Simulated practice learning (SPL) has become an integral component of nursing education, offering students a structured and immersive environment to combine theoretical knowledge with practical application. SPL provides students with unique opportunities to develop their skills in supportive, safe and controlled settings. Whereas clinical placements remain fundamental to practice-based learning, SPL serves as a vital complement, preparing students for the complexities of healthcare practice.
The Nursing and Midwifery Council (NMC) recognises the value of simulation as a teaching method, approving up to 600 hours of SPL in nursing programmes (NMC, 2024). Many institutions use these hours to enhance learning outcomes without replacing real practice experiences. SPL offers a safe environment where students can practise procedures, build confidence and refine skills without the pressures of a live clinical setting. This preparatory function is invaluable, particularly for students encountering complex or high-risk scenarios that may not routinely arise during placements.
Dedicated SPL weeks are often incorporated into curricula, allowing students to engage intensively with simulated learning and focus on achieving specific learning objectives. These sessions are designed to replicate the challenges of clinical practice while incorporating the structured feedback and reflection essential for deep learning. Evaluations of these SPL weeks consistently demonstrate their significant impact. Many students report that SPL is highly effective in meeting their learning objectives, describing the sessions as both engaging and immersive, reflecting the value of realistic and interactive teaching methods (Hill et al, 2024).
In addition to technical skills, SPL offers significant emotional and psychological benefits to nursing students. Many students report that SPL helps to reduce the anxiety often associated with real clinical placements. By providing a safe space where students can make mistakes, SPL allows them to learn and build confidence without the immediate pressures of patient care. This reduces stress and enhances emotional resilience, preparing students for the emotional challenges they will face in the real world (Royal College of Nursing (RCN), 2023).
Encouraging teamwork
SPL not only involves individual skill development but also fosters teamwork and communication skills, which are essential components of modern nursing practice. In simulated scenarios, students often work in teams, mimicking the collaborative nature of healthcare delivery. By engaging in multidisciplinary simulations, students enhance their ability to communicate effectively, solve problems as a team and perform under pressure – skills crucial for patient safety and high quality care. This collaborative learning is particularly beneficial in areas such as emergency care, where effective team co-ordination is paramount (Bruce, 2023).
Simulation also enhances students’ readiness for key clinical activities such as patient handovers and ward rounds. These are essential components of daily nursing practice, requiring not only knowledge but also confidence and effective communication. Students consistently report feeling more prepared for tasks following SPL experiences. Similarly, many note increased comfort in conducting patient assessments, a fundamental skill in delivering safe, effective care. These outcomes demonstrate how SPL builds confidence and competence (Bruce, 2023).
Preparing for complex specialties
SPL also provides opportunities for students to experience specialist areas of nursing that may be difficult to replicate in a traditional clinical setting. For example, complex paediatric care, mental health nursing or complex critical care scenarios can be simulated to prepare students for these high-pressure fields. By engaging in these targeted simulations, students are exposed to scenarios that might not frequently arise during their clinical placements, preparing them for the unique challenges of these specialties.
It is crucial to emphasise that SPL is not a replacement for real clinical practice but rather a bridge between theory and practice. Traditional clinical placements remain irreplaceable for exposing students to the complexities, unpredictability and interpersonal dynamics of healthcare environments. However, SPL addresses some limitations of traditional placements by offering a controlled setting where students can focus on skill acquisition and problem-solving without the immediate pressures of patient care. Many students find that SPL enhances their confidence and readiness for clinical placements, where they can apply these skills in real-world contexts (RCN, 2023).
Innovations
Innovations such as virtual reality (VR) and augmented reality (AR) have the capacity to revolutionise how simulations are conducted in nursing education. These technologies provide students with an interactive environment to practice clinical scenarios in a more lifelike setting, thus improving their preparedness for actual clinical situations. Additionally, AI-driven simulations and mobile applications enable students to engage in learning remotely, providing more flexible learning opportunities that complement traditional face-to-face experiences (Association for Simulated Practice in Healthcare (ASPiH), 2023).
One of the most innovative tools in SPL is the use of simulated electronic patient record systems, such as SimEPR. In modern nursing practice, proficiency with electronic documentation systems is essential. Platforms such as SimEPR bridge this gap by providing students with hands-on experience in managing patient records. Evaluations of such systems have found that students rate them as userfriendly and realistic, enabling the practise of skills that are directly transferable to clinical settings. Furthermore, students consistently report that SPL significantly refines their clinical documentation skills, better preparing them for the realities of patient care (Mitchell, 2022).
Educators’ expertise
The success of SPL also relies heavily on faculty expertise. Faculty members bring a wealth of clinical and educational experience to the simulation environment, providing students with guidance that is both practical and pedagogically sound. Students frequently praise the clarity and support offered by faculty staff, particularly in explaining complex technologies and providing constructive feedback. This collaborative and supportive approach ensures that students feel empowered to take risks, learn from mistakes and develop their skills in a nurturing environment (ASPiH, 2023).
Faculty staff also facilitate simulation debriefing (SD), which primarily focuses on providing feedback, breaking down actions and promoting reflection to enhance future performance. During SD, students are guided to reflect on their simulation experience with the educator acting as a facilitator (Kim and Kim, 2017). This includes reflecting on feedback regarding students’ performance, mistakes and cognitive development (Kim and Kim, 2017).
The debriefing phase is essential for fostering deep learning through reflection and feedback, and it often takes the form of a conversation following the simulation to enhance future performance (Mulli et al, 2021).
‘Students frequently rate SPL as highly effective in meeting their learning objectives and find the experiences engaging and immersive’
Feedback
Feedback from clinical placement educators is a critical aspect of assessing the effectiveness of SPL. Clinical placement educators who observe students applying their SPL-acquired skills in real-world settings often report an improvement in students’ competence, confidence, critical thinking and decision-making. Many have highlighted that students who have participated in well-structured SPL are more capable of handling complex situations, communicating effectively and performing clinical tasks with accuracy and efficiency (RCN, 2023).
SPL is not confined to the UK alone. Many healthcare education programmes around the world are integrating simulation as a key component of their curricula. For example, in the USA and Australia, SPL has become a critical tool for addressing nursing shortages and enhancing clinical training. Although practices may vary across countries, there is a growing recognition of the value of simulation in nursing education. By learning from global best practices, UK institutions can continue to refine their SPL offerings and maintain their competitive edge in preparing nursing professionals (Barlow, et al, 2024).
Positive student feedback highlights the value of this balanced approach. Students frequently rate SPL as highly effective in meeting their learning objectives and find the experiences engaging and immersive. Many praise the real-world relevance of simulations, reporting that SPL enhances their readiness for clinical tasks such as documentation, patient handovers and ward rounds. These outcomes not only validate the integration of SPL into nursing education but also reflect the dedication of faculty and the innovative use of tools such as simulated patient record systems (Hill and Mitchell, 2024).
Looking ahead
SPL has the potential to play an even greater role in nurse education. Advances in simulation technology and pedagogical approaches will enable the development of more sophisticated scenarios that reflect the realities of contemporary health care.