Simulation as a method in a supervision course, experiences of midwives and specialist nurses: A qualitative study

To explore supervisors' experience of simulation in a student supervision course BACKGROUND: The relationship between student and supervisor is crucial for the students' learning and quality of education. The supervisors have an important role in facilitating a good start and the best learning opportunities for students in clinical placement. Supervision can be demanding and there is a need to strengthen supervisors in their role. An interprofessional supervision course was designed, using simulation as a method. Simulation is frequently used for acute situations to improve patient safety but is less common in student supervision. In our supervision course, simulation was introduced in the digital component and practiced in the physical component. The 4-6 members of the interprofessional simulation groups were assigned roles as either participants or active observers. They were guided by a facilitator, who constructed student-supervisor scenarios, allocated roles and facilitated reflection.

A qualitative, explorative design involving focus groups and written reflections.

Two focus groups (n=9) were conducted following a pilot course in addition to written reflections (n= 80) after four courses. After revising the course and the interview guide, two additional focus groups (n =10) were held and a further 43 written reflections received. The empirical data were analyzed using thematic analysis by Braun and Clarke.

The three themes. 1. Interprofessional simulation provides a wider perspective on the student- supervisor relationship. The participants experienced being active in different roles, followed by subsequent joint reflection. They expressed increased relational understanding as well as the importance of verbal and nonverbal communication in supervision through learning from other interprofessional supervisors. 2. Simulation provides realism by entering into the situation. Simulation fostered activation of the senses that improved the supervisor's ability to be attentive to the student's needs. 3.Challenging to simulate the role of supervisor. Most participants were willing to force themselves out of their comfort zone to learn. However, quite a few felt uncomfortable participating in simulation on communication and preferred observing others.

The participants experienced simulation as valuable for strengthening their awareness of their ability to influence students' learning and relational understanding. The results showed the value of reflective observation in addition to participating in simulation. Simulation might contribute to improved supervision, although different experiences that inhibit learning outcomes must be acknowledged.