Nursing faculty perception on simulation-based education: a qualitative exploratory study at public and private nursing schools
Article Sidebar
Main Article Content
Abstract
Objective: To explore the perceptions of nursing faculty regarding simulation-based education (SBE), and to identify its facilitators and barriers in undergraduate nursing education.
Methods: An exploratory qualitative study was conducted in four nursing institutions (three private, one public) in Pakistan. Faculty members meeting inclusion criteria were recruited through purposive sampling. Data were collected through face-to-face, focus group discussions using a semi-structured, pilot-tested interview guide developed from literature. Discussions were audio-recorded, transcribed verbatim, and analyzed manually using content analysis as described by Creswell and Creswell (2018). Trustworthiness was ensured through member checking, peer review, and detailed contextual descriptions. Ethical approval was obtained from Aga Khan University Ethical Review Committee (Ref: 2023-7968-23860).
Results: Thirty-three participants contributed to the study. Four major themes emerged: (1) nursing faculty viewpoints on SBE, (2) facilitators of SBE, (3) barriers to SBE, and (4) future directions of simulation. Faculty perceived SBE as an effective teaching-learning strategy that enhances clinical skills, critical thinking, and patient safety. Facilitators included student engagement and proactive faculty initiatives. Major barriers were limited financial and material resources, lack of regulatory support, and insufficient faculty training. The fourth theme highlighted the future of simulation, emphasizing faculty development, resource availability, and strengthened institutional and regulatory support for effective SBE implementation.
Conclusion: SBE is recognized as a valuable pedagogical approach in nursing education; however, its implementation is constrained by resource limitations, lack of expertise, and inadequate regulatory frameworks. Strengthening faculty capacity, infrastructure, and policy support is essential to optimize the integration of SBE in nursing curricula.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
Work published in KMUJ is licensed under a
Creative Commons Attribution 4.0 License
Authors are permitted and encouraged to post their work online
(e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
1. Vandali V. Nursing profession: a review. Int J Nurs Educ Res 2017;5(4):444. https://doi.org/10.5958/2454-2660.2017.00095.3
2. Dykes S, Chu CH. Now more than ever, nurses need to be involved in technology design: lessons from the COVID-19 pandemic. J Clin Nurs 2021;30(7-8):e25-e8. https://doi.org/10.1111/jocn.15581
3. Yaseen K, Ibrahim R. Factors influencing integration of theory into practice in clinical skills acquisition among nursing students. Inform Med Unlocked 2023;37:101181. https://doi.org/10.1016/j.imu.2023.101181
4. Crowe S, Ewart L, Derman S. The impact of simulation based education on nursing confidence, knowledge and patient outcomes on general medicine units. Nurse Educ Pract 2018;29:70-5. https://doi.org/10.1016/j.nepr.2017.11.017
5. Greenway K, Butt G, Walthall H. What is a theory-practice gap? An exploration of the concept. Nurse Educ Pract 2019;34:1-6. https://doi.org/10.1016/j.nepr.2018.10.005
6. Akselbo I, Aune I. How can we use simulation to improve competencies in nursing? 2023: Springer Cham, (Springer Nature), Cham, Switzerland. https://doi.org/10.1007/978-3-031-10399-5
7. Korayem GB, Alshaya OA, Kurdi SM, Alnajjar LI, Badr AF, Alfahed A, et al. Simulation-based education implementation in pharmacy curriculum: a review of the current status. Adv Med Educ Pract 2022;13:649-60. https://doi.org/10.2147/amep.s366724
8. Murakami T, Yamamoto A, Hagiya H, Obika M, Mandai Y, Miyoshi T, et al. The effectiveness of simulation-based education combined with peer-assisted learning on clinical performance of first-year medical residents: a case-control study. BMC Med Educ 2023;23(1):859. https://doi.org/10.1186/s12909-023-04798-w
9. Swedberg R. Exploratory research. In Elman C, Gerring J, Mahoney J (eds). The production of knowledge: enhancing progress in social science. 2020, pp:17-41. Cambridge University Press, Cambridge UK. https://doi.org/10.1017/9781108762519.002
10. Campbell S, Greenwood M, Prior S, Shearer T, Walkem K, Young S, et al. Purposive sampling: complex or simple? Research case examples. J Res Nurs 2020;25(8):652-61. https://doi.org/10.1177/1744987120927206
