"She's dead!" - Nursing simulation practices: A discourse analysis approach.

Abstract

Background: The literature on nursing education has revealed a growing wave of interest in the use of simulation sessions to promote undergraduate nurses’ learning experiences. This high prevalence of simulation practices in nursing programs has led to opportunities to research this topic from various angles, including its impact on students’ skill performance, self-efficacy, self-confidence, self-satisfaction, and clinical knowledge acquisition.Design and Methods: Participants in this qualitative study included 54 senior female undergraduates enrolled in a critical care nursing course in Saudi Arabia. Recordings were made of six authentic, acute care simulation sessions. One of these sessions was examined in depth using discourse analysis approaches to gain insights into communication in simulation sessions, examining the way students linguistically managed this critical communication, exhibiting their logical, reflective, decision-making, problem-solving, and collaborative work skills and use of communicative strategies.Results: The analyses revealed various training and communication issues including the lack of harmony among the team members (e.g., regarding understanding and performing their assigned roles as well as delegating and conducting delegated tasks) and the students’ inability to effectively communicate with the patient as a valuable source of information and to make appropriate and timely clinical decisions regarding patient assessment.Conclusions: Simulation sessions have been shown to be a promising instructional tool to support nursing education, allowing students to practice in a safe and controlled environment. However, for more effective sessions and to avoid poor simulation sessions, students need to be thoroughly briefed regarding the sessions prior to implementation.Significance for public healthEffective and safe patient care in healthcare settings reflect effective academic training received by practitioners. In nursing education, there is a huge interest in simulation training as an instructional strategy that encourages learners to apply learned knowledge and practice clinical skills in interactive, controlled, and safe settings that mimic real-life medical scenarios. Research on simulation practices has examined this instructional tool descriptively, measuring its impact on learners’ skill performance, clinical knowledge acquisition, and self-satisfaction, to name but a few. This study is significant as it provides a thorough analysis of the communication exhibited in an authentic simulation session, revealing how this type of communication unfolds, as well as the communicative strategies used by learners and their impact on the training effectiveness. Amending and enhancing learners’ practices during simulation training could lead to improved understanding of best practices, which would eventually improve patient care in real-life settings.