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Using simulated patients as a learning strategy to support undergraduate nurses to develop patient-teaching skills

14 November 2019
17 min read
Volume 28 · Issue 20



An increase in the number of patients with long-term conditions has required a greater focus on nurse-led educational interventions to enable patients to develop self-management strategies. However, patient education is frequently taken for granted, and nurses sometimes consider that their undergraduate training does not prepare them to participate in effective patient teaching.


The study aimed to formatively evaluate a simulated role-play scenario facilitated with third-year nursing students to support the development of patient-teaching skills.


The study combined two approaches to simulation, using high-fidelity and mid-fidelity simulation scenarios sequentially. This enabled students (n=20) to apply the communication strategies learnt to both a skills-based procedural situation and a patient-teaching simulation. A five-item pro forma with four open questions and one closed question was used for formative evaluation.


The results indicated that using a simulated patient to practise patient-teaching skills was perceived by the students to be a valuable method of learning that they could transfer to clinical practice.


The findings suggested that facilitating learning with a simulated patient is useful in replicating authentic verbal and practical interactions with a patient in practice.

Patient teaching is a key component of nursing practice (Richard et al, 2018). However, Thompson (2017) argued that nurses are often quick to provide information and share skills without checking that patients have fully understood what they have been told. If patients do not fully understand what they have to do, this will potentially limit their ability to self-manage their condition. Kornburger et al (2013) argued that, if patients do not understand what is being taught, this will increase the risk of complications and readmission. However, the opportunity to practise clinical skills has changed due to increasing student numbers and structural changes in health services (Nielson et al, 2013), and with a higher degree of specialisation and shorter hospital admissions (Benner et al, 2010). As a result of these changes, the use of simulation as a teaching strategy has become increasingly popular (Sundler et al, 2015), with its use as a teaching and learning method endorsed by the Nursing and Midwifery Council (NMC) (2018a). Nestel et al (2014) suggested that role play with simulated patients facilitates the opportunity for students to immerse themselves in the experience within a protected and controlled environment, and to receive valuable feedback from the patient's perspective. In this role, simulated patients can be viewed as active facilitators of the specific learning outcomes (MacLean et al, 2017). This allows students the opportunity to check that the patient has understood what it is they have to do and to reinforce the patient's learning. A meta-analysis by Shin et al (2015) reported that the simulated patient approach in nursing education is a useful technique to use in addition to traditional learning methods.

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