What are the Types of Simulation in Nursing Education? (PLUS, Pros VS. Cons, & Tips to Make the Most of it)
Written By:
Sarah Cruzan
Sarah Cruzan RN, BSN
Sarah Cruzan is a registered nurse with 6 years of hospital, sales, and education experience. She is passionate about engaging clients and providing exceptional care. Sarah was a competitive swimmer for 15 years. She received a scholarship to The Ohio State University and swam varsity for 4 years. Read Full Bio »» RN, BSN
If you are in nursing school or preparing to go to nursing school, you have probably heard about simulation in nursing education. I love nursing and nursing education, and one of the things I enjoyed most as a nursing student were the opportunities to learn through simulation exercises and experiences.
If you are new to nursing, you may not know much about nursing simulations. You may wonder, “What are the types of simulation in nursing education?” In this article, we will dive deep into the various types of nursing simulations, their pros and cons, and frequently asked questions. When you finish this article, you will have a clear understanding of what to expect in simulations.
What Exactly is The Purpose of Simulation in Nursing Education?
You may be asking yourself, what exactly is the purpose of simulation in nursing education? You can only learn so much from a lecture or studying a textbook. It is important to experience a variety of nursing simulations and scenarios so that you are prepared to be a bedside nurse.
Simulations are designed to create an environment similar to a healthcare or hospital setting for you to practice your nursing skills and expertise. Simulations in nursing education are the perfect opportunity for you to apply the knowledge and skills that you have learned in your nursing classes.
Ensuring you have a school that prepares you with the right simulations is important. Accredited nursing programs typically follow guidelines established by the
National Council of State Boards of Nursing (NCSBN) to guide them in preparing curriculum plans with appropriate simulation experiences. These guidelines are designed to help schools create successful simulations to prepare nurses for real-life scenarios. The National Simulation Guidelines also provide helpful
checklists for schools and faculty to use in order to grade students on their overall competency during a simulation.
3 Main Pros of Simulation in Nursing Education
From my experience in nursing school, I can guarantee you will be excited when it comes to time for simulations. After all, as you practice your skills in simulations, you will begin to feel what it is like to be a real nurse! Simulation has several advantages in nursing education. The following are three of the main pros of this part of your nursing education.
Pro #1: You will have the opportunity to try out your nursing skills in a risk-free setting.
The simulation environment provides a risk-free setting for you to test out your skills without having to worry about harming a patient. Having the ability to practice your nursing skills on a mannequin or with basic nursing supplies will give you the confidence when it comes time to perform the skill on a patient. You will learn hands-on skills and techniques in a risk-free, controlled environment with your instructors leading the way!
Pro #2: You will get the chance to put your critical thinking skills to the test.
All throughout nursing school, you will hear the term "critical thinking." Simulations are one of the best ways to practice this abstract concept and begin to understand how important it is for nurses. As you practice simulations, your instructors will challenge you to “think outside the box” and consider every possible option for a solution to the problem posed in your simulation exercises.
For example, when I was in nursing school, I had a simulation scenario in which an elderly patient in hospice had consistent nighttime cognitive issues. Upon first glance, I remember thinking that this was probably caused by the massive combinations of medications and painkillers that the patient was on. However, as my instructor prompted me to look at the full picture of the patient, I began to use critical thinking skills. I realized the patient actually had a urinary tract infection caused by his catheter.
Pro #3: You will have the opportunity to collaborate and communicate with your fellow nursing students.
There are times in nursing school that you may feel like you are competing with classmates as you challenge one another to see who gets the highest grade. There is nothing wrong with a little friendly competition! The wonderful thing about simulation in nursing education is that, although simulations are challenging, these learning experiences help you learn to collaborate with your peers, which is essential for strong healthcare teams.
3 Main Cons of Simulation in Nursing Education
Just as there are advantages to simulation in nursing education, there are some disadvantages to consider. Since everyone has different experiences, the cons of nursing simulations may be a matter of opinion. The list below includes the three main cons of simulation in nursing education.
Con #1: Nursing simulations can be very stressful!
Nursing school can be very stressful, and simulation experiences in nursing school are no exception. The important thing to remember is that these scenarios are designed to be stressful, but they will ultimately prepare you for becoming a successful nurse.
I remember when I was in nursing school, I was so nervous and stressed out before a nursing simulation that my hands were shaking uncontrollably. However, when the simulation began, I took a deep breath and focused on the steps I needed to follow to help the patient. When the simulation was over, I remember thinking how silly it had been to be so nervous because I got through very well. I realized just how important the simulation was for my nursing education.
