A strategy for meaningful simulation learning experiences in a postgraduate paediatric nursing programme

[摘要] English: Learning through simulation is a relatively young science in nursing education. Although the benefits of simulation as an effective learning strategy in nursing education are supported by extensive research on the subject, the development of meaningful simulation learning experiences can be challenging, especially to nurse educators who do not feel prepared for this type of educational approach. The purpose of this study was to develop a strategy for meaningful simulation learning experiences in a postgraduate paediatric nursing programme.An educational action research design, based on a social constructivist paradigm, was used to answer the research question: How can meaningful simulation learning experiences be achieved in the postgraduate paediatric nursing programme? Through the process of three action cycles extending over a period of two years, a strategy was developed, refined and finalised, based on data gathered from two separate groups of paediatric nursing students. The first group of participants consisted of 21 students, and the second group of participants consisted of 18 students. Qualitative data were gathered by means of the nominal group technique, field/reflective notes, recording of debriefing sessions and focus group interviews. In the third cycle, in addition to qualitative data, quantitative data were gathered by means of a simulation evaluation questionnaire.At completion of the two-year project, a final strategy for meaningful simulation learning experiences emerged, based on a synthesis of data gathered. Aspects relating to meaningful simulation learning experiences included a safe learning environment, authenticity, a responsive simulator, cognitive processes such as reflection-on-action, independent thinking, and meaningful knowledge construction. Furthermore, the students valued simulation learning experiences as opportunities to improve competence, psychomotor skills, self-confidence and teamwork. They learned to integrate theory and practice and experienced a paradigm shift that influenced their view of the conditions under which nursing care should be provided to children. A major hindrance to learning through simulation was the students' dependence on an educator and reluctance in taking ownership of their own learning. This finding related to a discovery made in the first action cycle, which was that nurse educators should be careful to assume that postgraduate nursing students, who are considered mature individuals, naturally have the characteristics of adult learners.Apart from a strategy consisting of specific action items and expected outcomes upon their implementation, seven characteristics of meaningful simulation learning experiences were identified, namely constructively aligned instruction, challenging learning tasks, a non-judgmental student-centred approach to students, collaboration through a community of learning, deliberate practice, an authentic learning environment, and relevant student preparation.The strategy developed in this study endorses the use of constructivist learning theory and Kolb's experiential learning theory to achieve meaningful simulation learning experiences. The study contributes to the practice of simulation in nursing education because it gives nurse educators a theoretically and empirically founded plan for implementing simulation in a way that students find meaningful and conducive to learning. The paediatric nursing students experienced a paradigm shift in terms of their practice as healthcare providers to children, which translated into strengthened nursing values and renewed motivation to transfer their learning to the practice setting.

[发布机构] University of the Free State