skip to main content

Simulation-Based Learning in Emergency Nursing Practice: A Phenomenological Study

*Hardin La Ramba orcid  -  Department of Disaster Nursing, Emergency Nursing, and Community Health Nursing, Sekolah Tinggi Ilmu Kesehatan (STIKes) RS Husada, Indonesia
Olivia P. Tapit orcid  -  Department of Accident and Emergency, Khoula Hospital, Oman
Tommy Jemmy Fansiscus Wowor  -  Department of Nursing, Faculty of Health Sciences, Universitas Nasional, Indonesia
Yarwin Yari orcid  -  Department of Adult Health Nursing, Sekolah Tinggi Ilmu Kesehatan (STIKes) RS Husada, Indonesia
Elizabeth Monteiro  -  Doctor of Philosophy in Nursing Science Program, St. Paul University Philippines, Indonesia
Samsinar Butar Butar  -  Doctor of Philosophy in Nursing Science Program, St. Paul University Philippines, Indonesia
Elizabeth C. Baua orcid  -  Graduate School, St. Paul University Philippines, Philippines
Josephine Daquioag D. Lorica orcid  -  Graduate School, St. Paul University Philippines, Philippines
Jessus B. Pizzaro  -  Graduate School, St. Paul University Philippines, Philippines
Wireen Leila T. Dator orcid  -  Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Saudi Arabia
Hezel N. Villagracia orcid  -  Department of Medical-Surgical Nursing, College of Nursing, University of Ha’il, Saudi Arabia
Melenie Reboldera Adolfo orcid  -  Graduate School, St. Paul University Philippines, Philippines
Aisha Sultan Hamood Al-Azri  -  Ministry of Health, Quality Assurance Center, Oman
Open Access Copyright (c) 2026 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Simulation-based learning (SBL) is widely used in nursing education, especially in high-risk settings such as emergency departments. However, limited qualitative research has explored how emergency nurses experience simulation in clinical practice.

Purpose: This study aimed to explore emergency room nurses’ lived experiences of simulation-based learning and to understand how simulation contributes to their professional development and clinical practice.

Methods: A descriptive phenomenological approach was used. Ten emergency room nurses from a public hospital under Oman’s Ministry of Health were recruited using purposive sampling. Data were collected through in-depth interviews and analyzed using Colaizzi’s seven-step phenomenological method to identify the meaning of participants’ experiences.

Results: Three themes emerged from the analysis: (1) simulation as a bridge between theory and clinical practice, where simulation enabled nurses to translate theoretical knowledge into practical decision-making in realistic emergency scenarios; (2) developing professional confidence and clinical competence, where repeated simulation practice strengthened clinical skills, preparedness, and confidence; and (3) simulation as a strategy for improving nursing services, where participants perceived simulation as contributing to improved clinical performance, teamwork, and patient care quality. Participants also identified practical challenges, including scheduling constraints and workload demands, which limited participation in simulation activities.

Conclusion: Simulation-based learning is experienced by emergency nurses as a meaningful experiential learning process that supports the integration of theoretical knowledge with clinical practice. In addition to improving individual competencies, simulation contributes to professional confidence, teamwork, and the quality of emergency care. Further research across diverse healthcare settings is needed to explore its long-term impact on nursing practice and patient outcomes.

Keywords: Emergency nursing; lived experiences; phenomenology; professional development; simulation-based learning

Article Metrics:

