Registered Dietitians' Knowledge, Attitudes and Use of Simulation-Based Education in Ireland: A Mixed-Methods Study

Simulation-based education (SBE) is increasingly used in healthcare training to support the development of communication, clinical reasoning and professional competence. Despite its growing use in medicine and nursing, little is known about how SBE is understood and used within dietetics in Ireland. This study investigated dietitians' knowledge, attitudes and use of SBE, and explored factors influencing its implementation in pre-registration dietetic education.

A convergent mixed-methods design was used. An online questionnaire was distributed to CORU-registered dietitians in Ireland, assessing familiarity with SBE, attitudes, use, and perceived barriers and facilitators. Data were analysed using descriptive and inferential statistics. Semi-structured interviews were conducted with a sample of respondents and analysed using thematic analysis informed by the Capability, Opportunity, Motivation-Behaviour (COM-B) model. Quantitative and qualitative findings were integrated at interpretation using the COM-B framework.

The study included 114 dietitians, of whom 15 participated in the qualitative component. Although 78% had been exposed to simulation activities and 85% expressed interest in further training, only 14% of respondents reported using SBE. Greater familiarity with SBE was associated with more positive attitudes, stronger motivation, and fewer perceived resource and cost barriers (p < 0.001). Years of professional experience was the only significant predictor of SBE use. Qualitative findings revealed uncertainty about what constitutes SBE, with many dietitians using role-play or case-based activities without identifying them as simulation. Participants viewed SBE as a supportive tool, but not a replacement for real patient contact. Key barriers included limited time, educator training, resource constraints and limited institutional support. Enablers included shared resources, interdisciplinary collaboration and clearer guidance from higher education institutions.

Dietitians in Ireland support SBE, but its use remains inconsistent due to gaps in understanding. Coordinated educator training, clearer definitions and stronger institutional support may enable more effective integration of SBE into dietetic education.