Perceptions and Implementation of a High-Fidelity Simulation Within the Undergraduate Nursing Curriculum at a University in Saudi Arabia A Qualitative Case Study Research

Abstract

Introduction: Developments in nursing education in the form of various teaching strategies and teacher- and student-centred approaches are evident in the literature. Technology can enhance the delivery of nurse training and education by supporting experiential learning. Various types of simulation exist, including those involving humans, manikins, task trainers, and virtual reality. The concept of 'fidelity’ is used in relation to the level of realism provided by the simulation system and should reflect how closely the appearance and behaviour experienced inside the simulation resemble that of the actual situation being simulated. High-Fidelity Simulation (HFS) refers to a variety of advanced full-body manikins that can replicate human body functions with a high level of realism. Applying HFS, therefore, has the potential to guide practice-focused learning, which may have a strong impact on future nursing practice. HFS can significantly improve learning outcomes for nursing students by providing realistic and immersive experiential learning opportunities. In Saudi Arabia, there are few centres that offer HFS due to its high cost, the limited time available to use it, and lack of experience. Consequently, nursing students and nursing faculty may not experience the benefits of HFS, which may negatively affect clinical practice, the care of patients, and patient safety. Aim: This study aimed to explore nursing faculty and students’ perceptions of HFS and to understand how HFS is being conducted within undergraduate nursing curricula in a university in Saudi Arabia. Design, method, and data analysis: This study followed a qualitative case study design. Nursing students (13) and faculty members (10) were recruited from one university in Saudi Arabia, and data collection included interviews and gathering of eight documents related to curriculum design and HFS briefing/debriefing for analysis using a thematic approach. 12 Findings: The study identified significant curriculum challenges in the planning and implementation of HFS in nursing education. Faculty and students reported issues with variability in simulation module development and practice in simulation, lack of clarity on learning objectives, and insufficient support and training hours. Faculty expressed concerns about inadequate resources and training program features, including debriefing structures, access to HFS resources, and support for staff. Cultural suitability and gender issues also surfaced, impacting students’ comfort and engagement. The findings emphasize the need for a consistent and pedagogically sound approach to HFS curriculum design. Operational challenges and under- preparedness among both faculty and students were noted. Overall, addressing these issues is crucial for optimizing the effectiveness of HFS in nursing education. The findings of this study were used to develop a framework that integrates Kolb's Experiential Learning Theory (ELT) with the socio-cultural and educational factors identified in this research. Dissemination: This study generates insights from nursing faculty members and students that may contribute more broadly to the development of higher-quality nursing education and practices in Saudi Arabia, which may subsequently inform national health policy. Its contribution to knowledge lies in its demonstration of the importance of culturally appropriate HFS for the Saudi context and the need to adapt the learning model underpinning the curriculum to accommodate this approach.