Simulation Course Research Articles

1D-2D hydrodynamic and sediment transport modelling using MIKE models

A comprehensive modeling framework utilizing hydrodynamic and sediment transport models (MIKE Hydro River, MIKE 21 FM, MIKE 21C) was applied to the 33.57 km stretch of the Banshadhara River from Banshadhara bridge, Gunupur to Kashinagar town. Daily discharge, water levels, and sediment data from 2013 to 2022 of Gunupur and Kashinagar gauge stations was used as model input, and calibration–validation of models. Additionally, satellite remote sensing data used for determined Manning’s roughness (n) values as well compared the model outputs. Calibration procedures ensured high accuracy, with MIKE Hydro River achieving 98.3% agreement between observed and simulated water levels. 1D sediment transport model showing significant variability in total bed load values ranging from 0.3 to 3.83 m^3/s. The Wilcock & Crowe gravel bed load formula accurately predicted bed load transport within the expected magnitude, albeit tending to overestimate transport, indicative of supply-limited conditions. 2D MIKE 21 FM simulations highlighted flow dynamics, with rapid flood arrival at Kashinagar and varying current speeds along the river, especially at bends. MIKE 21C, focused on the central portion, indicated erosion processes at river bends with high discharge. Sediment transport model accuracy was approximately 86.7%, capturing general trends despite occasional discrepancies. Over a 10-year simulation, erosion trends and potential river course shifting were observed, particularly near bends. The analysis provides valuable insights for river management, flood risk mitigation, water resource management, infrastructure planning, and environmental preservation in the Banshadhara River basin and similar environments.

A breath of fresh air: a pilot flipped classroom approach to airway management skills training

ObjectivesWhile flipped classroom instruction has repeatedly shown efficacy in undergraduate medical education, evidence for its utility in procedural domains remains sparse. This holds particular significance for surgical subspecialties such as otolaryngology, which have limited time in undergraduate medical curricula. We designed a novel airway management skills simulation course with a flipped classroom approach and evaluated its efficacy in a pilot study.MethodsA simulation course was designed to provide instruction in seven airway management skills: bag valve mask ventilation, laryngoscopy, intubation, cricothyroidotomy, tracheotomy, and tracheostomy care. Publicly available YouTube videos were selected as pre-learning materials. Participating students completed surveys before the pre-learning assignment and after completion of the simulation center workshop.ResultsSixteen students participated in the workshop, and data was collected from 14 participants. Learners reported significant improvements in knowledge regarding all covered skills except tracheotomy; mean self-rated knowledge improved from 2.9 to 5.8 (p < 0.001) on a scale from 0 to 10. Significant increases in self-reported confidence in performing all seven skills were also observed, with an overall increase from 1.1 to 5.7 (p < 0.001). Students also rated all elements of the workshop highly, including a prevailing belief that the pre-learning materials markedly enhanced their learning.ConclusionOur novel framework for skills-based education using a flipped classroom approach demonstrated remarkable efficacy in improving learner knowledge and self-reported confidence regarding airway management skills. This educational design, including the use of high-quality, publicly available pre-learning videos, has significant implications for undergraduate medical education in surgical subspecialties.

Nursing and midwifery simulation training with a newly developed low-cost high-fidelity placenta simulator: a collaboration between Italy and Ethiopia

BackgroundSimulation training provides safe environment for skill acquisition and retention. This study addresses a critical challenge in Africa – umbilical cord and placenta management after childbirth – aiming to bridge theoretical learning with practical experiences through simulation. We realized a new low-cost high-fidelity simulator of placenta and umbilical cord. We conducted a needs-based training course for nursing and midwifery students at St. Luke Hospital of Wolisso, Ethiopia, to validate our new simulator and compare its acceptability and teaching effectiveness with other two simulators (conventional low-fidelity model and human placenta).MethodsWe surveyed St. Luke Hospital medical experts to obtain their feedback on the new simulator’s face, content, and usability. We carried out a simulation training course for 67 students who received theoretical lectures and simulation courses being divided into three groups according to the simulator used. We assessed the simulators’ user acceptability using the Technology Acceptance Model (TAM) and compared the final objective evaluations by tutors between groups.ResultsExperts confirmed the new simulator’s fidelity, material quality, and usability. Students training on the new simulator demonstrated higher objective scores and perceived it as more useful and user-friendly compared to human placenta, while there was no difference between conventional simulator and human placenta in the TAM items.ConclusionWe validated a new high-fidelity simulator developed by the Sant’Anna School of Advanced Studies in Pisa, Italy, using the TAM scale and robust statistical methods, thanks to a successful collaboration with St. Luke’s Hospital in a simulation training course where students achieved higher objective scores and perceived the simulator as more useful and easier to use than a real human placenta, suggesting significant educational benefits and potential for future research.

