Baccalaureate Nursing Students' Perceptions of Simulation and the Development of Clinical Judgment

Purpose:

The purpose of this study was to explore baccalaureate nursing students’ perceptions of simulation and the development of clinical judgment.  

Methods:

Qualitative description was used to describe the perceptions of thirty four baccalaureate nursing students who participated in seven focus groups.  

Results:

Four descriptive categories and related sub-categories emerged from the data: learning and practicing clinical skills, affecting self-perceptions, learning from others, and bridging the gap between theory and practice. From each of these categories and sub-categories student perceptions identified aspects of simulation that enhanced or hindered learning. Students perceived that they learned the most during simulation when faculty were present and asked questions or talked them through the scenario, a significant amount of learning was also obtained through peers. Feelings of “awkwardness” and dissatisfaction with the learning environment hindered learning for many students. All aspects of simulation contributed to students’ self-efficacy and confidence by allowing students to apply knowledge in context, which contributed to their ability to make decisions in the clinical area.  Although students indicated the ability to connect knowledge and make decisions, they could not describe clinical judgment and did not perceive they participated in clinical judgment.  

Conclusion:

Simulation as a learning activity is widely used in nursing education as an adjunct to clinical experience to allow students to make clinical decisions in a safe, non-threatening environment.  The use of simulation continues to grow in nursing education as a means to allow students to apply theoretical knowledge from the classroom to the clinical area. Identifying student perceptions of simulation assists nursing faculty to use simulation to the fullest extent to enhance student learning and help students develop clinical judgment.  Consistent incorporation of clinical judgment as it relates to the nursing process may help students to identify and develop this important skill. Simulation activities that enhance learning allow students to reinforce the steps of clinical judgment and make to make safe clinical decisions.