11. Mishra L. Focus group discussion in qualitative research. J Educ Technol 2016;6:1-5.
12. Sofer D. The value of simulation in nursing education. Am J Nurs 2018;118(4):17-8. https://doi.org/10.1097/01.naj.0000532063.79102.19
13. Verkuyl M, Hughes M. Virtual gaming simulation in nursing education: a mixed-methods study. Clin Simul Nurs 2019;29:9-14. https://doi.org/10.1016/j.ecns.2019.02.001
14. Nye C, Campbell SH, Hebert SH, Short C, Thomas M. Simulation in advanced practice nursing programs: a North-American survey. Clin Simul Nurs 2019;26:3-10. https://doi.org/10.1016/j.ecns.2018.09.005
15. Alshehri, Alenazi FS, Alturki H, Khan FH. Exploring faculty perception of simulation-based education: Benefits and challenges of using simulation for improving patient safety in cardiovascular diploma program. Pak J Med Sci 2023;39(2):354-60. https://doi.org/10.12669/pjms.39.2.6693
16. Stenseth HV, Steindal SA, Solberg MT, Ølnes MA, Mohallem A, Sørensen AL, et al. Simulation-based learning supported by technology to enhance critical thinking in nursing students: protocol for a scoping review. J Med Internet Res 2022;11(4):e36725. https://doi.org/10.2196/58744
17. Rico H, de la Puente Pacheco MA, Pabon A, Portnoy I. Evaluating the impact of simulation-based instruction on critical thinking in the Colombian Caribbean: an experimental study. Cogent Educ 2023;10(2):2236450. https://doi.org/10.1080/2331186X.2023.2236450
18. Hwang Y, Oh J. The relationship between self-directed learning and problem-solving ability: the mediating role of academic self-efficacy and self-regulated learning among nursing students. Int J Environment Res Public Health 2021;18(4):1738. https://doi.org/10.3390/ijerph18041738
19. Hanshaw SL, Dickerson SS. High fidelity simulation evaluation studies in nursing education: a review of the literature. Nurse Educ Pract 2020;46:102818. https://doi.org/10.1016/j.nepr.2020.102818
20. Carey JM, Rossler K. The How When Why of High Fidelity Simulation: StatPearls Publishing, Treasure Island (FL); 2022 2022. https://www.ncbi.nlm.nih.gov/books/NBK559313/
21. Sarmah P, Voss J, Ho A, Veneziano D, Somani B. Low vs. high fidelity: the importance of ‘realism’ in the simulation of a stone treatment procedure. Curr Opin Urol 2017;27(4):316-22. https://doi.org/10.1097/mou.0000000000000401
22. Kim Y-J, Noh G-O, Im Y-S. Effect of step-based prebriefing activities on flow and clinical competency of nursing students in simulation-based education. Clin Simul Nurs 2017;13(11):544-51. https://doi.org/10.1016/j.ecns.2017.06.005
23. Chernikova O, Heitzmann N, Stadler M, Holzberger D, Seidel T, Fischer F. Simulation-based learning in higher education: a meta-analysis. Rev Educ Res 2020;90(4):499-541. https://doi.org/10.3102/0034654320933544
24. Oliveira SNd, Massaroli A, Martini JG, Rodrigues J. From theory to practice, operating the clinical simulation in nursing teaching. Rev Bras Enferm 2018;71:1791-8. https://doi.org/10.1590/0034-7167-2017-0180
25. Bryant K, Aebersold ML, Jeffries PR, Kardong-Edgren S. Innovations in simulation: nursing leaders' exchange of best practices. Clin Simul Nurs 2020;41:33-40.e1. https://doi.org/10.1016/j.ecns.2019.09.002
26. Moabi PS, Mtshali NG. Simulation-based education model for under-resourced nursing education institutions in Lesotho. Health SA 2022;27:1889. https://doi.org/10.4102/hsag.v27i0.1889
27. Buchanan DT, O'Connor MR. Integrating diversity, equity, and inclusion into a simulation program. Clin Simul Nurs 2020;49:58-65. https://doi.org/10.1016/j.ecns.2020.05.007
28. Benchadlia F, Rabia Q, Abderrahim K. Simulation in Basic Nursing Student Education: Uses and Barriers. Open Nurs J 2023;17(1): e187443462307030. http://doi.org/10.2174/18744346-v17-230717-2023-198
29. Jamalpuri V, Gunda RK, Ramachandra G, Thyagarajan S, Shetty R, Seethamraju RR, et al. Breaking barriers in establishing simulation in India–A collaborative approach by pediatric simulation training and research society (PediSTARS). Front Pediatr 2022;10:927711. https://doi.org/10.3389/fped.2022.927711
30. Koukourikos K, Tsaloglidou A, Kourkouta L, Papathanasiou IV, Iliadis C, Fratzana A, et al. Simulation in clinical nursing education. Acta Inform Med 2021;29(1):15-20. https://doi.org/10.5455/aim.2021.29.15-20
31. Almotairy MM, Algabbashi M, Alshutwi S, Shibily F, Alsharif F, Almutairi W, et al. Nursing faculty perceptions of simulation culture readiness in Saudi universities: a cross-sectional study. BMC Nurs 2023;22(1):105. https://doi.org/10.1186/s12912-023-01278-w
32. Park H, Yu S. Policy issues in simulation-based nursing education and technology development. Health Policy Technol 2018;7(3):318-21. https://doi.org/10.1016/j.hlpt.2018.06.003
33. Younas, Rasheed SP, Sommer J. Current situation and challenges concerning nursing education in Pakistan. Nurse Educ Pract 2019;41:102638. https://doi.org/10.1016/j.nepr.2019.102638