Greater than the sum of its parts: A longitudinal qualitative study exploring learning and practice impacts of a 4-week simulated nursing placement

Abstract

Background

There is increasing international interest in simulated placements to partially replace clinical placements within pre-registration nursing programmes. A 4-week simulated elective placement for Bachelor of Nursing students and Student Nursing Associates was delivered at a UK university in response to a shortage of clinical placements and an increase in permitted simulated practice hours.

Aims

To explore 1) learning and practice impacts of the simulated placement for Nursing and Nursing Associate students, and 2) student perceptions of the key features of the simulated placement which contributed to identified learning and practice impacts.

Design

Qualitative longitudinal study.

Settings

University teaching and simulation facilities, with a small number of sessions delivered online.

Participants

Year 2 Bachelor of Nursing students (n = 24) and Year 1 Student Nursing Associates (n = 11).

Methods

Data were collected from all participants using 2 written reflections during the placement. Focus groups were conducted with a random sample of participants 4 weeks post (n = 8) and 5 months post the simulated placement (n = 7). Data were analysed using thematic analysis.

Results

Six themes of learning and practice impacts were identified: 1) self-growth, 2) humanised person-centred care, 3) collaborative teamwork, 4) creative problem-solving, 5) speaking up and 6) complex care management. Five key features of the simulated placement facilitating these impacts were identified: 1) different types of learning opportunities, 2) the supportive formative learning environment, 3) doing and experiencing things together, 4) learning ‘the how’, and 5) greater than the sum of its parts. Participants also described getting more out of subsequent clinical placements and their nursing programmes and forming new peer support groups and friendships.

Conclusions

Identified significant positive learning and practice impacts from the simulated placement were in core areas of professional nursing that are often challenging to nurture. In view of this, and the ongoing positive impacts on subsequent clinical placements and participation in nursing programmes, this model of simulated placement warrants consideration as core element of Pre-registration Nursing and Apprenticeship Nursing Associate curricula.