  1. Al Gharibi, K. A., & Arulappan, J. (2020). Repeated simulation experience on self-confidence, critical thinking, and competence of nurses and nursing students—An integrative review. SAGE Open Nursing, 6, 1–8. https://doi.org/10.1177/2377960820927377
  2. Alanazi, A. A., Nicholson, N., & Thomas, S. L. (2017). The use of simulation training to improve knowledge, skills, and confidence among healthcare students: A systematic review. The Internet Journal of Allied Health Sciences and Practice, 15(3), 6. https://doi.org/10.46743/1540-580x/2017.1666
  3. Alharbi, A., Nurfianti, A., Mullen, R. F., McClure, J. D., & Miller, W. H. (2024). The effectiveness of simulation-based learning (SBL) on students’ knowledge and skills in nursing programs: A systematic review. BMC Medical Education, 24, 1099. https://doi.org/10.1186/s12909-024-06080-z
  4. Alharbi, K. N., & Alharbi, M. F. (2022). Self-confidence and satisfaction of nursing students after simulation experience: Literature review. International Journal of Biotech Trends and Technology, 12(1), 1–8. https://doi.org/10.14445/22490183/ijbtt-v12i1p601
  5. Almeida, R. S., Mazzo, A., Martins, J., Jorge, B. M., Souza Júnior, V. D. S., & Mendes, I. (2019). Self-confidence in the care of critically ill patients: Before and after a simulated intervention. Revista Brasileira de Enfermagem, 71(6), 1618–1623. https://doi.org/10.1590/0034-7167-2018-0758
  6. Campbell, S., Greenwood, M., Prior, S., Shearer, T., Walkem, K., Young, S., Bywaters, D., & Walker, K. (2020). Purposive sampling: Complex or simple? Research case examples. Journal of Research in Nursing, 25(8), 652–661. https://doi.org/10.1177/1744987120927206
  7. Campbell, S. H., Nye, C., Hébert, S. H., Short, C., & Thomas, M. H. (2021). Simulation as a disruptive innovation in advanced practice nursing programs: A report from a qualitative examination. Clinical Simulation in Nursing, 61, 79-85. https://doi.org/10.1016/j.ecns.2021.08.001
  8. Cant, R. P., & Cooper, S. J. (2010). Simulation-based learning in nurse education: Systematic review. Journal of Advanced Nursing, 66(1), 3–15. https://doi.org/10.1111/j.1365-2648.2009.05240.x
  9. Cant, R., & Cooper, S. (2017). Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Education Today, 49, 63–71. https://doi.org/10.1016/j.nedt.2016.11.015
  10. Colaizzi, P. F (1978). Psychological research as a phenomenologist views it. In R. S. Valle & M. King (Eds.), Existential phenomenological alternatives for psychology (pp. 48-71). Oxford University Press
  11. Cook, D. A, Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., Erwin, P. J., & Hamstra, S. J. Technology-Enhanced Simulation for Health Professions Education: A Systematic Review and Meta-analysis. JAMA, 306(9), 978–988. https://doi.org/10.1001/jama.2011.1234
  12. Daneshfar, M., & Moonaghi, H. K. (2025). The impact of clinical simulation on bridging the theory–practice gap in nursing education: A systematic review. BMC Medical Education, 25, 1216. https://doi.org/10.1186/s12909-025-07790-8
  13. El Hussein, M. T., & Cuncannon, A. (2022). Nursing students’ transfer of learning from simulated clinical experiences into clinical practice: A scoping review. Nurse Education Today, 112, 105327. https://doi.org/10.1016/j.nedt.2022.105327
  14. Elhakam, E. M. A., Elshabory, N. E. M., & others. (2022). Effect of simulation-based training on maternity nurses’ performance and self-efficacy regarding management of preeclampsia. Evidence-Based Nursing Research, 4(3), 34–45. https://doi.org/10.47104/ebnrojs3.v4i3.246
  15. Giorgi, A. (2009). The descriptive phenomenological method in psychology: A modified Husserlian approach. Duquesne University Press
  16. Haukedal, T. A., Reierson, I. Å., Hedeman, H., & Bjørk, I. T. (2018). The impact of a new pedagogical intervention on nursing students’ knowledge acquisition in simulation-based learning: A quasi-experimental study. Nursing Research and Practice, 2018, 1–10. https://doi.org/10.1155/2018/7437386
  17. Hayes, C., Jackson, D., Davidson, P., Daly, J., & Power, T. (2017). Pondering practice: Enhancing the art of reflection. Journal of Clinical Nursing, 26, 1815–1824. https://doi.org/10.1111/jocn.13876
  18. Husserl, E. (1983). Ideas pertaining to a pure phenomenology and to a phenomenological philosophy: First book—General introduction to a pure phenomenology (F. Kersten, Trans.). Martinus Nijhoff Publishers
  19. Husserl, E. (2012). Ideas: General introduction to pure phenomenology (D. Moran, Intro.). Routledge
  20. Hustad, J., Johannesen, B., Fossum, M., & Hovland, O. J. (2019). Nursing students’ transfer of learning outcomes from simulation-based training to clinical practice: A focus-group study. BMC Nursing, 18, 53. https://doi.org/10.1186/s12912-019-0376-5
