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Nursing Students' Learning in High Fidelity Simulation: An Ethnographic Study Open Access


Other title
High fidelity simulation
Nursing education
Type of item
Degree grantor
University of Alberta
Author or creator
Harder, B. Nicole
Supervisor and department
Paul, Pauline (Nursing) and Ross, Carolyn (Nursing)
Examining committee member and department
Cameron, Brenda (Nursing)
Myrick, Florence (Nursing)
Carbonaro, Michael (Education)
Pepin, Jacinthe (Nursing) Université de Montréal
Williams, Beverley (Nursing)
Faculty of Nursing

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Understanding what happens to students’ learning in high-fidelity simulation (HFS) is important as we build our knowledge around the use of HFS in nursing education. Research in the area of high-fidelity is emerging at a rapid pace, however much of the literature surrounds the area of self-efficacy and or that of outcomes related to the clinical skill performance in HFS. To date there has been little research that examines what happens in HFS that affects nursing students’ learning. The purpose of this thesis was to look at the culture of learning in HFS in undergraduate nursing education. Specific areas that were explored were students’ and instructors’ views about: the use of HFS on student learning, what it is like to participate in HFS, and factors that either enhance or impair the simulated clinical experience. Using the ethnographic method, participant observations were conducted over a period of two academic terms. A convenience sample of 12 students and two clinical instructors were interviewed regarding their perspectives, and 20 instructors participated in one of two focus groups. The interviews and observations yielded rich data that was initially coded and then segmented to form themes. Member checks were conducted to ensure rigor. To triangulate data, four reflective journals were also used in this focused ethnographic study. The key findings were that students believed that the level of instructor involvement at critical points during HFS was important and instructors believed that their comfort level in teaching with HFS had an important influence on teaching and subsequently learning in HFS. Other factors that enhanced or impaired the simulated clinical experience included realism, the ability to make mistakes in HFS and the specific roles assigned to students during HFS. An important limitation of the study was the possible bias that might have resulted from the researcher’s extensive experience with HFS. A major implication for practice pertains to the preparation of faculty and students for HFS. How students’ mistakes during HFS inform their clinical practicum is an important question to address in future research.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
Harder, B. N. (2010). "Use of Simulation in Teaching and Learning in Health Sciences: A Systematic Review." Journal of Nursing Education, 49(1): 23-28.Harder, B. N. (2009). "Evolution of Simulation Use in Health Care Education." Clinical Simulation in Nursing, 5(5): e169-e172.

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