Scaffolding safety in nursing simulation: A grounded theory

Simulation-based learning is a teaching technique that allows learners to apply theoretical knowledge to enhance patient safety. Despite limited evidence about the relationship between simulation and patient safety outcomes, nursing programs continue using simulation to improve student competencies.

To explore the processes driving the actions of nursing students while providing care for a rapidly deteriorating patient during a simulation-based experience.

Following the constructivist grounded theory method, the study recruited 32 undergraduate nursing students to explore their experiences during simulation-based experiences. Data were collected using semi-structured interviews over 12 months. Interviews were recorded, transcribed and analyzed using constant comparison and simultaneous data collection, coding, and analysis.

Two theoretical categories emerged from the data to explain the processes driving the students' actions during simulation-based experiences: Nurturing and contextualizing safety. The themes revolved around a core category of "Scaffolding Safety" in simulation.

Simulation facilitators can use the findings to build effective and targeted simulation scenarios. Scaffolding safety steers students' thinking and contextualizes patients' safety. It can be utilized as a lens to guide students and assist them with transferring skills from simulation to the clinical practice setting. Nurse educators should consider deliberately integrating the concepts of scaffolding safety into simulation-based experiences to connect theory and practice.