Trial of an Inexpensive Training Simulation Model for Laparoscopic Appendicectomy.

Introduction Laparoscopic surgery is now the gold standard for many common procedures; however, there has been a lack of emphasis on laparoscopic training at the junior level. Simulation is an effective form of training in surgery, but surgical simulation models and courses can be expensive and inaccessible to medical students and foundation doctors. With procedures becoming more minimally invasive, it is key that we train laparoscopic skills at an earlier stage; and to do so, we need to remove the barriers of cost and accessibility. Our study aims to develop and assess the effectiveness of a simulated laparoscopic appendicectomy training model in developing laparoscopic knowledge, skills, and confidence in a cohort of foundation doctors. Methods A simulated mesoappendix model was fashioned from supermarket chicken wings with the bone removed, and it was put inside a laparoscopic box trainer with laparoscopic tools and equipment. This was trialed in a surgical-themed hub day for foundation doctors in the East of England Deanery, UK, and the simulated model was set up as a workshop following a teaching session detailing the steps of a laparoscopic appendicectomy. Participants completed questionnaires pre- and post-session to assess perceived skills, experience, and confidence in laparoscopic surgery, laparoscopic skills, and the usefulness of this training model. Results A total of 29 foundation doctors with limited formal surgical training completed the survey. The model is quick to prepare and assemble, costing around £0.30 ($0.40). Trainees found the model acceptable and helpful in developing their laparoscopic skills and knowledge of laparoscopic surgery. There was also an increase in self-perceived confidence in performing laparoscopic procedures under supervision. Discussion This modification to the model allows the dissection and division of a simulated mesoappendix using only laparoscopic scissors and forceps in a box trainer. This simulation model is a promising and inexpensive tool which can be used for early-stage laparoscopic training for medical students and junior doctors.

Uses of simulation during COVID-19 pandemic: a scoping review

Abstract Background: Some experts have made suggestions on how to use simulation during the pandemic, and simulation activities were carried out observing COVID-19 restrictions to improve technical and non-technical skills in health professionals. A number of papers have been published detailing the use of simulation during this period, but it is not clear for this reason, through a retrospective literature review, we analyzed studies published during the pandemic period to assess how simulation was used during this historical period. Methods: Retrospective literature review. Results: The search generated 11,375 records. After removing duplicates, 5431 studies were screened. Of the 643 eligible full-texts, 221 were excluded. A total of 422 articles met the inclusion criteria. Half of the 422 included studies were carried out specifically for COVID-19 (211), while 152 (36%) were performed during the pandemic but for other reasons. Analysis showed that simulation was used during the pandemic, with clear educational and research objectives. Most of the included studies dealt with COVID-19, focusing on high-acuity and critical scenarios but also including technical and non-technical skills. Conclusion: The experience gained with both “COVID-related” and “During COVID” studies could be applied to other settings in case of urgent training needed in case of disasters and to tailor simulation courses to retain technical skills.

Subjective learning gain from a simulation-based health management course: a mixed methods study.

Simulations are increasingly being offered as part of the educational experience of healthcare students. We used a Health Management Scenario Simulation system to create a course. This study aimed to evaluate learning gains before and after the course. Based on the learning strategies of framing, simulation, and debriefing, the Health Management Scenario Simulation course lasted 4 weeks and was conducted online. Learning gain was assessed using a comparative self-assessment questionnaire administered electronically at the beginning and end of the course. We organized focus group interviews and collected quantitative data after students completed the simulations and the questionnaire. These data were subjected to descriptive statistical analysis and thematic grouping using frequency counting. There were 195 health management students enrolled in the course. In total, 265 anonymously completed questionnaires were received, 141 (72.31%) on the pre-simulation and 124 (63.59%) on the post-simulation. All questionnaire item gain values were positive, except the item "I can identify common health risk factors," which showed no change. The skills domain showed the highest learning gain, ranging from 16 to 22%. Six students participated in the focus-group study. The main themes that emerged from students' reflections were learner-centeredness, competencies, and career development. Students acquired health management skills through the simulation, which contributed to the development of basic attitudes and skills in their professional careers. Students' comments highlighted the value of practicing health management skills in a simulated environment.

