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Article History

Received: 4 June 2025

Accepted: 23 January 2026

First Online: 3 February 2026

Declarations

:

: The study received ethical approval from the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences (IR.AJUMS.REC.1402.302) and was carried out in line with the principles of the 2013 Declaration of Helsinki. To ensure educational equity, all participants in the control group were provided with the complete BOPPPS-based training after the final data collection, thereby eliminating any potential educational disadvantage. Specific measures were implemented to protect patient welfare during clinical assessments: all patients provided written informed consent specifically for student involvement in their pre-anesthesia care; each student was assessed individually to minimize patient exposure to observers; patient privacy was maintained through use of private assessment areas; and clinical supervisors monitored continuously for any signs of patient discomfort. For students, an orientation session was held to brief second- and third-year nurse anesthesia students on the study’s goals and procedures. Participation was voluntary, and written informed consent was obtained from all students who agreed to take part. Participant anonymity and confidentiality were maintained throughout the research process.

: Not applicable.

: The authors declare no competing interests.