Con #2: Sometimes, feedback can be difficult to hear, especially if you need to improve the skill.
After completing a simulation, there is usually a debrief or discussion regarding your performance. It can be difficult to hear feedback as a nursing student, even if it is meant to be constructive. It is important to remember that receiving feedback is a necessary part of any job. Try not to take the feedback personally and apply it to your growth as a nursing student.
Con #3: You will be put on the spot and required to think critically during simulations.
During any nursing simulation, you are put on the spot and required to think on your feet. If you get social anxiety or are shy, you may find simulations in nursing education difficult.
I remember being very shy during nursing school; I did not like to be put on the spot, even during a nursing lecture. During one of my first nursing simulations for CPR/first response, I was picked to be the lead nurse who came onto the scene first. I thought that I would crumble under the pressure of having to think, react, and speak first. However, my nursing instincts kicked in, and I led the simulation successfully!
Remember, it is perfectly natural to be nervous! Just take a deep breath and gather your thoughts before responding. You’ve got this!
What are the Types of Simulations Used in Nursing Education?
(The following are the 10 types of simulations used in nursing education and how they help students.)
Type Of Simulation #1: Instructor-led scenarios.
About the Simulation:
An instructor-led scenario is exactly what it sounds like: a simulation led by your nursing professors. In this type of simulation, your nursing professor will lead the scenario, usually pretending to be the patient. They will explain the scenario and act out the patient’s role, and you will have to respond appropriately.
For example, I remember when I was in nursing school, my professor led a scenario where I had to walk into a patient's room and find the patient on the floor. My professor was playing the role of the patient who had fallen on the floor, and I had to respond.
How it Helps Students:
During an instructor-led scenario, you will be working with a “live” pretend patient, aka your professor, who can verbally and physically respond to you. During the scenario where my professor was pretending to be a patient who had fallen on the floor, my professor challenged me by being a difficult patient who did not want to be helped up from the floor. As difficult as this scenario was, it really helped prepare me for being a bedside nurse.
Type Of Simulation #2: Group scenarios
About the Simulation:
During a group scenario, you will be grouped with three to five of your peers and given a script or scenario to act out. For example, one person could be the head nurse, one person the patient, and one person the charge nurse. You will then take turns rotating through the different roles.
How it Helps Students:
Group scenarios are a great type of simulation in nursing education because they can help you understand a simulation scenario from multiple perspectives. It is important for you to understand not only your role as a nurse but also the perspective of a patient or your charge nurse.
Type Of Simulation #3: Simple Mannequins
About the Simulation:
During a simple mannequin simulation, you will be working with a mannequin or part of a mannequin (like a pelvis or an arm) to use during the simulation. You will be required to perform a skill on the mannequin, such as catheter insertion, IV insertion, or many other skills.
How it Helps Students:
I always liked the concept of simple mannequin simulations because they help you practice basic nursing skills without the risk of harming a patient. It may take you fifty tries to successfully insert an IV on an arm mannequin or to insert a catheter on a pelvis mannequin. Being able to practice these skills in a risk-free environment on a mannequin that does not fight or feel pain will make it much easier for you to relax and learn. Then, you can feel more confident when it comes time for you to perform the skill on a real-life patient.
Type Of Simulation #4: Case studies
About the Simulation:
Case studies are designed to help you learn how to apply your critical thinking skills and nursing knowledge to a scenario. Most case studies will be in written format that provides a patient scenario and background to which you will respond in your own words.
For example, you could get a case study background that describes nurse’s notes on a patient who arrived in the ER with hypertension and chest pain. Your job would be to write out your observations, your response to the situation, and the possible outcomes.
How it Helps Students:
I will not lie to you; case studies were my absolute least favorite form of simulation in nursing school. I spent hours writing out my response to each case study simulation. However, looking back, I can confidently say that case studies helped me a great deal.
Case study simulations help students by challenging them to use their critical thinking skills to assess and respond to different types of patient situations.
Type Of Simulation #5: Role-playing
About the Simulation:
During a role-play simulation, you can expect your instructor or fellow classmates to have a script or scenario that they read from, and you will be expected to respond appropriately. For example, your teacher may play the role of a patient, and then you would play the role of the nurse during medication administration. As a nurse, you would be expected to act out the steps of administering medication, like washing your hands, scanning the medication, and checking the five rights of medication administration (correct patient, drug, dose, time, and route).
How it Helps Students:
Role-playing gives students a chance to see how well they remember what they have been studying. Also, role-playing can help students overcome the anxiety that may come with talking to patients.
