How Simulation in Nursing Education Improves Student Performance

Nursing students report feelings of inadequacy and fear when entering the clinical setting (AL Sabei & Lasater, 2016; Lawrence, Messias, & Cason, 2018; & Palmer & Ham, 2017). Because of these feelings, academic performance is not always aligned with performance in the clinical setting. It is not uncommon for nursing students to perform well in theory yet struggle in the clinical setting (Palmer & Ham, 2017).

Faculty themselves struggle with ways to create a rich simulated learning environment that ensures nursing students can appropriately transfer theoretical knowledge into the clinical setting. Nursing students thrive in a simulation environment that is lifelike and engaging (AL Sabei & Lasater, 2016; Lawrence, Messias, & Cason, 2018; Palmer & Ham, 2017; & Reid-Searl, Mainey, Bassett, & Dwyer, 2018).

Students perform more confidently in the clinical setting when they are exposed to learning experiences with realistic simulation scenarios. Literature supports the importance of students acting in the role of the nurse during simulation since it gives them the opportunity to learn from their mistakes without risk to actual patients. Students in the nurse role are given an opportunity to synthesize information learned from theory, and identify and interpret a patient’s condition (Lawrence, Messias, & Cason, 2018).

Realistic scenarios allow students to practice clinical judgement in a safe environment. Students find themselves in a rich learning environment when faculty pause a simulation, and say, “Now, in real life you may see this.” However, keeping simulations real can be a challenge for faculty. Just remember that incorporating intimate tasks such as toileting, showering, and care of a soiled patient are all valuable, realistic nursing skills to include during simulation (Lawrence, Messias, & Cason, 2018; & Reid-Searl, Mainey, Bassett, & Dwyer, 2018).

Lastly, with the incorporation of debriefing, faculty can assess how well students are transferring knowledge from theory to simulation. With the use of debriefing, faculty can correct students’ prior misconceptions from theory before bringing them into clinical practice. Also, debriefing allows students time to reevaluate their performance and self-identify knowledge gaps (AL Sabei & Lasater, 2016).

The use of realistic simulation experiences gives students the opportunity to refine skills and apply theoretical knowledge in a safe learning environment. Immediate faculty feedback during debriefing provides students with an opportunity to learn from their mistakes and respond to constructive critiques. Empirical evidence reveals faculty can ensure students are transferring theoretical knowledge into the clinical setting by keeping the simulation experience real, allowing the students to act in the role of nurse, and following up with a debriefing session (AL Sabei & Lasater, 2016; Lawrence, Messias, & Cason, 2018; Palmer & Ham, 2017; & Reid-Searl, Mainey, Bassett, & Dwyer, 2018).


AL Sabei, S.D., & Laster, K., 2016. Simulation debriefing for clinical judgement development: A concept analysis. Nursing Education Today, 45, 42-47.

Lawrence, K., Messias, D.K., Cason, M.L., 2018. The influence of simulation experiences on new nurses’ clinical judgement. Clinical Simulation in Nursing, 25, 22-27.

Palmer, B.J., & Ham, K., 2017. Collaborative simulation: Enhancing the transition to clinical practice. Nursing Education Perspectives, 38(5), 281-282.

Reid-Searl, K., Mainey, L., Bassett, J., & Dwyer, T., 2018. Using simulation to prepare neophyte nursing students to deliver intimate patient care. Collegian,