The study took place in the second year of a three-year Bachelor of Nursing programme at a Norwegian university. This undergraduate nursing education programme entailed 180 credits in the European Credit Transfer and Accumulation System (ECTS) [34 ]. More specifically, the nursing students got 90 ECTS credits from theoretical courses mainly in the academic setting, minimum 75 ECTS credits from clinical placement in a variety of settings, and maximum 15 ECTS credits from simulation-based education in laboratories [34 ]. The study was conducted in two learning settings: a simulation centre on the university campus and an acute care hospital unit.
In the simulation setting, the students took part in a two-day simulation-based education course comprising six simulation sessions focusing on different deteriorated patient conditions and diagnoses. Nine faculty members were involved as facilitators and operators. Students were divided into groups of six to nine, alternating between the roles of nurse and observer. The simulation environment mirrored a patient room in a hospital unit and Laerdal SimMan 3G™ and ALS™ manikins were used. Each simulation session (90 min) consisted of a prebriefing (15 min), a simulated scenario (15 min), a viewing of the video recording of the simulated scenario (15 min), and a facilitator-led group debriefing (45 min). For the debriefing, the Promoting Excellence and Reflection in Simulation (PEARLS) structured and scripted debriefing [35 (link)] method was used.
After the simulation-based education course, the students attended an eight-week clinical placement course in a medical or surgical hospital unit hosting adult patients with acute, critical, and chronic conditions. Students provided nursing care under the supervision of a registered nurse working in the relevant unit. Nurse educators supervised the students in groups to promote reflection and learning and to evaluate their learning outcomes.
The learning outcomes for both courses entailed the same clinical judgment skills.
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