  21. INACSL Standards Committee. (2021). Healthcare simulation standards of best practice™: Professional development. Clinical Simulation in Nursing, 58, 5-7. https://doi.org/10.1016/j.ecns.2021.08.007
  22. Jeffries, P. R. (2016). The NLN Jeffries simulation theory. Wolters Kluwer
  23. Johnston, S., Coyer, F., & Nash, R. (2017). Simulation debriefing based on principles of transfer of learning: A pilot study. Nurse Education in Practice, 26, 102–108. https://doi.org/10.1016/j.nepr.2017.08.002
  24. Kaldheim, H. K. A., Fossum, M., Munday, J., Creutzfeldt, J., & Slettebø, Å. (2023). Professional competence development through interprofessional simulation-based learning assists perioperative nurses in postgraduation acute clinical practice situations: A qualitative study. Journal of Clinical Nursing, 32, 2757–2772. https://doi.org/10.1111/jocn.16377
  25. Koukourikos, K., Tsaloglidou, A., Kourkouta, L., Papathanasiou, I. V., Iliadis, C., Fratzana, A., & Panagiotou, A. (2021). Simulation in clinical nursing education. Acta Informatica Medica, 29(1), 15–20. https://doi.org/10.5455/AIM.2021.29.15-20
  26. Lewis, K. A., Ricks, T. N., Rowin, A., Ndlovu, C., Goldstein, L., & McElvogue, C. (2019). Does simulation training for acute care nurses improve patient safety outcomes: A systematic review to inform evidence-based practice. Worldviews on Evidence-Based Nursing, 16(5), 389–396. https://doi.org/10.1111/wvn.12396
  27. Li, Y. Y., Au, M. L., Tong, L. K., Ng, W. I., & Wang, S. C. (2022). High-fidelity simulation in undergraduate nursing education: A meta-analysis. Nurse Education Today, 111, 105291. https://doi.org/10.1016/j.nedt.2022.105291
  28. Lincoln, Y., & Guba, E. G. (1985). Naturalistic inquiry. Sage
  29. Mishra, R., Hemlata, & Trivedi, D. (2023). Simulation-based learning in nursing curriculum: Time to prepare quality nurses: A systematic review and meta-analysis. Heliyon, 9(5), e16014. https://doi.org/10.1016/j.heliyon.2023.e16014
  30. Mohamed, S. A., & Fashafsheh, I. H. (2019). The effect of simulation-based training on nursing students’ communication skill, self-efficacy and clinical competence for nursing practice. Open Journal of Nursing, 9(8), 855–869. https://doi.org/10.4236/ojn.2019.98064
  31. Mulyadi, M., Tonapa, S. I., Rompas, S. S. J., Wang, R.-H., & Lee, B.-O. (2021). Effects of simulation technology-based learning on nursing students’ learning outcomes: A systematic review and meta-analysis of experimental studies. Nurse Education Today, 107, 105127. https://doi.org/10.1016/j.nedt.2021.105127
  32. Oh, S., & Park, J. (2023). A literature review of simulation-based nursing education in Korea. Nursing Reports, 13(1), 506–517. https://doi.org/10.3390/nursrep13010046
  33. Prakoeswa, A. C., Arofiati, F., & Hidayah, N. (2022). The effect of basic trauma and cardiac life support training in increasing the competence of emergency room nurses. Jurnal Ners, 17(1), 8–13. https://doi.org/10.20473/jn.v17i1.33754
  34. Radkowitsch, A., Sailer, M., Schmidmaier, R., Fischer, M. R., & Fischer, F. (2021). Learning to diagnose collaboratively: Effects of adaptive collaboration scripts in agent-based medical simulations. Learning and Instruction, 75, 101487. https://doi.org/10.1016/j.learninstruc.2021.101487
  35. Salifu, D. A., Heymans, Y., & Christmals, C. Dela. (2022). A simulation-based clinical nursing education framework for a low-resource setting: A multimethod study. Healthcare, 10, 9. https://doi.org/10.3390/healthcare10091639
  36. Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., & Jinks, C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality & Quantity, 52, 1893–1907. https://doi.org/10.1007/s11135-017-0574-8
  37. Shin, S., Park, J. -H., & Kim, J. -H. (2015). Effectiveness of patient simulation in nursing education: Meta-analysis. Nurse Education Today, 35(1), 176–182. https://doi.org/10.1016/j.nedt.2014.09.009
  38. Theobald, K. A., Tutticci, N., Ramsbotham, J., & Johnston, S. (2021). Effectiveness of using simulation in the development of clinical reasoning in undergraduate nursing students: A systematic review. Nurse Education in Practice, 57, 103220. https://doi.org/10.1016/j.nepr.2021.103220
  39. Uppor, W., Klunklin, A., Viseskul, N., & Skulphan, S. (2024). Effects of experiential learning simulation-based learning program on clinical judgment among obstetric nursing students. Clinical Simulation in Nursing, 92, 101553. https://doi.org/10.1016/j.ecns.2024.101553
  40. Wang, W., Han, C., Zhang, X., Tong, Y., Zhao, R., Wang, B., Xing, W., Wang, N., & Chen, C. (2021). Application of in situ simulation teaching in the training of trainee nurses to respond to emergencies. Annals of Palliative Medicine, 10(4), 4509–4515. https://doi.org/10.21037/apm-21-545

Last update:

No citation recorded.

Last update: 2026-05-12 23:08:10

No citation recorded.