Appendix 2 - Tools and Outcomes from the Hybrid Roleplay Intervention

The Hybrid Roleplay Intervention aimed at improving nursing documentation quality involved multiple tools to assess outcomes. The Documentation Quality Assessment Tool (DQAT) showed significant improvements in the completeness of assessments, accuracy of SOAP notes, and timeliness of documentation, with high expert ratings for organization and readability. Post-intervention results indicated a marked improvement in documentation skills, with the experimental group showing a substantial effect size, which was sustained at a 12-week follow-up. Similarly, the Nursing Documentation Self-Efficacy Scale (NDSES) demonstrated a significant increase in nurses' confidence and familiarity with structured notes, particularly in real-time digital documentation use. The intervention had a high effect size in boosting self-efficacy, which remained after 12 weeks. Additionally, the NASA Task Load Index (NASA-TLX) results revealed significant reductions in mental, temporal, and effort demands, indicating a decreased cognitive load during documentation tasks. These improvements were sustained over time, showing that the roleplay intervention effectively reduced the strain on nurses while enhancing documentation performance and self-efficacy.