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Sustainability in undergraduate nursing clinical simulation: A mixed methods study exploring attitudes, knowledge and
Bangyun Wang1, Louise Sheehy2, Astrid Frotjold2
1Clinical Skills and Simulation Education, Operation Unit, Susan Wakil Health Building, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
Nurse Education Today
|June 24, 2025
Summary
Integrating sustainability education into nursing clinical simulations improved student application of eco-friendly practices. While waste reduction showed no significant change, students
Area of Science:
- Environmental Health
- Nursing Education
- Healthcare Sustainability
Background:
- Climate change poses significant threats to human health, with healthcare systems contributing to environmental degradation through emissions and waste.
- Sustainability is a critical issue for the nursing profession, necessitating integration into healthcare education and practice.
Purpose of the Study:
- To explore the impact of an educational module on sustainability principles within clinical simulation for student nurses.
- To assess changes in student attitudes, knowledge, and practices related to climate change and sustainability in a simulated clinical setting.
Main Methods:
- A mixed-methods study involving pre- and post-intervention waste audits and student surveys.
- An educational intervention using a digital clinical simulation module focused on professional conduct, work health and safety, and resource stewardship.
- Analysis of quantitative data (waste audits, survey responses) and qualitative data (thematic analysis of barriers and facilitators).
Main Results:
- No significant difference in overall waste generated per student was observed post-intervention.
- A proportional increase in the diversion of reusable items to recycling stations following the intervention.
- Student-reported application of sustainability principles during clinical simulation significantly increased (mean 4.8 to 5.4, p ≤0.01), alongside perceived application in clinical practice and adherence to 'reduce' and 're-use' principles.
Conclusions:
- Embedding sustainability principles in nursing clinical simulation curricula positively impacts student engagement and perceived application of sustainable practices.
- Student nurses are motivated to adopt sustainability but face barriers such as cognitive overload, time pressure, and the desire for authentic practice.
- Ongoing efforts are required to address these barriers and enhance sustainable practices within clinical simulation and future nursing careers.
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