Indium‐Catalyzed Direct Amidation Reaction of Carboxylic Acids and In Silico Study for Screening the Activity of Potential Therapeutics of the Synthesized Products

AbstractAmide bonds are ubiquitous and valuable motifs in synthetic chemistry, found in a wide range of applications such as the backbone of proteins and pharmaceutical agents. Thus, environmentally friendly and selective methods for synthesizing amide bonds are important. Herein, we report a simple, efficient, and rapid route to access a range of functionalized amides from non‐activated carboxylic acids and amines using indium (III) trifluoromethanesulfonate as an efficient catalyst. A wide range of carboxylic acids – including aliphatic, aromatic, heterocyclic, and dicarbonyl acids – participate smoothly in these reactions, generating structurally diverse amides in moderate to good yields (up to 91 % in 24 examples). The reactions are conducted in dry tetrahydrofuran (THF) under reflux conditions. Furthermore, this amidation strategy provides a method for addressing challenging molecules, such as protected amino acids, to produce biocompatible products. These products can then be used as substrates for various organic transformations, including C−H functionalization reactions. We also demonstrate the synthetic utility of our protocol through the synthesis of essential substrates in organic and medicinal chemistry by reacting N‐protected carboxylic acids with 8‐aminoquinoline to produce a series of biologically valuable compounds. Five of these products, named 4 f, 4p, 9a, 9c, and 9d, have been biologically evaluated through an in‐silico study. The interaction of these compounds with receptor protein 8DQT was examined to assess their potential as drug candidates for hypertension treatment. Effective binding was detected between these compounds and the receptor. Data from molecular docking studies show that compounds 4d and 4 m are the most active, with binding scores of −8.8 and −8.6 kcal/mol, respectively. However, compound 4 m exhibited a stronger binding affinity than compound 4d over the course of dynamic simulation. Our ADMET study suggests that all five compounds are highly safe in the body. Based on the BOILED‐Egg model study, good absorption is suggested for all the molecules, and they can cross the blood‐brain barrier.

A Simulation and Small-Group Pediatric Emergency Medicine Course for Generalist Healthcare Providers: Gastrointestinal and Nutrition Emergencies.

This is a review curriculum utilizing multiple methods of education to enhance the skills of generalist healthcare providers in low- and middle-income countries (LMICs) in the identification and stabilization of pediatric respiratory emergencies. Our audience of implementation was Belizean generalist providers (nurses and physicians). 8-10 hours. Early recognition and stabilization of critical pediatric patients can improve outcomes. Compared with resource-rich systems, many low-resource settings (i.e., LMICs) rely on generalists to provide most pediatric acute care. We created a curriculum for general practitioners comprising multiple educational modules focused on identifying and stabilizing pediatric emergencies. Our aim was to develop an educational framework to update and teach generalists on the recommendations and techniques of optimally evaluating and managing pediatric nutritional and gastrointestinal emergencies: bowel obstructions, gastroenteritis, and malnutrition. The aim of this curriculum is to increase learners' proficiency in identifying and stabilizing acutely ill pediatric patients with gastrointestinal medical or surgical disease or complications of malnutrition. This module focuses on the diagnosis and management of gastroenteritis, acute bowel obstruction, and deficiencies of feeding and nutrition. The target audience for this curriculum is generalist physicians and nurses in limited-resource settings. The educational strategies used in this curriculum include didactic lectures, medical simulation, and small-group sessions. We evaluated written pretests before and posttests after intervention and retested participants four months later to evaluate for knowledge retention. Participants provided qualitative feedback on the module. We taught 21 providers. Eleven providers completed the pretest/posttest and eight completed the retest. The mean test scores improved from 8.3 ± 1.7 in the pretest to 12.2 ± 2.6 in the posttest (mean difference: 1.4, P=0.027). The mean test score at pretest was 8.3 ± 2.3, which increased to 10.8 ± 3.0 at retest (mean difference: 2.5, P=0.060). Seven (71.4%) and four (28.5%) participants found the course "extremely useful" and "very useful," respectively (n=11). This curriculum may be an effective and welcome training tool for Belizean generalist providers. There was a statistically significant improvement in the test performance but not in retesting, possibly due to our small sample size and high attrition rate. Evaluation of other modules in this curriculum, application of this curriculum in other locations, and measuring clinical practice interventions will be included in future investigations. Medical simulation, rapid cycle deliberate practice (RCDP), Belize, gastrointestinal, nutrition, emergency, gastroenteritis, acute bowel obstruction, Belize, low- and middle-income country (LMIC), collaboration, global health.

