us in coding and identifying themes— thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. (highlighted in yellow). Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties to maintain transparency and clarity. During our analysis, the authors meet to review all coding and reach consensus. Regular meetings are held throughout the process to review the data and implement any necessary adjustments. 3. Consider sharing an anonymized transcript excerpt or coding framework to enhance reproducibility. Response: Thank you very much for your comment. In this study, reproducibility is achieved by obtaining consistent results through the thematic analysis steps, coding, and conditions. We provided clear, specific, and thorough information about the data products that support our published results, allowing other researchers to replicate the analysis. Additionally, all data are available from the first author or the corresponding author upon reasonable request. 4. Are all the source data underlying the results available to ensure full reproducibility? Response: Thank you. Participant data contains sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. The Institutional Review Board (IRB) has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author, Dr. Richard Mottershead. Dear editor and reviewers, Thank you for your email and comments on our manuscript. We revised our manuscript in response to the reviewers' comments and concerns. Our revisions and comments are highlighted in yellow throughout the manuscript. Please see our responses below. Reviewer Comments: The manuscript is scientifically sound, clearly presented, and contributes valuable insights into simulation-based pedagogy for male nursing students. However, minor revisions are required to strengthen methodological transparency and reproducibility: 1. Include interview/FGD guide questions (appendix/supplement). Response: Thank you so much for your comment. We added and included the interview guide questions in the appendix. 1. How would you describe your overall experience during the maternity practicum labs? ( Probe: What stood out the most to you?) 2. What were your feelings and thoughts on the first day of your maternity practicum? (Probe: Were you nervous, excited, or unsure?) 3. How did your feelings change by the last day of the practicum? (Probe: What had improved or become more comfortable?) 4. Can you share a positive experience you had during your maternity practicum? (Probe: What made it a good experience?) 5. Can you describe a negative or challenging experience during the practicum? (Probe: How did you handle it?) 6. What was the most difficult part of your experience in the maternity lab or clinical setting? (Probe: Skills, communication, environment, etc.) 7. As this was your first exposure to maternity care, what specific fears or anxieties did you experience? (Probe: Were any of these related to gender, confidence, or knowledge?) 8. Did participating in the maternity practicum affect your daily life or your mental/emotional health? If so, how? 9. What specific challenges did you face as a male student in the maternity practicum setting? (Probe: Interaction with patients, acceptance by staff, cultural barriers, etc.) 10. What advice would you give to a second-year male student who will soon enter the maternity practicum? (Probe: What do you wish you had known beforehand?) 11. How were you able to apply maternity theory learned in class during your practicum or simulation sessions? (Probe: Can you give specific examples?) 12. Would you consider working in the maternity department in the future? Why or why not? (Probe: Did your practicum influence this decision?) 13. How did simulation activities in the lab prepare you for real-life maternity clinical experiences? (Probe: What scenarios or skills were most helpful?) 2. Clarify the analytic tools used and how coding disagreements were resolved. Response: Thank you for your comment. This study employed a thematic analysis, adhering to the six data analysis phases described by Braun and Clarke (2006). We employed NVivo 12 as our data management tool, which assists us in coding and identifying themes— thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. (highlighted in yellow). Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties to maintain transparency and clarity. During our analysis, the authors meet to review all coding and reach consensus. Regular meetings are held throughout the process to review the data and implement any necessary adjustments. 3. Consider sharing an anonymized transcript excerpt or coding framework to enhance reproducibility. Response: Thank you very much for your comment. In this study, reproducibility is achieved by obtaining consistent results through the thematic analysis steps, coding, and conditions. We provided clear, specific, and thorough information about the data products that support our published results, allowing other researchers to replicate the analysis. Additionally, all data are available from the first author or the corresponding author upon reasonable request. 4. Are all the source data underlying the results available to ensure full reproducibility? Response: Thank you. Participant data contains sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. The Institutional Review Board (IRB) has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author, Dr. Richard Mottershead. