Nursing Students' Perceptions of a Clinical Simulation Experience in Community Care: Strengths and Limitations

To explore nursing students' perceptions of and satisfaction with a clinical simulation experience in community care.

A descriptive mixed-methods study was conducted at a private university in Spain with 103 s-year nursing students during the academic year 2023-2024. Four simulation scenarios were designed to represent community care settings. Quantitative data were collected using the Simulation Design Scale, and qualitative data were collected through reflective narratives. Data were analysed using SPSS and ATLAS.ti.

The students reported a high level of satisfaction. The main perceived strengths included the scenarios' close resemblance to real-world practice, the opportunity to apply theoretical knowledge, the development of clinical reasoning and communication skills, psychological safety and collaborative learning. The main limitations concerned facilitator support, session timing, pre-simulation preparation, students' anxiety when performing individually in front of others, and limited opportunities for active participation.

Clinical simulation in community care scenarios was perceived as an effective and engaging strategy for developing both technical and non-technical competencies. Its potential lies in combining realistic and structured scenarios, although aspects such as time management, preparation and instructor support should be strengthened to maximize educational impact.

Our findings reinforce the value of clinical simulation as an educational strategy for preparing future nursing professionals to address the challenges of community-based practice. Students' positive perceptions of the realism and applicability of the simulation, together with its contribution to the development of clinical, communication and reflective skills, suggest that such experiences can facilitate theory-practice integration and strengthen decision-making in community care contexts. Furthermore, by identifying areas for improvement, this study provides practical recommendations for optimizing the instructional design of future simulation-based learning experiences. These enhancements may contribute to improving the quality of nursing education and fostering safer, more empathetic and more competent professional practice aligned with the core principles of primary health care.

The EQUATOR Network guidelines were followed, specifically the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline for the quantitative component of the study. Given the mixed-methods design, reporting also adhered to the Good Reporting of A Mixed Methods Study (GRAMMS) recommendations. There was no patient or public involvement in the design, conduct, reporting, or dissemination of this study.