Cultivating learning in vitro: A meta-ethnography of learning experiences of nursing students regarding high-fidelity simulation.

Abstract

To synthesise the experience of nursing students in their final years regarding high-fidelity simulation in acute and critical care. For the complex and changing healthcare environment, new tools are required to help health students, educational staff and managers to design and present rewarding educational simulations. Due to the complexity and limited learning opportunities in real settings, high-fidelity simulation enables students to acquire skills for the provision of acute and critical care in a controlled environment that closely imitates reality; however, the literature on students' learning experiences with this education methodology is still limited. This study followed Noblit and Hare's interpretive meta-ethnography, which was written and reviewed for reporting clarity against the EQUATOR checklist using the eMERGe. A comprehensive systematic search strategy was carried out in five databases: PubMed, Scopus, CINAHL, Web of Science and PsycINFO. Ten studies met the research objective and inclusion criteria. The metaphor 'Cultivating learning in vitro' and four themes were developed to describe the learning experiences of nursing students regarding high-fidelity simulation in acute and critical care. The themes were as follows: Learning roots-Ways to learn during high-fidelity simulation; Learning stimulants-Elements that favour learning; Learning impairments-Elements that hinder learning; and Learning flourishing-Results after high-fidelity simulation. Seeing, doing and reflecting constituted the main sources of learning. Students identified the stimulating and debilitating aspects of learning which could help in the design of simulation sessions and promote their incorporation into nursing curricula. Finally, 'the flowering of the plant' represents the learning outcomes developed in a controlled and safe environment. The results of this meta-ethnography provide keys to promote change in teaching planning in relation to acute and critical care.