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 15 Sep 2025 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 2 (revision) 06 Oct 25 read read read Version 1 15 Sep 25 read Agussalim Agussalim , Makassar Health Polytechnic, Makassar, Indonesia Mulyadi Mulyadi , Sam Ratulangi University, , Manado,, Indonesia Mohamed Benfatah , Hassan First University of Settat, Settat, Morocco Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Benfatah M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 04 Nov 2025 | for Version 2 Mohamed Benfatah , Hassan First University of Settat, Settat, Morocco 0 Views copyright © 2025 Benfatah M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Summary: This manuscript presents a descriptive qualitative study exploring the experiences of male undergraduate nursing students using simulation-based learning at the University of Sharjah, UAE. Forty-three students participated through individual interviews and two online focus groups. Thematic analysis revealed four main themes: (1) students’ perceptions of simulation, (2) preparation for realistic situations, (3) feelings of anxiety and stress, and (4) theory-practice gaps. The authors report that simulation enhances knowledge, practical skills, communication, self-confidence, and integration of theory into practice, while also revealing challenges such as anxiety, limited lab time, and gaps between theory and practice. Overall, the manuscript is well-written, comprehensive, and provides novel insights into the experiences of male nursing students in a culturally specific context. Simulation is positioned as a valuable pedagogical tool for bridging clinical training gaps. Evaluation of Key Aspects Originality and Relevance: Strengths: The study addresses a clear gap in nursing education research, particularly the experiences of male students in maternity and neonatal simulation training in a culturally conservative environment. The topic is timely and relevant to educators seeking alternative methods to supplement clinical placements. Areas for Improvement: None significant. The manuscript is original and contributes to the field. Methodology: Strengths: The study uses an appropriate qualitative design with semi-structured interviews and focus groups. Thematic analysis following Braun & Clarke’s six-phase approach is appropriate, and the use of NVivo 12 for coding adds rigor. Ethical considerations are well-addressed. Weaknesses / Points to Address: Sampling Clarification: The text mentions 32 participants in interviews but 43 in total; a clear table or figure summarizing participant distribution across interviews and focus groups would improve clarity. Interview Guide Transparency: Although Table 1 includes questions, providing the full interview and focus group guide in a supplementary appendix would enhance reproducibility. Reflexivity Statement: The authors do not discuss their positionality or potential biases as researchers, which is important in qualitative research to ensure credibility. A brief statement on the researchers’ background, relationship with participants, and steps taken to minimize bias should be added. Data Analysis and Rigor: Strengths: Thematic analysis is described in detail. Steps to resolve coding disagreements are explained, and triangulation with focus groups increases credibility. Data storage, confidentiality, and ethical considerations are thorough. Weaknesses / Points to Address: Codebook and Theme Validation: Consider including an anonymized excerpt of the codebook or examples of coding to illustrate transparency. This is optional but strengthens reproducibility. Data Saturation: The authors mention that 25 participants are enough per Charmaz (2006). It would strengthen the manuscript to explicitly state how saturation was confirmed during analysis. Results: Strengths: The results are well-organized into four main themes with subthemes, supported by participant quotes. The findings align with the study objective and provide clear insight into students’ experiences. Weaknesses / Points to Address: Some quotes are repeated or paraphrased multiple times, which can be condensed for clarity. Consider a table summarizing the themes, subthemes, and representative quotes; this improves readability for journal reviewers and readers. Discussion: Strengths: The discussion contextualizes findings within existing literature, highlighting the positive effects of simulation on skills, confidence, and communication. Cultural and gender-specific challenges are acknowledged. Weaknesses / Points to Address: Some parts of the discussion are repetitive, particularly when addressing stress, anxiety, and theory-practice gaps. Condensing and synthesizing these points will improve clarity. Consider explicitly linking recommendations (e.g., increasing lab time, individualized feedback) to the literature and study findings in a concise table or paragraph. Limitations: Clearly stated (single institution, small sample). Consider adding a comment on potential social desirability bias in interviews, especially as students were discussing sensitive experiences. Conclusion and Recommendations: Clear and actionable recommendations are provided. Ensure the conclusion explicitly states how findings contribute to advancing nursing education, particularly for male students in culturally restricted contexts. References: Current references appear appropriate and recent. Ensure all references are correctly formatted according to the journal guidelines. Specific Points that Must Be Addressed to Ensure Scientific Soundness: Issue Recommendation Participant distribution clarity: Provide a table showing total participants, interviews, and focus groups to remove ambiguity. Interview/FGD guide transparency: Include full interview and focus group guide as supplementary material. Reflexivity: Add a brief statement on researcher