Teaching Associate Degree in Nursing Students Caring Behaviors Using High-Fidelity Simulation: A Basic Qualitative Study

The professional practice of nursing is both an art and science grounded in caring nursing behaviors. Teaching caring behaviors is critical to nursing practice. It is difficult for nurses to demonstrate basic caring behaviors in practice if those behaviors are not a focus within nursing education programs. Teaching and evaluating these behaviors can be challenging due to the subjective nature of the experience. High-fidelity simulation provides an appropriate forum to teach and evaluate caring behaviors. It is important to investigate whether associate degree nursing students feel they can demonstrate caring behaviors in high-fidelity simulation and how these behaviors may influence their future practice as a nurse. The overall purpose of this basic qualitative study is to provide associate degree nursing students with an opportunity to (a) explore their ability to convey caring behaviors in a high-fidelity simulation environment and (b) examine how conveyed caring behaviors are transferred to clinical practice. A purposive sampling strategy approach was used. The population for the study consists of 17 first- and second-year associate degree nursing students enrolled in a community college in the West. Of the 17 students who participated in the focus group sessions, 12 were first-year associate degree nursing students and five were second-year associate degree nursing students. Completion of data collection occurred through the use of two focus group sessions using guided interview questions. Data saturation occurred after two of the four focus group sessions. Recording of the focus group sessions occurred by using an iPad device and a Voice recorder application. These recordings were manually transcribed into a Microsoft Word document and transferred to a Microsoft Excel spreadsheet for qualitative analysis. Data for this study was analyzed using a constant comparative analysis process. Direct quotes from the participants in this study are used and are guided by the principle of authenticity. The two main themes focused on during this study included the demonstration of caring behaviors and the transference of caring behaviors from simulation to the clinical. When discussing the demonstration of caring behaviors three sub-themes emerged: (a) general demonstration of caring behaviors, (b) caring behaviors demonstrated within simulation experiences, and (c) the difference between caring behaviors demonstrated in the simulation environment versus real life. When exploring the transference of caring behaviors from simulation to the clinical setting two sub-themes emerged: (a) influences, and (b) barriers. All 17 participants agreed that there is potential for the transference of the caring behaviors learned and demonstrated in high-fidelity simulation to the clinical setting. Recommendations for future research include completing additional studies related to this topic with a larger and more diverse sample size, evaluating how to best introduce and integrate caring into nursing education programs, and completing additional research focused on simulation and caring behaviors that measure the growth and development of caring behaviors over time