How does Simulation Influence Critical Thinking?

Abstract

It is imperative that registered nurses are skilled critical thinkers so that they are able to safely and effectively respond to the multifarious, complex, and often critical needs of their patients within a dynamic and constantly evolving healthcare environment. Nursing faculty are professionally and ethically bound to ensure graduates are workforce ready, and are therefore required to deliver learning opportunities that effectively and reliably facilitate the development of critical thinking skills. Simulation has been critically lauded in the literature as a learning strategy that supports critical thinking. However there is a paucity of empirical evidence to support these assertions, and little is known about ‘how’ simulation fosters the development of critical thinking within the context of undergraduate nursing. This phenomenological study sought to determine, from the perspective of undergraduate nursing students, the specific aspects of clinical simulation training that support or hinder the development of critical thinking. A convenience non-probability sample of 27 undergraduate Bachelor of Nursing students enrolled and completed two days of High-Fidelity Simulation training. Data was collected via participant demographic questionnaires and focus groups. Utilizing Colaizzi’s (1978) phenomenological method of data analysis, verbatim transcriptions of the participant discourse during the focus group sessions were scrutinised for patterns and themes. Undergraduate nursing students identified that the impacts, both positive and negative, of simulation on their ability to think critically depend on the way they are prepared for the simulation; the simulation environment; the simulation scenario; the degree of authenticity; the opportunity to work in a team and take on an assigned role; and the opportunity to reflect and receive feedback. There was unanimous agreement amongst participants that the overall simulation experience supported development of cognitive and metacognitive skills by affording the opportunity to practice the process of critical thinking. This study presents information that will assist nursing faculty to develop and manage simulation experiences for undergraduate nursing students to support critical thinking.