CONFORMATIONAL STRUCTURE OF POLYAMPHOLYTES AND POLYELECTROLYTES ON THE SURFACE OF A LONGITUDINALLY POLARIZED GOLD SPHEROCYLINDER

Conformational changes in generally neutral polyampholytic, as well as uniformly charged macrochains, polypeptides adsorbed on the surface of a longitudinally polarized gold spherocylinder—a cylindrical nanorod with spherical ends—were studied. An analytical model of the equilibrium structure of adsorbed macrochains on the surface of a polarized spherocylinder is presented, highlighting the entropy and field factors of the radial-angular distribution of link density. In the course of molecular dynamics simulation, the radial distributions of the density of polypeptide atoms in the central cylindrical part of the nanorod, as well as on its terminal hemispheres, were calculated. In addition, the distributions of the linear density of polypeptide atoms along the axis of the nanorod were calculated. A dumbbell-shaped polyampholyte edge was formed on the surface of the polarized nanorod, dense in the extended central cylindrical part and loose at the ends of the nanorod. There was also a shift of the macromolecular edge from the units of a uniformly charged polypeptide to the oppositely charged end of the nanorod, onwhich this polyelectrolyte edge swelled.

Basic Surgical Skill Training before a Vascular Course Improves the Quality of Vascular Anastomoses: A Randomized Controlled Trial

ObjectivesDuring the past decade simulation has become standard in most surgical training programs, but objective evaluation of the performance has been a challenge. The optimal components of open surgery's simulation have also been questioned. The goal of this study was to evaluate the benefit of adding a hands-on exercise prior to a formal vascular training course. The participants’ performance was objectively evaluated using Computional Fluid Dynamics (CFD) assessment of vascular anastomoses. MethodsIn this study 51 residents participated in an on-line surgical hands-on training course, performing six end-to-side anastomoses. The residents were randomly divided into two groups. Group 1. also underwent basic surgical skill training (BSST) before starting the vascular course. The groups were compared based on CFD assessment of vascular anastomoses, combined with on-line personalized feedback. ResultsAmong measured parameters of functional assessment, the mean of six anastomoses showed significantly better results in Group 1. when compared with control Group 2 (Oscillatory Shear Index: 0,022 vs. 0,025 p=0,002; Maximum pressure: 7939 vs. 7971 p=0,00037; Velocity: 0,12 vs. 0,12 p=0,0000; Helicity: 297 vs. 393 p=0,0065; Vorticity: 5258 vs. 6628 p=0,0019; Wall Shear Stress: 1,83 vs. 1,97 p= 0,000047). These results showed no significant correlation between participants' experience level, specialization, and workplace. ConclusionsBSST before a formal vascular simulation course positively affects the anastomosis quality, independent of experience level, specialization, and workplace. BSST is suggested before a vascular course to improve performance and progress. Further studies are needed to analyse the impact of this combined simulation training on performing anastomoses.

Dynamics of Satisfaction with the Simulation Course on Basic Medical Manipulations

This study presents a comparative analysis of the survey data of the 2nd year medical university students who completed a simulation course on basic medical manipulations for the period from 2018 to 2023. The purpose of the study is to assess changes in students' perception and satisfaction with this course, as well as to identify trends and factors influencing their opinion. The study highlights the importance of regular monitoring and evaluation of educational programs to ensure that they meet the needs of students and improve the quality of medical education.

Nursing students’ perceptions and satisfaction with a self-learning methodology in simulated environments: A mixed-methods study

