Performing in the fishbowl: Strategies to empower students in the simulated clinical setting

Purpose: On a global level, many undergraduate nursing education programs have adopted high-fidelity human patient simulation (HPS) to enhance knowledge integration and clinical skills acquisition. Although the literature... [ view full abstract ]

Purpose: On a global level, many undergraduate nursing education programs have adopted high-fidelity human patient simulation (HPS) to enhance knowledge integration and clinical skills acquisition. Although the literature indicates that HPS has the potential to meet the modern students’ preference for immersive social construction of knowledge, many students face stress and anxiety when performing for others in the “fishbowl” of the traditional HPS-based clinical laboratory.

Method: A study was undertaken to explore the social-psychological process that facilitates knowledge acquisition through HPS use. Due to the limited amount of literature related this process, grounded theory method was chosen to explore HPS-based scenarios as a teaching/learning modality. The study sample included students and faculty from a Canadian baccalaureate nursing program. The data collection consisted of semi-structured interviews, supplemented by secondary data from the observation of participants as they engaged in HPS-based clinical scenarios. Data was also gathered from field notes, analytical and operational memos, and journaling.

Results: Through constant comparative analysis a substantive theory emerged comprising a twofold process incorporating the use of adaptive scaffolding and dynamic assessment in the HPS learning environment. The thematic analysis also uncovered a variety of strategies linked directly to the complex social process within the simulated clinical environment. These strategies have the potential to empower students to realistically transform their frame of reference related to the cognitive stress of participating in HPS-based clinical training.

Conclusion/Discussion: The purpose of this presentation is to build upon the mid-range theory that evolved from the social-psychological processes occurring within HPS-based clinical scenarios and provide the audience with strategies to maximize the modern nursing student's knowledge acquisition when engaging with this technology-based teaching/learning modality.