Perceptions of staff and students of the role of clinical simulation on students’ ability to perform academically

Main Article Content

S Sobuwa


Background. The Bachelor of Emergency Medical Care (BEMC) uses clinical simulation for teaching, learning and assessing students. The voices of staff and students in understanding how simulation affects academic performance in paramedic students have not been studied before.
Objective. To understand the aspects of clinical simulation assessments that might lead to underperformance in the BEMC degree.
Methods. An exploratory qualitative approach was used in this study. Twelve focus groups and eight semi-structured interviews were conducted with students and academic staff, respectively, at the four universities that offer the BEMC in South Africa. The data were thematically analysed using NVivo 11.
Results. Five themes emerged from the study: These included: (i) environmental realism; (ii) stress during simulations; (iii) cognitive process dimension; (iv) classroom-based v. field-based practicals; and (v) static evolution of simulation practice.
Conclusion. While clinical simulation is a useful educational tool for training health professions students in patient management, there are pitfalls that result in student underperformance


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Perceptions of staff and students of the role of clinical simulation on students’ ability to perform academically. (2023). African Journal of Health Professions Education, 15(3), 16-20.
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Perceptions of staff and students of the role of clinical simulation on students’ ability to perform academically. (2023). African Journal of Health Professions Education, 15(3), 16-20.


Jones F, Passos-Neto C, Braghiroli O. Simulation in medical education: Brief history and methodology. Principles Pract Clin Res 2015;1(2):56-63.

Lestander Ö, Lehto N, Engström Å. Nursing students’ perceptions of learning after high fidelity simulation: Effects of a three-step post-simulation reflection model. Nurse Educ Today 2016;40:219-224. https://doi. org/10.1016/j.nedt.2016.03.011

Campbell RG, Labuschagne MJ, Bezuidenhout J. Perspectives of advanced life support paramedics on clinical simulation for summative assessment in South Africa: Is it time for change? Afr J Health Professions Educ 2018;10(3):183-188.

Bong C, Lightdale J, Fredette M, Weinstock P. Effects of simulation versus traditional tutorial-based training on physiologic stress levels among clinicians: A pilot study. Simul Healthcare 2010;5(5):272-278. https://doi. org/10.1097/SIH.0b013e3181e98b29

LeBlanc V, Regehr C, Tavares W, Scott A, MacDonald R, King K. The impact of stress on paramedic performance during simulated critical events. Prehosp Disaster Med 2012;27(4):369-374. S1049023X12001021

Piquette D, Tarshis J, Sinuff T, Fowler R, Pinto R, LeBlanc V. Impact of acute stress on resident performance during simulated resuscitation episodes: A prospective randomised cross-over study. Teach Learn Med 2014;26(1):9-16.

Demaria S, Bryson E, Mooney T, et al. Adding emotional stressors to training in simulated cardiopulmonary arrest enhances participant performance. Med Educ 2010;44(10):1006-1015. 2923.2010.03775.x

LeBlanc V, MacDonald R, McArthur B, King K, Lepine T. Paramedic performance in calculating drug dosages following stressful scenarios in a human patient simulator. Prehosp Emerg Care 2005;9(4):439-444. https://doi. org/10.1080/10903120500255255

Kuhnell R, Whitwell Z, Arnold S, et al. Assessing the association of university stress and physiological reactivity with decision-making among students. Stress 2020;23(2):136-143. 10. Stein C. The effect of clinical simulation assessment on stress and anxiety measures in emergency care students.

Afr J Emerg Med 2019;10(1):35-39.

Sweller J. Element interactivity and intrinsic, extraneous, and germane cognitive load. Educ Psychol Rev


Debue N, van de Leemput C. What does germane load mean? An empirical contribution to the cognitive load theory. Front Psychol 2014;5.

Sobuwa S, Lord B. A self-determination theory perspective on student success in attaining an emergency care degree. Afr J Health Professions Educ 2019;11(4):114-117.

Sobuwa S, Christopher L. Emergency care education in South Africa: Past, present and future. Australasian J Paramed 2019;16:01-05.

Giordano NA, Whitney CE, Axson SA, Cassidy K, Rosado E, Hoyt-Brennan AM. A pilot study to compare virtual reality to hybrid simulation for opioid-related overdose and naloxone training. Nurse Educ Today 2020;88:104365.

Kennedy DM, Jewell JJ, Hickey JE. Male nursing students’ experiences of simulation used to replace maternal- child clinical learning in Qatar. Nurse Educ Today 2020;84:104235.

Romero-Collado A, Baltasar-Bagué A, Puigvert-Viu N, Rascón-Hernán C, Homs-Romero E. Using simulation and electronic health records to train nursing students in prevention and health promotion interventions. Nurse Educ Today 2020;89:104384.

Tun J, Alinier G, Tang J, Kneebone R. Redefining simulation fidelity for healthcare education. Simul Gaming 2015;46(2).

Lapkin S, Levett-Jones T. A cost–utility analysis of medium vs. high-fidelity human patient simulation manikins in nursing education. J Clin Nurs 2011;20(23-24):3543-3552.

Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Med Educ 2012;46(7):636-647.

Leighton K, Dubas J. Simulated death. Clin Simul Nurs 2009;5(6):e223-e230. ecns.2009.04.093

Guerrero J, Hafiz A, Eltohamy N, Gomma N. Repeated exposure to high-fidelity simulation and nursing interns’ clinical performance: Impact on practice readiness. Clin Simul Nurs 2021;60:18-24. ecns.2021.06.011

Lioce L, Lopreiato J, Downing D, et al. Healthcare Simulation Dictionary. 2nd ed. Agency for Healthcare Research and Quality (AHRQ): Rockville, MD, 2020.

Massoth C, Röder H, Ohlenburg H, et al. High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students. BMC Med Educ 2019;19(1).

Clarke S, Horeczko T, Cotton D, Bair A. Heart rate, anxiety and performance of residents during a simulated critical

clinical encounter: A pilot study. BMC Med Educ 2014;14(1):153.

Kharasch M, Aitchison P, Pettineo C, Pettineo L, Wang E. Physiological stress responses of emergency medicine residents during an immersive medical simulation scenario. Disease-A-Month 2011;57(11):700-705. https://doi.


Arora S, Russ S, Petrides K, et al. Emotional intelligence and stress in medical students performing surgical tasks.

Acad Med 2011;86(10):1311-1317.

Mills B, Carter OB, Ross NP, Quick JK, Rudd CJ, Reid DN. The contribution of instructor presence to social evaluation anxiety, immersion and performance within simulation-based learning environments: A within- subject randomised cross-over trial with paramedic students. Australasian J Paramed 2016;13(2). https://doi.


Kaddoura M, Vandyke O, Smallwood C, Gonzalez KM. Perceived benefits and challenges of repeated exposure

to high fidelity simulation experiences of first degree accelerated Bachelor nursing students. Nurse Educ Today


Wheelahan L, Moodie G. Rethinking skills in vocational education and training: From competencies to capabilities. (accessed 23 June 2023).

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