AimThe aim of this study was to explore the perceptions and satisfaction of last-year nursing students with the Self-Learning Methodology in Simulated Environments (MAES©). BackgroundAs a learning method, clinical simulation uses elements that replicate real clinical practice scenarios and facilitates the acquisition of competencies and learning objectives. Simulations promote critical thinking, knowledge, techniques and teamwork in nursing students. The Self-Learning Methodology in Simulated Environments (MAES©) is a method that integrates problem-based learning with realistic clinical simulation. DesignA cross-sectional mixed-method study implemented a simulation learning method as part of the mandatory nursing training practice; that was registered in Open Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/R89PZ). MethodsStudents were invited to complete a cross-sectional questionnaire about satisfaction with the simulation and were asked to participate in an interview about their perceptions on the simulation. All data were collected in December 2023 in a mid-sized southern Spanish university. A total of 69 last-year nursing students were enrolled in the simulation course and were selected using eligibility criteria. ResultsSatisfaction measures showed no significant differences across gender, university access, or age (p>0.05 each). However, strong correlations were found between students' preference for the simulation method and perceived effort value (p<0.001 each). Qualitative analysis identified key themes in different stages of simulation (prebriefing, scenario, briefing, debriefing), simulation benefits (learning, usefulness, positive emotions) and challenges (difficulty, realism, time constraints). Despite some realism concerns, overall, students viewed the methodology positively. ConclusionsThe findings of this study underscore the vital role of simulation-based learning in nursing education. As the field of nursing continues to evolve, so too must the educational methods we employ, with simulation-based learning standing at the forefront of this transformative journey.

The Experience of Teaching the Discipline "Phantom Course" for the 6th Year Students

Simulation courses play an important role in the development of professional competencies, emotional and communicative skills of future medical professionals. Constant feedback from students after completing the training of simulation courses allows updating the methodology of mastering practical and clinical skills in order to ensure a high level of training of medical personnel.

Development of basic thermodynamics workshops integrating a cubic equations of state simulator and MATLAB Grader courses

This paper describes the development of EoS Simulator, a cubic equations of state simulator created in the MATLAB R2022b App Designer platform, which aims to be a practical digital tool for chemical engineering students that facilitates the solution, analysis, and critical thinking about thermodynamic problems. In the simulator, numerical algorithms were implemented based on a theoretical framework, such as fugacity test, bracketing methods, and the calculation of residual properties. EoS Simulator can estimate two-phase envelopes, isobars, isotherms, and surfaces related to PTVHS properties. MATLAB Grader courses were proposed to test student learning using the software in two different workshops. The evaluation was based on the achievement of tasks related to intended learning outcomes. Survey responses about the simulator and learning environment were collected, concluding that most students improved their skills in understanding thermodynamics phenomena, but some improvements are necessary for future versions of the software and online courses.

From FUSE to a hands-on electrosurgery course using a cadaveric model.

Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices. We developed a simulated training course for first-year general surgery and orthopedic residents. First, a survey was conducted regarding their knowledge perception about energy devices. The course consisted of two online theoretical sessions, followed by three in-person practical sessions. First-year residents performed three video-recorded attempts using a cadaveric model and were assessed through a digital platform using the Objective Structured Assessment of Technical Skill (OSATS), a Specific Rating Scale (SRS), and a surgical energy-based devices scale (SEBS). Third-year residents were recruited as a control group. The study included 20 first-year residents and 5 third-year residents. First-year residents perceived a knowledge gap regarding energy devices. Regarding practical performance, both OSATS and checklist scores were statistically different between novices at their first attempt and the control group. When we analyzed the novice's performance, we found a significant increase in OSATS (13 vs 21), SRS (13 vs 17.5), and SEBS (5 vs 7) pre- and post-training scores. The amount of feedback referred to skin burns with the electro-scalpel reduced from 18 feedbacks in the first attempt to 2 in the third attempt (p-value = 0.0002). When comparing the final session of novices with the control group, no differences were found in the SRS (p = 0.22) or SEBS (p = 0.97), but differences remained in OSATS (p = 0.017). This study supports the implementation of structured education in electrosurgery among surgical trainees. By teaching first-year residents about electrosurgery, they can acquire a skill set equivalent to that of third-year residents. The integration of such courses can mitigate complications associated with energy device misuse, ultimately enhancing patient safety.