positionality, potential bias, and mitigation strategies. Saturation: Explicitly describe how data saturation was assessed. Coding transparency: Consider including a sample of coding or excerpts from the codebook. Repetitive quotes: Condense similar quotes to improve readability. Discussion clarity: Synthesize repetitive points on anxiety, stress, and theory-practice gaps; link recommendations directly to findings. Additional Constructive Suggestions: Adding a visual summary (e.g., table or figure) of themes and subthemes with representative quotes. Consider highlighting gender- and culture-specific insights in a separate paragraph to strengthen the manuscript’s unique contribution. Minor language edits for conciseness and clarity, particularly in Results and Discussion, will enhance readability. Overall Assessment: This manuscript is scientifically sound, original, and relevant. With minor clarifications and revisions—particularly around methodology transparency, reflexivity, and condensation of repetitive text it will be suitable for indexing in journal. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Nursing education, simulation-based learning, clinical pedagogy, qualitative research methods in healthcare education. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Benfatah M. Peer Review Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r421782) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-421782 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Agussalim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Nov 2025 | for Version 2 Agussalim Agussalim , Makassar Health Polytechnic, Makassar, Indonesia 0 Views copyright © 2025 Agussalim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions No further comments from my end Competing Interests No competing interests were disclosed. Reviewer Expertise Nursing in Medical surgical Research I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 05 Nov 2025 Dr. Richard Mottershead, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates Dear Dr. Agussalim, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for proving your peer-review for our article. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Agussalim A. Peer Review Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r420842) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-420842 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Mulyadi M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 03 Nov 2025 | for Version 2 Mulyadi Mulyadi , Sam Ratulangi University, , Manado,, Indonesia 0 Views copyright © 2025 Mulyadi M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for the opportunity to review this manuscript, title: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates I have provided the following feedback which I believe will strengthen the manuscript. Abstract: The conclusion is meaningful but could be more focused on the main research theme. It would be helpful if the authors emphasized how their findings contribute to nursing education, especially in enhancing simulation learning experiences for male nursing students. Highlighting this connection would make the study’s message clearer and more impactful for readers. Methods: The interview questions can be found in Table 1 . The interview guide is clear, but the authors should explain the theoretical or empirical basis used to develop it. This would strengthen the study’s methodological rigor and ensure alignment with the research objectives. Study rigor The authors provide clear ethical safeguards for confidentiality and data security. To further strengthen this section, a brief explanation of how trustworthiness and methodological rigor, such as credibility, transferability, dependability, and confirmability, were ensured would enhance the study’s transparency and robustness Results and Discussion: The results are clearly presented. However, mentioning the number of subthemes identified under each main theme would improve the clarity and completeness of the findings. The third theme, “Feelings of Anxiety and Stress,” lacks subthemes and is supported by only one participant quote (out of forty-three male students). While not all themes require subthemes, this limited evidence may not adequately capture the participants’ overall experiences. The authors are encouraged to provide additional supporting data or reconsider whether this theme should stand alone. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Nursing education, trauma and emergency nursing I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 05 Nov 2025 Dr. Richard Mottershead, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates Dear Dr. Mulyadi, On behalf of the research team, I would like to sincerely thank you for your hard work and diligence for providing your peer-review for our article. Your insight was very useful and if will certainly consider your recommendations for our future publications. So often, we are constrained by the word-limit of the journals we publish within. Collectively, we feel that our article has benefited from your guidance and expert knowledge. Again, thank you Dr. Richard Mottershead View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Mulyadi M. Peer Review Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.188736.r421780) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-920/v2#referee-response-421780 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Agussalim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 23 Sep 2025 | for Version 1 Agussalim Agussalim , Makassar Health Polytechnic, Makassar, Indonesia 0 Views copyright © 2025 Agussalim