Perception of simulation-based training as a replacement for clinical practice training among pre-licensure nursing students: a qualitative study

Abstract Background Despite the increasing adoption of simulation during clinical training disruptions, little is known about how students perceive its ability to replace clinical placements. This study aims to explore the perceptions, attitudes and experiences of final-year pre-licensure nursing students regarding simulation-based training as a substitution for clinical practice. Methods This study adopted an exploratory qualitative design with face-to-face focus group interviews. Two accident and emergency case scenarios involving tachycardia and drug overdose were developed and simulated in the simulation wards of the participating nursing institution to substitute for clinical practice during the COVID-19 pandemic. We recruited a total of 40 final-year pre-licensure nursing students (80% female) enrolled in both bachelor’s (n = 20) and master’s programs (n = 20) in a government-funded public university in Hong Kong to participate in focus group interviews via convenience sampling until data saturation was reached. All interviews were audio-recorded and moderated by nurse instructors using a pre-determined interview guide. Qualitative data were subjected to thematic analysis. Results A total of eight focus group interviews were conducted. Three themes emerged from the qualitative data: (i) effective preparation for clinical practice, (ii) the limitations of simulation-based training in replacing clinical practice and (iii) refining simulation-based training. All students recognised that the simulation-based training helped to bridge the gap between theory and practice and to improve their case management, communication, clinical decision-making and nursing skills. However, limitations concerning the differences in procedures and facilities not reflective of the most current practices and challenges in replicating certain aspects of clinical placement (such as clinical atmosphere, patient variety and complexity) hindered the ability of simulation-based training to fully replace clinical practice. Conclusion The study findings demonstrate the potential use of simulation-based training to complement clinical practice in pre-licensure nursing education in Hong Kong. To further refine the training programme, it is recommended to enhance the briefing, develop more complex and diverse case scenarios to better replicate clinical situations and upgrade the laboratory facilities to include more realistic equipment. Further research should explore the potential use of this training modality in other speciality areas and broader variety of institutions using a longitudinal design. Clinical trial number Not applicable.