Beyond technique: The ethics of simulation in care education

IF 4 3区医学 Q1 NURSING

Nurse Education in Practice Pub Date : 2025-10-01 DOI:10.1016/j.nepr.2025.104578

Paola Arcadi , Aurelio Filippini

{"title":"Beyond technique: The ethics of simulation in care education","authors":"Paola Arcadi , Aurelio Filippini","doi":"10.1016/j.nepr.2025.104578","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>To explore the ethical implications of simulation in healthcare education, promoting an approach that integrates technical competence with ethical responsibility and relational sensitivity.</div></div><div><h3>Background</h3><div>Simulation is widely used in nursing and healthcare education to develop technical, decision-making and relational skills. However, its growing use raises ethical concerns related to psychological safety, authentic representation of diversity, simulation practitioner responsibilities and the risk of reducing educational relationships to performance logics<strong>.</strong></div></div><div><h3>Design</h3><div>This discussion paper critically analyzes recent scientific literature and ethical standards, particularly the Healthcare Simulationist Code of Ethics, integrating philosophical and pedagogical reflections to address the ethical challenges of simulation-based education.</div></div><div><h3>Methods</h3><div>A narrative analysis was conducted, drawing on scholarly literature, ethical guidelines and philosophical perspectives to identify key ethical issues in simulation practices and suggest educational strategies.</div></div><div><h3>Results</h3><div>Five main ethical concerns were identified: simulation as an ethical imperative for patient safety; safeguarding psychological safety of learners and simulated patients; risks of stereotyping and tokenism; educators’ ethical responsibilities; and the potential dehumanization arising from hyperrealistic simulation environments. Additional attention is given to emerging technologies, such as virtual reality and cadaver labs and their ethical implications. The integration of narrative medicine is proposed as a strategy to humanize simulation practices<strong>.</strong></div></div><div><h3>Conclusions</h3><div>Simulation offers an extraordinary educational opportunity but requires a reflective, responsible and ethical approach. Ethical simulation practices should foster professional integrity, psychological safety, cultural sensitivity and relational responsibility, ensuring that learners develop not only technical skills but also the capacity to care ethically and humanely in complex healthcare contexts.</div></div>","PeriodicalId":48715,"journal":{"name":"Nurse Education in Practice","volume":"88 ","pages":"Article 104578"},"PeriodicalIF":4.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nurse Education in Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S147159532500335X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

To explore the ethical implications of simulation in healthcare education, promoting an approach that integrates technical competence with ethical responsibility and relational sensitivity.

Background

Simulation is widely used in nursing and healthcare education to develop technical, decision-making and relational skills. However, its growing use raises ethical concerns related to psychological safety, authentic representation of diversity, simulation practitioner responsibilities and the risk of reducing educational relationships to performance logics.

Design

This discussion paper critically analyzes recent scientific literature and ethical standards, particularly the Healthcare Simulationist Code of Ethics, integrating philosophical and pedagogical reflections to address the ethical challenges of simulation-based education.

Methods

A narrative analysis was conducted, drawing on scholarly literature, ethical guidelines and philosophical perspectives to identify key ethical issues in simulation practices and suggest educational strategies.

Results

Five main ethical concerns were identified: simulation as an ethical imperative for patient safety; safeguarding psychological safety of learners and simulated patients; risks of stereotyping and tokenism; educators’ ethical responsibilities; and the potential dehumanization arising from hyperrealistic simulation environments. Additional attention is given to emerging technologies, such as virtual reality and cadaver labs and their ethical implications. The integration of narrative medicine is proposed as a strategy to humanize simulation practices.

Conclusions

Simulation offers an extraordinary educational opportunity but requires a reflective, responsible and ethical approach. Ethical simulation practices should foster professional integrity, psychological safety, cultural sensitivity and relational responsibility, ensuring that learners develop not only technical skills but also the capacity to care ethically and humanely in complex healthcare contexts.

查看原文本刊更多论文

超越技术：护理教育中的模拟伦理

目的探讨模拟在医疗保健教育中的伦理意义，促进一种将技术能力与伦理责任和关系敏感性相结合的方法。模拟被广泛应用于护理和保健教育中，以培养技术、决策和关系技能。然而，它越来越多的使用引起了与心理安全、多样性的真实表现、模拟从业者的责任以及减少教育关系到绩效逻辑的风险有关的伦理问题。这篇讨论论文批判性地分析了最近的科学文献和伦理标准，特别是医疗模拟主义者的伦理准则，整合了哲学和教学反思，以解决基于模拟的教育的伦理挑战。方法采用叙事分析方法，借鉴学术文献、伦理准则和哲学观点，识别模拟实践中的关键伦理问题，并提出教育策略。结果确定了五个主要的伦理问题：模拟是患者安全的道德要求；保障学习者和模拟患者的心理安全；刻板印象和象征主义的风险；教育工作者的伦理责任；以及超现实模拟环境中潜在的非人性化。额外的关注给予新兴技术，如虚拟现实和尸体实验室及其伦理影响。将叙事医学的整合作为一种使模拟实践人性化的策略。模拟提供了一个非凡的教育机会，但需要反思，负责任和道德的方法。道德模拟实践应该培养专业诚信、心理安全、文化敏感性和关系责任，确保学习者不仅发展技术技能，而且在复杂的医疗保健环境中培养道德和人道关怀的能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nurse Education in Practice NURSING-

CiteScore

5.40

自引率

9.40%

发文量

180

审稿时长

51 days

期刊介绍： Nurse Education in Practice enables lecturers and practitioners to both share and disseminate evidence that demonstrates the actual practice of education as it is experienced in the realities of their respective work environments. It is supportive of new authors and will be at the forefront in publishing individual and collaborative papers that demonstrate the link between education and practice.