A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Summary of the Article This study, “Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates” (Dias et al., 2025), investigates the experiences of male nursing students with simulation-based learning in a context where clinical placements, especially in maternity care, are limited due to cultural barriers. Using a descriptive qualitative design, the authors conducted semi-structured interviews with 32 male nursing students and two focus groups (11 additional participants), for a total of 43 students. Data were analyzed using Braun and Clarke’s six-phase thematic analysis framework. Four themes were identified: (1) Students’ perceptions of simulation (e.g., improved skills, self-confidence, and communication), (2) Preparation for realistic situations, (3) Feelings of anxiety and stress, and (4) Theory–practice gaps. The authors conclude that simulation is a valuable and well-received pedagogy for male students, though improvements are needed in lab time, individualized feedback, and integration with clinical practice. Evaluation Against Review Questions 1. Is the work clearly and accurately presented and does it cite the current literature? Yes. The manuscript is clearly structured (IMRaD), with transparent reporting of objectives, methods, results, and discussion. The literature cited is current, including very recent studies (2022–2025), and covers both global and regional perspectives. Some reliance on the authors’ own prior work is noted, but this does not overshadow the breadth of references. 2. Is the study design appropriate and is the work technically sound? Yes. The descriptive qualitative design is entirely appropriate for the research aim of exploring experiences and perceptions. The sampling strategy, data collection methods, and analytic approach are sound. Rigor is addressed through triangulation, ethical safeguards, and anonymization. The main technical limitation is that the study is confined to one institution, which restricts transferability, but this is acknowledged. 3. Are sufficient details of methods and analysis provided to allow replication by others? Partly. The methodology is generally well described, including sampling, data collection, and thematic analysis steps. However, some details are missing: The interview and focus group guides (or at least example questions) are not provided, making it difficult to replicate the data collection exactly. The software or tools used for data analysis are not specified (e.g., NVivo, Atlas.ti, or spreadsheets). It is not clear how disagreements in coding were handled (e.g., consensus meetings, inter-rater reliability checks). Recommendation: The authors should include an appendix with the interview guide, clarify whether any qualitative analysis software was used, and describe how coder agreement was reached. This would significantly strengthen transparency and replicability. 4. If applicable, is the statistical analysis and its interpretation appropriate? Not applicable. As a qualitative study, no statistical analysis is required. Thematic analysis is appropriate and correctly applied, with adequate use of participant quotations to support interpretation. 5. Are all the source data underlying the results available to ensure full reproducibility? Partly. The raw interview and FGD transcripts are not publicly available due to confidentiality concerns, but the authors provide a controlled access pathway for qualified researchers via ethics approval. This is standard practice in qualitative research involving sensitive personal data. Recommendation: The current data availability statement is acceptable, but the authors could improve transparency by providing an anonymized sample transcript or coding framework in supplementary material. This would give readers a clearer sense of the raw data without breaching confidentiality. 6. Are the conclusions drawn adequately supported by the results? Yes. The conclusions align well with the identified themes and are supported by direct quotations from participants. Recommendations (e.g., individualized feedback, integration of simulation with clinical practice) logically follow from the findings. The limitations are acknowledged, which keeps the conclusions appropriately cautious. Overall Strengths Timely and relevant focus on male nursing students in a cultural context with clinical placement restrictions. Clear and logical structure with transparent reporting of ethical considerations. Use of triangulation (interviews + FGDs) and thematic analysis strengthens trustworthiness. Engagement with very recent literature makes the study well-situated in current debates. Overall Limitations & Required Revisions Interview/FGD guide not included → Must be added (appendix or supplementary file). Analysis software not specified and coder agreement process unclear → Should be clarified. Data availability → While full transcripts cannot be shared, providing an anonymized sample transcript or coding framework would strengthen reproducibility. Final Recommendation The manuscript is scientifically sound, clearly presented, and contributes valuable insights into simulation-based pedagogy for male nursing students. However, minor revisions are required to strengthen methodological transparency and reproducibility: Include interview/FGD guide questions (appendix/supplement). Clarify analytic tools used and how coding disagreements were resolved. Consider sharing an anonymized transcript excerpt or coding framework to enhance reproducibility. With these revisions, the paper will meet high scientific and reporting standards. