Utilizing Simulation Instruction with Nursing Students

Ronette Shaw, Assistant Professor
Allied Health Sciences, Nursing Department


Lectures, group discussion, clinical experience, and simulation have been cited as effective methods to introduce students to scenarios in the learning environment to cultivate cultural and ethnic knowledge. The primary goal for these educational interventions is to equip learners with knowledge and skills to better understand effective encounters in the clinical setting.


Virtual scenarios for nursing students can be created to provide preparation for actual encounters students may face in the clinical setting while allowing experimentation with alternative responses (Jones & Barrett, 2017). Simulation designed to address healthcare scenarios are introduced in lessons to provide students with potential medical situations they may face in professional practice.


Simulation is recognized as an instructional approach instituted for the purpose of creating learning opportunities. Educators institute simulation learning experiences to replicate or mimic, realistic events, skills or procedures (Jones & Barrett, 2017); Sanko, 2017).


The origins of simulation in nursing dated back to the early 1900s when it was utilized within nursing programs to train student nurses. The increasing popularity and the use of simulation laboratories noted around the mid-1930s can be traced to Indiana University, which was recorded to have the first nursing program to establish a skills simulation laboratory. The research literature attributes the benefits of simulation to skill learning and development while addressing patient safety goals. The positive effects on student learning outcomes have prompted full adoption of simulation into nursing programs across the United States. In these nursing programs across the country, there have been increasing opportunities for nursing students to experience simulation experiences. Within the past decade, the widespread use of simulation in nursing programs has demonstrated an educational paradigm shift (Sanko, 2017). ​To improve future practice, student reflection or debriefing integrates the practice of providing constructive feedback and allowing time for reflection. Feedback following the simulation lesson engages learners in a dialogue specific to their performance, whereas reflection encourages deeper acknowledgement focused on the simulation experience.


In 2018, I incorporated the use of Panopto videoing to record a simulation activity in the simulation laboratory which included sessions that allowed time for debriefing. The Panopto recordings allowed nursing students to view the simulated scenarios in addition to their reflective thoughts related to the entire simulated activity. The students discussed their experience completing the skills within the assigned teams while allowing team members to openly share their experiences and provide peer-to-peer feedback. The teams responded positively and continued with additional constructive discussions which included suggestions to enhance future practice. In addition to utilizing Panapto videoing to view simulated activities and reflect on the simulation experience, several planned scenarios within the simulation environment were assigned to further enhance student learning within the established teams. The activities were created to involve small teams of three to four students, with each student assigned a different role. Each role was appropriate to mimic a potential real-life clinical scenario that students may potentially experience in the clinical practice settings. Students were encouraged to formulate scripts based on prior experiences as while assuming the role as a patient, nurse, family member, visitor or an identified member of the interdisciplinary team. Simulating clinical scenarios while completing assigned clinical skills and engaging each team member provides learners with the opportunity to develop decision making skills while learning team building skills.


Theoretical Framework 

Brenner’s theory of novice to expert, recognizes that knowledge or skill acquisition progresses while advancing from the beginner level. Brenner’s novice to expert theory anticipates a progressive pattern of learning that builds on prior knowledge and experiences (Alligood, 2014). Learning through the application of simulation scenarios provide student the opportunity to practice and repeat skills in a safe, less intimidating environment. Recording and reviewing the simulation experience, students have the opportunity to view the skills reflect and consider team comments. This provides the opportunity to refine and enhance their practice. This instructional approach provides faculty with a wide range of tools that can be incorporated to support student learning and engagement.



The simulated environment is designed to mimic real-life scenarios and provides the learner with a less intimidating environment to practice and develop skills while engaging with their peers. Students provided with the opportunity to reflect on skills or simulation scenarios can enhance their skills and practice coupled with constructive feedback from team members to cultivate peer engagement and collaboration.



Alligood, M. (2014). Nursing theorists and their work (8th ed.). Maryland Heights, MO: Mosby/Elsevier

Jones, J.D, & Barrett, C., E. (2017). Simulation as a classroom teaching method. I-Manager’s Journal on School Educational Technology, 12(4), 49-53.

Sanko. J. S. (2017). Simulation as a teaching technology: A brief history of its use in nursing education. Distance Learning, 14(1), 21-29.


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