I remember being great at studying in nursing school, but when it came time for a role-playing simulation, I would freeze up and forget everything! I had to challenge myself to get over my social anxiety and learn to be confident.
Type Of Simulation #6: Video simulations
About the Simulation:
There are several different types of video simulations available online through YouTube or sites like
Montgomery College that instructors often assign to students. The video simulations are usually 15-30 minutes in length and portray someone performing a specific skill or scenario. For example, you can find videos online demonstrating medication error scenarios, code blue scenarios, and much more. After the video has ended, you will have time to reflect and identify key points that were important to the simulation.
How it Helps Students:
Video simulations are a great way for you to understand what to expect from nursing simulations or real-life scenarios at the bedside. When I was in nursing school, I loved the fact that I had the ability to rewatch the video simulations as many times as I needed. Every time I rewatched the video, I would catch something new that I had missed before.
Type Of Simulation #7: Computer-controlled mannequins
About the Simulation:
Computer-controlled mannequins are a combination of simple mannequins and audio or physical manipulation behind the scenes. For example, it may appear to be the same abdominal mannequin you just practiced CPR on, but this mannequin can talk and interact with you! Your professors will be in another room speaking for the mannequin and causing a sequence of events to unfold in front of you. Your job is to respond verbally and hands-on in order to assist the "patient."
How it Helps Students:
In my opinion, computer-controlled mannequins are the best form of simulation because they combine multiple forms of simulation into one. I really enjoyed being able to practice my skills, interact with a "patient," and role-play a scenario. These simulations for me were the best way for me to practice my skills and grow my knowledge.
Type Of Simulation #8: Virtual reality (VR)
About the Simulation:
Virtual reality (VR) simulations are one of the newest innovations in the nursing education world. With this new technology, you can visually immerse yourself in the simulation and then physically act out the scenario in the virtual world. VR technology consists of a standard VR headset and hand device controllers. The simulation video/scenario is typically provided by a company like
Ubisim. Ubisim has a variety of nursing
scenarios, such as blood transfusions and taking care of a COVID-19 patient.
How it Helps Students:
VR simulations are extremely helpful for nursing students because they help you become immersed in a realistic nursing scenario. While in the VR simulation, you can play around and test out your skills.
Type Of Simulation #9: The difficult patient simulation.
About the Simulation:
As the name suggests, the “difficult patient simulation” deals with different scenarios where a patient may pose challenges to providing nursing care. I remember when I was in nursing school, I had one teacher who loved to play the "difficult patient" role. For example, during our gait belt simulation, she would pretend to be a patient who did not want to get out of bed and complained that the gait belt was uncomfortable. I had to respond to her complaints, educate her on why it was important to get out of bed, and then safely get her to the restroom.
How it Helps Students:
Not all patients are compliant or willing to work with you. Therefore, it is important to learn how to respond in situations when their behavior is less than accommodating. Difficult patient simulations give you a chance to think of ways to respond to challenging patients and provide care that is safe and error-free.
Type Of Simulation #10: Basic skills simulations
About the Simulation:
During a basic skills simulation, you will have the opportunity to practice a nursing skill step by step. For example, spiking and priming an IV line, pulling up medication from a vial with a filter needle, or giving an injection.
How it Helps Students:
Basic skill simulations are the foundation of your nursing skill set. Learning basic skills in simulations helps you develop good techniques and become experienced at completing specific nursing tasks. When you learn these skills in the simulation lab, where there is less pressure, you can develop the confidence and skills needed to perform the same skills at your real patient's bedside.
7 Tips for Nursing Students to Make the Most of Their Simulation Training
Simulation in nursing education is one of the best ways to learn how to be a bedside nurse. Books and classes cannot teach you everything you need to know. Therefore, hands-on simulation experiences are vital, and taking simulations seriously will help you get the most out of your experience. Here are seven tips for nursing students to make the most of their simulation training.
Tip #1: Mentally practice ahead of time.
Spend a few minutes closing your eyes and mentally acting out the nursing scenario before the real simulation. By playing out the scenario in your mind, you can think about different ways to address the situation/scenario before completing the simulation exercise.
Tip #2: Take a few deep breaths before you begin.
Remember, when you begin simulations, you may be nervous, but you have classmates who are learning with you and experiencing the same thing. It is perfectly normal to be nervous! Take a few deep breaths and try to relax. Also, keep in mind that your instructors do not expect you to be perfect. This is a learning experience!
Tip #3: Learn to take feedback with a positive attitude.
