‘A much kinder introduction’: exploring the benefits and challenges of paediatric simulation as a transitioning tool prior to clinical practice

Abstract

Simulated practice is an opportunity to transition nursing students from on-campus learning to clinical practice. There is limited evidence on simulated practice’s role in assisting this transition at the beginning of a nursing student’s education in terms of benefits, challenges, differences and affordances. This study aimed to research the impact of a simulated practice programme as a transitioning tool for first-year paediatric nursing students. A participatory action research approach was used to address challenges in student’s transitioning to clinical practice and a lack of clinical placement capacity. A low-technological (physical), high-authenticity (emotional and environmental)-simulated practice programme for first-year paediatric nursing students was implemented. Forty students across two cohorts were recruited, and a qualitative survey was completed post-simulation/pre-clinical practice and post-clinical practice. Reflexive thematic analysis was used to develop the resulting themes. There was an initial 93% response rate after the simulated practice and 88% after clinical placement. Eight themes (‘bridging’ from simulation to practice and to enhance practice; ‘preparedness’ once on clinical placement; ‘applied learning’ reliably transferred to practice; ‘skill decay’ between simulation and practice; ‘same but different experiences’ between simulation and practice; simulation and clinical ‘practice pace’; ‘safety’ of simulation; and ‘unique affordances’ of simulated practice) were constructed from the data, and an additional nine sub-themes were identified (transference to practice; practice enhancement; slow-motion care; hectic; it is safe; it was safe; feedback and reassurance; practice and practice; and unpressured). Collectively, the themes indicated that simulated practice in this context is conveyed as a well-being tool in addition to having experiential learning and bridging benefits. This study revealed that simulated practice can assist in transitioning paediatric student nurses to clinical practice. It identified its value in terms of fostering holistic learning, well-being and bridging theory to practice. To ensure long-term effectiveness, simulation maintenance training, booster training and refresher strategies should be included as part of the programme to prevent skill decay. Future studies should consider isolating these key findings for a more in-depth look at their meaning.