Designing simulation-based curriculum content for emergency medicine residents in France: a Delphi method

BackgroundThe value of simulation in emergency medicine is indisputable because it allows training and acquisition of many technical and non-technical skills (TS and NTS). In France, there are no curriculum regarding the use of simulation as a teaching tool during emergency medicine residency. The aim of this study was to design the content of a national simulation-based curriculum for emergency medicine residency programs.MethodsThe Delphi method was conducted between March and June 2022. The questionnaire was divided into three sections: TS, NTS and clinical situations as starting points (SSPs). A panel of emergency physicians’ experts on simulation education was established. An online survey was conducted in which they were asked to score, on a four-point Likert scale, the suitability of skills and SSPs to be taught through simulation courses during the emergency medicine residency. The questionnaire was revised between each round following comments or suggestions for additional items from the experts.ResultsSixty-six experts completed the Delphi process. The initial questionnaire included 64 TS, 37 NTS and 103 SSPs. The experts’ comments led to the addition of 12 TS, 24 NTS and 6 SSPs. Consensus was obtained after three rounds. The experts selected 24 TS and 20 NTS to be taught as a priority through simulation during the emergency medicine residency, and 15 SSPs to be used in priority.ConclusionWith a Delphi method, French experts in simulation-based emergency medicine education have selected 24 technical and 20 non-technical skills to be taught as a priority with simulation-based training to emergency medicine residents.

Analysis of Mixed Teaching Mode of Financial Accounting Comprehensive Simulation and Practical Training Courses in Colleges and Universities

Hybrid teaching has significant advantages in financial accounting courses in colleges and universities, which is conducive to improving students learning interest and promoting ability training. However, there are few studies on hybrid teaching in comprehensive simulation practical training courses of financial accounting. Therefore, this paper analyzes this and finds that it still has problems such as insufficient technical equipment. In order to better play the advantages of mixed teaching, improve the quality of teaching.

Development and Evaluation of Interprofessional High-Fidelity Simulation Course on Medication Therapy Consultation for German Pharmacy and Medical Students-A Randomized Controlled Study.

Recently, there has been a remarkable move towards interprofessional collaboration in response to the COVID-19 pandemic and the care of comorbidities. In Germany, there has been a gradual increase in interprofessional learning in medical and pharmacy education, aiming to enhance patient care. To adapt the pharmacy curriculum for collaborative practice between pharmacy and medical students, we developed an immersive interprofessional collaboration course for pharmacy students using adult and pediatric high-fidelity simulators (HFS) to assess and train medication consultation skills. In a randomized controlled trial, we investigated whether interprofessional training between pharmacy and medical students results in differences in pharmacy students' performance of medication therapy consultation compared to the case of mono-professional training of pharmacy students only. Before and after inter/mono-professional training, each pharmacy student performed an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire. Additionally, an attitude survey towards interprofessional learning was completed by pharmacy and medical students at the end of the training. As expected, interprofessional as well as mono-professional training showed a statistically significant increase in medication consultation skills. Of importance, the performance in the interprofessional training group was significantly better than in the mono-professional group, particularly in drug therapy counselling and consultation behaviors. There was a significant difference between the intervention and control groups in self-assessment scores, and all study participants had positive attitudes toward interprofessional collaboration and training. Therefore, interprofessional training using HFS has been shown to appropriately train pharmacy students for collaborative practice and consultation skills.

Practical Aspects of the Simulation Course "Dispensary Observation at a Feldsher-Obstetric Station" as an Improvement in the Quality of Education

Currently, the protection of rural population health is of particular importance. This article presents the experience of organizing a simulation course "Dispensary observation at a Feldsher-Obstetric Station ", it also considers practical issues of its implementation and results.

Post-simulation debriefing as a stepping stone to self-reflection and increased awareness — a qualitative study

BackgroundThe voice of the students should be engaged in simulation curriculum development. Involving the students in the development of debriefing strategies might result in a deeper understanding of learning. However, few studies have investigated the students’ perspectives on debriefing strategies. The aim of the study was to explore nursing students’ perspectives on the post-simulation debriefing.MethodsAn explorative, descriptive design with a qualitative approach was used. Data were collected in December 2017 and May 2018 through focus group interviews with undergraduate nursing students in Norway immediately after a 2-day high-fidelity simulation course in the second year of their Bachelor of Nursing degree. Data were analysed using systematic text condensation.ResultsThirty-two nursing students participated in the study. The data analysis identified two main categories. The category ‘Facilitator as a catalyst for reflection’ illustrated the facilitator’s multifaceted and vital role in initiating and guiding the students’ reflection process in the debriefing. The category ‘A process towards increased awareness’ encompasses the students’ guided process of acquiring new insight into their professional development, and how they put parts together to see the wholeness in what was simulated.ConclusionsThis study provides knowledge to facilitators regarding nursing students’ perspectives on facilitating reflection and learning during debriefing discussions. The facilitator’s multifaceted role in guiding the students’ reflections and their process of acquiring new insight into their professional development were identified as critical to learning during debriefing.