Perception of simulation-based education among nursing and midwifery students in Tanzania: a qualitative study

While many nursing programs in developed countries have implemented simulation-based education as a pedagogic method of teaching, implementation of simulation in developing countries like Tanzania is rare. Traditional methods of auditorium lectures are widely conducted in low-income nursing and midwifery education institutions. Such pedagogy provides students with theoretical knowledge yet with limited hands-on exposure for clinical skills, which might affect the professional integration of students and quality care delivery. This study explored perceptions of simulation-based education among diploma nursing students and midwifery students in one of the urban nursing schools in Tanzania.

An exploratory qualitative study design was employed. Thirty-four nursing and midwifery students who had experience with simulation-based education were selected purposively to participate in focus group interviews. Data was collected in July 2023. Data analysis was conducted based on Graneheim and Lundman's content analysis approach.

Two major themes emerged from the analysis: (1) Strengthened confidence through practice in a safe teaching environment. This theme included three sub-themes: (i) Increased overall confidence, (ii) reduced fear through practice in a safe environment, and (iii) enhanced knowledge and skills in procedures and equipment. The second theme was as follows: (2) Enhanced critical thinking and reasoning in debriefing and included two sub-themes: (i) Integrating theory into practice, (ii) communication in neonatal emergency management.

Nursing and midwifery students perceived simulation-based education as an effective method to prepare for clinical practice and quality neonatal care. Introducing simulation-based education in nursing education may benefit students' learning and strengthen the sustainability of skilled healthcare providers in low-income contexts where resources are scarce. Further research is needed to assess whether students can transfer knowledge into clinical skills practice.