Using simulation with Simulated Patients and Peer Role-play for adverse event disclosure training in an undergraduate nursing program
: A comparative study

Student thesis: Doctoral ThesisDoctor of Education (EdD)


Adverse events (AE), occur inevitably in the healthcare system. However, many healthcare professionals receive insufficient training in adverse event disclosure (AED), especially in terms of handling such emotionally charged situations. Simulation training may help in overcoming these difficulties but needs further study to find the optimal teaching method for AED training. The aim of this practitioner research study was to find the optimal way of applying AED in the nursing curriculum. Mixed methods were used to compare the learning variables in two approaches to simulation-based AED training with Simulated Patients (SP) and Peer Role-Play (PRP) along with their effects in a longitudinal follow-up. The experiential experience of the stakeholders, i.e. students, SP and the teaching faculty, were also explored.
Results showed that the performance and the self-efficacy in groups using SP were both significantly higher than PRP groups in two out of three measured constructs, namely professionalism and emotions. In relation to anxiety, the SP groups had a lower score for the item “I am worried” compared with the PRP groups. Finally, there was no difference between groups in terms of their satisfaction and self-confidence in learning and simulation design characteristics. In a follow-up workshop, the differences between the two teaching methods were less, with only the performance in the professionalism construct being significantly different between the groups. This changed from SP being higher than PRP, to PRP being higher than SP in the end. Other learning variables such as self-efficacy, anxiety and satisfaction and self-confidence did not show a significant difference between groups.
Moreover, the study demonstrated that students used reflection from the observation of their peers, facilitator and the SPs to strengthen their learning. Finally, this study also suggested that cooperation between the SP and the School using the simulation is important and different learning resources and simulation environments were needed for different groups.
Date of Award24 Mar 2020
Original languageEnglish
Awarding Institution
  • University of Bristol
SupervisorWilliam J Browne (Supervisor)

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