Using in-situ simulation in undergraduate nursing clinical examination: Lessons and perspectives of educators and students from Sultan Qaboos University, Oman

Abstract

Undergraduate nursing education traditionally separates theoretical learning from clinical practice, often creating a gap between what students learn and how they apply it in real settings. To bridge this gap, simulation has emerged as a powerful tool for integrating theory and practice while enhancing students’ problem-solving skills. In-situ simulation, conducted within hospital environments, was introduced in Fall 2022. The objectives of this study are (1) to explore students' and faculty's experience with using in-situ simulated examinations, (2) to identify challenges and lessons from using in-situ simulated clinical examinations, and (3) to identify strategies to improve in-situ simulated clinical hospital-based examinations. Qualitative data were collected from eight student focus group interviews and eight in-depth interviews involving faculty members. Participants were purposively selected, and informed consent was obtained before data collection. A reflexive thematic analysis approach was used to analyze participant data. In-situ simulation provided authentic, real-life learning opportunities that better reflected clinical realities. The experience was both challenging and rewarding, since hospital-based simulations exposed learners to real noise, distractions, and teamwork dynamics. Educators were also able to assess students’ performance under realistic conditions. The study concludes that in-situ simulation should be prioritized in nursing education as it effectively bridges the theory-practice gap and prepares students for the complexities of real clinical environments.