Caring is a skill from the affective domain that important to nursing (Morse, Solberg, Neander, Bottorff, & Johnson, 1990). There is little evidence that supports the use of human patient simulators in teaching and practicing the art and skill of caring. This skill can be developed, enhanced, and practiced in the clinical or hospital environment. Thus, it is important to understand and evaluate caring in the simulated learning environment.
The purpose of this qualitative study is to evaluate and understand the concept of caring and associated caring behaviors as they relate to high-fidelity human patient simulations.
Methods: A purposive sample was collected from an INACSL discussion page as well as through a snowball method. Nurse faculty and educator perspectives were explored because they are the lead facilitators of simulation and directly observe and foster student application of the affective domain. After providing informed consent, fifteen nurse educators answered a demographic survey and were individually interviewed using a semi-structured technique. Participants were asked about their simulation experience and whether they felt caring behaviors were practiced among students towards human patient simulators. All interviews were audio-taped and transcribed for phenomenological review and assessment of emerging themes
Results: Six themes emerged which described caring behaviors’ students display with high-fidelity human patient simulators based on faculty perspective during the interviews. These themes included (1) fidelity/realism of the setting, (2) role modeling of faculty, (3) the patient story/scenario, (4) clear expectations in pre-briefing, (5) verbal and non-verbal behaviors, and (6) faculty simulation roles. The study revealed that 14 out of 15 participants believe students can practice caring using high-fidelity human patient simulation. All participants were able to describe a caring experience of a student with a simulator which frequently highlighted the importance of non-verbal behaviors.
Conclusion: Faculty do believe students demonstrate caring in high-fidelity human patient simulation scenarios. Faculty can use the results of this study to better prepare, guide, and debrief the simulation scenario with students to foster the development of caring behaviors. Study findings also informed the development of a checklist for caring behaviors, both verbal and non-verbal.