Nursing students' experiences of developing spiritual care competencies through simulation: a qualitative exploratory...

Spiritual care is a core component of holistic nursing; however, nursing students frequently report limited preparation and confidence in addressing patients' spiritual needs. Although simulation-based education has shown promise for developing complex professional competencies, little is known about how nursing students experience the process of learning spiritual care through high-fidelity simulation. Therefore, this study aimed to explore nursing students' perceptions and experiences regarding the development of spiritual care competencies through high-fidelity clinical simulation.

The design of the study was qualitative phenomenological study. First-year undergraduate nursing students (n = 55) from a public Spanish university participated in a structured high-fidelity simulation focused on spiritual care. Data were collected through reflective narratives written after the simulation, following Lederman's debriefing model. Data were analyzed using reflexive thematic analysis based on Braun and Clarke's approach, combining inductive and deductive coding strategies and supported by ATLAS.ti software.

Four themes were identified: (1) emotional positioning in relation to spirituality, reflecting initial emotional responses to a novel learning experience; (2) negotiating complexity in spiritual care practice, comprising two subthemes: (2.1) relational uncertainty and ethical tension in spiritual encounters, and (2.2) relational enablers and communicative attunement in spiritual care; (3) meaning-making and reflective transformation, representing the development of reflective capacity and a deeper understanding of spiritual care as part of holistic nursing; and (4) integration of spiritual care into professional identity, highlighting perceived transferability to future clinical practice. Participants described simulation as a psychologically safe environment that promoted emotional engagement, ethical awareness, and reflective learning.

High-fidelity simulation shows potential as an educational strategy for developing spiritual care competencies in nursing education. Introducing spiritual care training early in nursing curricula may enhance students' ability to provide holistic, person-centered care that addresses patients' spiritual needs.

Not applicable.