Perceptions of final year nursing students transer of clinical judgement skills from simulation to clinical practice: A qualitative study

Aim: To explore final year nursing student's ability to transfer clinical judgement skills to the clinical practice setting following immersive simulation. Background: Clinical judgement is considered a fundamental skill for nurses to ensure safe, quality care is delivered. In undergraduate nursing education where students have limited clinical experience, simulation-based education is an important educational strategy for introducing and developing these skills. Simulation allows for students to be exposed to repeated experiences and emotional responses to varying clinical situations. Despite this, there is a paucity of literature relating to students' ability to transfer clinical judgement skills from the simulated environment into clinical practice. Design: A naturalistic philosophical approach informed data collection in this qualitative phase of a larger study. Methods: Data were collected from students and nurse educators using semi-structured interviews as well as from facilitated simulation debriefs. Data were thematically analysed. Results: Four themes were identified which related to student knowledge, self-awareness and the clinical context: Safely collecting the data; Understanding the data to safely make decisions; Emotional intelligence; and Role variation. Students and educators held similar views on many of these elements. Conclusions: Questioning was identified as a key component of nursing students' clinical judgements. There were challenges in assessing students' ability to link theory to practice in the clinical setting, despite evidence of this occurring in the simulated setting. Simulation prepares students for practice by exposing them to new experiences and stressors and therefore an effective educational technique for developing clinical judgement skills in this cohort.