Building Skills in Infection Prevention Through Simulation: Insights from Nursing Students in Brazil and Peru

Background/Objectives: Healthcare-associated infections (HAIs) require specific skills in nursing education, yet their curricular integration often remains fragmented, limiting the consolidation of knowledge and safe clinical practice. This study aimed to explore the perceptions of nursing students from Brazil and Peru regarding the use of clinical simulation as a strategy to develop skills in HAIs prevention and control. Methods: A qualitative approach was employed, involving 12 focus groups (n = 297 students) across four universities. The discussions were conducted following simulation activities based on standardized scenarios structured into four phases: pre-reading, briefing, execution, and debriefing. Data were collected using a semi-structured interview guide flowed by content analysis, through which saturation was achieved. The study adhered to COREQ guidelines. Results: Three main themes emerged: (i) clinical simulation as a student-centered teaching-learning strategy, where pre-reading and briefing materials enhanced students' confidence and clarity in performing tasks, with checklists suggested to avoid omissions; (ii) simulation as a facilitator of autonomy and safety in HAI prevention, offering a protected environment for making mistakes and learning, with formative feedback during debriefing increasing risk awareness, although debriefing time was noted as an area for improvement; and (iii) meaningful learning and integration with traditional education, as students reported increased engagement, better knowledge retention, and greater perceived transfer of skills to real clinical settings. Conclusions: Clinical simulation demonstrated strong potential to support the development of HAI prevention skills in undergraduate nursing students. Longitudinal implementation with standardized scenarios and further evaluation of educational effectiveness and debriefing strategies is recommended.