Evidence-based support measures for simulation-based nursing: participatory action research from universities in South Africa

Abstract

Introduction: Clinical time in nursing education has been augmented with simulation to accommodate many nursing students who need clinical experience. Students are exposed to the simulation laboratory to facilitate learning and enhance their preparedness for patient care. Depending on the degree to which they match reality, several simulators range from low- fidelity to high-fidelity. Both medium-fidelity and high-fidelity simulators are underutilised, and the lack of support for clinical facilitators is viewed as the key aspect of this problem.

Objectives of the study: The objectives of the study were achieved in different phases. Phase 1: To critically evaluate the available evidence regarding simulation-based nursing using an integrative literature review. Phase 2: To establish a working relationship with clinical facilitators participating in the study. Phase 3: To explore and describe the challenges of simulation-based nursing education in South African Universities; Phase 4: To identify the transformative values that contribute to the effective or ineffective simulation-based education in undergraduate nursing programmes; and Phase 5: To develop guidelines as evidence-based support for simulation-based guidelines for nursing education.

Research design and methods: An integrative literature review was conducted. Co-operative inquiry and Metens’ transformative approach were used to conduct qualitative participatory action research with clinical facilitators from selected universities in South Africa. Transformative learning theory and transformative paradigm were used to ground the philosophical tenets of the study. The study was conducted at the selected Universities in South Africa. The researcher and the participants agreed on the data collection and analysis methods. Data were gathered through cooperative inquiry group meetings and analysed using thematic data analysis. The cooperative inquiry group decided on the outcome of the study. Ethical considerations were adhered to, and quality in the cooperative inquiry was achieved through eight proposed criteria.

Findings: Three themes emerged from phase two of the integrative literature review structure, process, and outcome. Four themes emerged from phase three, barriers in simulation-based resources, feeling of inadequacy, questioning one’s assumption and perspective, and navigating shared experience through knowledge and practice. Five themes emerged from phase four as, exploring the relationships, simulation-based resources management, staff capacitation, development of policies and procedures and adjustment of simulation-based roles.

Conclusion: The study findings and the transformative learning theory were used to develop the simulation-based guidelines. Qualtrics survey was used by experts to validate the guidelines.