Andrew Bland

A concept analysis of simulation as a learning strategy in the education of undergraduate nursing students

Simulation is increasingly referred to in the nursing literature and its use in healthcare has developed dramatically over the past decade. Whilst the concept of simulation is not new, there is now a greater emphasis on its use in nurse education (Murray et al., 2008). The purpose of this article is to develop understanding and define the concept of simulated learning as a strategy used in the education of undergraduate nursing students. The analysis outlined in this paper was guided by a systematic process of studying a concept presented by Walker and Avant (2005). The analysis sought to identify how the concept of simulation is interpreted in the existing literature printed in English and retrieved from databases (Medline, CINAHL, PubMed, and Cochrane Library), internet search engines (GoogleScholar) and hand searches. The definition offered is a work in progress and presents a theoretically grounded understanding of what simulated learning currently represents. The identified antecedents, critical attributes and consequences are presented as a basis to stimulate further research, development and understanding.

Time to unravel the conceptual confusion of authenticity and fidelity and their contribution to learning within simulation-based nurse education. A discussion paper

High-fidelity patient simulation is a method of education increasingly utilised by educators of nursing to provide authentic learning experiences. Fidelity and authenticity, however, are not conceptually equivalent. Whilst fidelity is important when striving to replicate a life experience such as clinical practice, authenticity can be produced with low fidelity. A challenge for educators of undergraduate nursing is to ensure authentic representation of the clinical situation which is a core component for potential success. What is less clear is the relationship between fidelity and authenticity in the context of simulation based learning. Authenticity does not automatically follow fidelity and as a result, educators of nursing cannot assume that embracing the latest technology-based educational tools will in isolation provide a learning environment perceived authentic by the learner. As nursing education programmes increasingly adopt simulators that offer the possibility of representing authentic real world situations, there is an urgency to better articulate and understand the terms fidelity and authenticity. Without such understanding there is a real danger that simulation as a teaching and learning resource in nurse education will never reach its potential and be misunderstood, creating a potential barrier to learning. This paper examines current literature to promote discussion within nurse education, concluding that authenticity in the context of simulation-based learning is complex, relying on far more than engineered fidelity.

Towards an understanding of the attributes of simulation that enable learning in undergraduate nurse education: A grounded theory study

BACKGROUND Simulation has become an established feature of nurse education yet little is understood about the mechanisms that lead to learning. OBJECTIVES To explore the attributes of simulation-based education that enable student learning in undergraduate nurse education. METHODS AND PARTICIPANTS Final year students drawn from one UK University (n=46) participated in a grounded theory study. First, nonparticipant observation and video recording of student activity was undertaken. Following initial analysis, recordings and observations were deconstructed during focus group interviews that enabled both the researcher and participants to unpack meaning. Lastly emergent findings were verified with final year students drawn from a second UK University (n=6). RESULTS A staged approach to learning emerged from engagement in simulation. This began with initial hesitation as students moved through nonlinear stages to making connections and thinking like a nurse. Core findings suggest that simulation enables curiosity and intellect (main concern) through doing (core category) and interaction with others identified as social collaboration (category). SUMMARY AND CONCLUSION This study offers a theoretical basis for understanding simulation-based education and integration of strategies that maximise the potential for learning. Additionally it offers direction for further research, particularly with regards to how the application of theory to practice is accelerated through learning by doing and working collaboratively.

Developing a multi-method approach to data collection and analysis for explaining the learning during simulation in undergraduate nurse education.

Simulation has become an established feature of undergraduate nurse education and as such requires extensive investigation. Research limited to pre-constructed categories imposed by some questionnaire and interview methods may only provide partial understanding. This is problematic in understanding the mechanisms of learning in simulation-based education as contemporary distributed theories of learning posit that learning can be understood as the interaction of individual identity with context. This paper details a method of data collection and analysis that captures interaction of individuals within the simulation experience which can be analysed through multiple lenses, including context and through the lens of both researcher and learner. The study utilised a grounded theory approach involving 31 under-graduate third year student nurses. Data was collected and analysed through non-participant observation, digital recordings of simulation activity and focus group deconstruction of their recorded simulation by the participants and researcher. Focus group interviews enabled further clarification. The method revealed multiple levels of dynamic data, concluding that in order to better understand how students learn in social and active learning strategies, dynamic data is required enabling researchers and participants to unpack what is happening as it unfolds in action.