During every nursing simulation, oral or written feedback will be given to you. It can be easy to feel defeated by not passing a simulation or receiving negative feedback. However, remember that your instructors are there to help you. It is critical for your success that you learn how to take feedback (even if it feels critical) and grow from it.
Tip #4: Break down the scenario into steps.
Every scenario in simulation in nursing education has some type of complex situation that has many different steps and outcomes. If you take a moment to simply break down the different steps needed to help a patient, this will make the simulation easier to tackle. For example, if you see a patient who has collapsed on the street, think of the first steps that you need to take to secure the scene and call for help. From there, your next steps will be clearer.
Tip #5: Don’t let mistakes make you feel frustrated.
It can be easy to get frustrated when you make a mistake during your simulation. Always remember the whole purpose of simulation in nursing education is to give you learning opportunities in a secure environment. You WILL make mistakes, but you can learn from them and move forward!
Tip #6: Study with a partner or a group ahead of time.
When you study with fellow classmates, you can learn about your strengths and weaknesses. You may be good at talking with patients, while your partner may be good at implementing safety precautions. Together, you can collaborate and learn from each other.
Tip #7: Ask for help!
There is no shame in asking for help. If you find yourself struggling to pass a nursing simulation, ask your professors or mentors for assistance. We have all been there at some point!
My Final Thoughts
In this article, you explored the importance of simulation in nursing education and learned the answer to, “What are the types of simulation in nursing education?” With the tips from this article, you are well on your way to making the most of your nursing simulations! Now, take a deep breath and face your simulations head-on! You can do this!
Frequently Asked Questions Answered by Our Expert
1. Are Simulations In Nursing Education Realistic?
Although in a real bedside nursing environment, there are variables or curveballs thrown your way that are hard to simulate, simulations in nursing education are designed to be as realistic as possible.
2. What Type Of Simulation Is Most Commonly Used In Nursing Education?
Each nursing school has access to a variety of different simulations based on their funding or resources. A school with a vast supply of resources would likely use VR or computer-based mannequins for many of their simulations. At the same time, a school with fewer resources may rely on simple mannequins and role-playing. One of the most popular nursing simulations that are cost-effective and highly effective are case studies because they are easy to use and in a written format.
3. What Is Virtual Simulation In Nursing Education And How Does It Differ From Physical Simulations?
A virtual simulation in nursing education consists of e-learning, computer, or virtual reality simulation. During these simulations, you are not physically acting out the scenario; rather, it is being acted out on the computer by you, or you are watching a video.
4. How Do Nursing Students Measure The Effectiveness Of Simulations?
You may find that certain types of simulations are more effective for you than others. Some people are hands-on learners and need to physically perform a skill to learn it, while other people learn best by watching videos. The true measure of the effectiveness of simulations is evident when you begin providing in-person care to patients.
5. What Is A Debriefing Session In A Simulation?
After you participate in a simulation, you will be asked to debrief with your nursing instructors. Debriefing is an excellent time to receive positive feedback and constructive criticism. When I was in nursing school, I would often dread the debriefing sessions because I didn’t want to know what I had done wrong during the simulation. However, remember that these debriefing sessions are not meant to hurt your feelings. They are there to help you grow as a nurse!
6. How Often Do Nursing Students Participate In Simulations?
Students can expect to spend about 25-50% of their clinical hours in nursing simulations. Most schools will spread out their simulations over several quarters and various classes to give students a well-rounded simulation experience.
7. Can Nursing Students Tailor Simulation Experiences To Align With Their Goals?
Many nursing programs allow nursing students to tailor their simulation experiences to align with their goals. For example, if your goal is to become a charge nurse or nursing manager one day, ask your nursing instructor if you can mentor other students who are struggling to pass their simulation classes. You could also ask your professors if you could lead a role-play simulation.
List Of Sources Used For This Article
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https://nursejournal.org/resources/types-of-simulation-in-nursing-education/
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https://nursejournal.org/resources/expanding-distance-education-in-nursing/
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https://nursejournal.org/resources/clinical-experience-for-online-nursing-students/#:~:text=Average%20Required%20Clinical%20Hours%20by,vary%20by%20program%20and%20state.
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https://www.unitekcollege.edu/blog/a-step-by-step-guide-to-administering-medications/
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https://ems-works.com/blog/content/types-of-simulation-in-nursing-education/
Sarah Cruzan, RN, BSN
Sarah Cruzan is a registered nurse with 6 years of hospital, sales, and education experience. She is passionate about engaging clients and providing exceptional care. Sarah was a competitive swimmer for 15 years. She received a scholarship to The Ohio State University and swam varsity for 4 years.