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? No Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Nursing in Medical surgical Research I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 27 Sep 2025 Dr. Richard Mottershead, Sakina, Behavioural Science Institute, SEHA, Al Ain, United Arab Emirates Dear editor and reviewers, Thank you for your email and comments on our manuscript. We revised our manuscript in response to the reviewers' comments and concerns. Our revisions and comments are highlighted in yellow throughout the manuscript. Please see our responses below. Reviewer Comments: The manuscript is scientifically sound, clearly presented, and contributes valuable insights into simulation-based pedagogy for male nursing students. However, minor revisions are required to strengthen methodological transparency and reproducibility: 1. Include interview/FGD guide questions (appendix/supplement). Response: Thank you so much for your comment. We added and included the interview guide questions in the appendix. 1. How would you describe your overall experience during the maternity practicum labs? ( Probe: What stood out the most to you?) 2. What were your feelings and thoughts on the first day of your maternity practicum? (Probe: Were you nervous, excited, or unsure?) 3. How did your feelings change by the last day of the practicum? (Probe: What had improved or become more comfortable?) 4. Can you share a positive experience you had during your maternity practicum? (Probe: What made it a good experience?) 5. Can you describe a negative or challenging experience during the practicum? (Probe: How did you handle it?) 6. What was the most difficult part of your experience in the maternity lab or clinical setting? (Probe: Skills, communication, environment, etc.) 7. As this was your first exposure to maternity care, what specific fears or anxieties did you experience? (Probe: Were any of these related to gender, confidence, or knowledge?) 8. Did participating in the maternity practicum affect your daily life or your mental/emotional health? If so, how? 9. What specific challenges did you face as a male student in the maternity practicum setting? (Probe: Interaction with patients, acceptance by staff, cultural barriers, etc.) 10. What advice would you give to a second-year male student who will soon enter the maternity practicum? (Probe: What do you wish you had known beforehand?) 11. How were you able to apply maternity theory learned in class during your practicum or simulation sessions? (Probe: Can you give specific examples?) 12. Would you consider working in the maternity department in the future? Why or why not? (Probe: Did your practicum influence this decision?) 13. How did simulation activities in the lab prepare you for real-life maternity clinical experiences? (Probe: What scenarios or skills were most helpful?) 2. Clarify the analytic tools used and how coding disagreements were resolved. Response: Thank you for your comment. This study employed a thematic analysis, adhering to the six data analysis phases described by Braun and Clarke (2006). We employed NVivo 12 as our data management tool, which assists us in coding and identifying themes— thematic analysis. These tool helps us interpret interviews and focus groups, uncover patterns, and derive insights in identifying themes. (highlighted in yellow). Coding disagreements in qualitative research can happen when different coders assign varying labels to the same data, reflecting different interpretations or ambiguities. This study addresses coding disagreements through systematic procedures, including detailed discussions where coders justify their choices, consult established guidelines, and seek input from third parties to maintain transparency and clarity. During our analysis, the authors meet to review all coding and reach consensus. Regular meetings are held throughout the process to review the data and implement any necessary adjustments. 3. Consider sharing an anonymized transcript excerpt or coding framework to enhance reproducibility. Response: Thank you very much for your comment. In this study, reproducibility is achieved by obtaining consistent results through the thematic analysis steps, coding, and conditions. We provided clear, specific, and thorough information about the data products that support our published results, allowing other researchers to replicate the analysis. Additionally, all data are available from the first author or the corresponding author upon reasonable request. 4. Are all the source data underlying the results available to ensure full reproducibility? Response: Thank you. Participant data contains sensitive personal information, and sharing such data publicly could compromise confidentiality and anonymity. The Institutional Review Board (IRB) has mandated that data sharing is permissible only under specific conditions that ensure participant privacy and align with ethical guidelines. Access to the data may be granted to qualified researchers for legitimate academic purposes upon request. Requests for access must be submitted in writing to the corresponding author, Dr. Richard Mottershead. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Agussalim A. Peer Review Report For: Exploring simulation as a teaching pedagogy for male undergraduate nursing students: A Qualitative Study in the United Arab Emirates [version 2; peer review: 3 approved] . F1000Research 2025, 14 :920 ( https://doi.org/10.5256/f1000research.184457.r414848) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/14-920/v1#referee-response-414848 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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