Objective: To view simulation as a learning method in the light of learning theories and to describe the student's reflections and experiences of simulating anaphylaxis during vaccination. Design and Sample:Public health nursing students at a university in Norway simulated scenarios related to anaphylaxis during vaccination of an infant. The aim of the intervention was to facilitate the competence of public health nurses to handle unforeseen events associated with vaccinations. The students wrote reflection notes about their experiences after the simulation. The reflection notes were analyzed using qualitative content analysis. Results:The students experienced simulation as a realistic educational method with feelings of stress in an acute situation. They discovered the importance of cooperation and communication to avoid misunderstandings that could lead to serious failure in the treatment. The students emphasized that simulation gave them a preparation for practice to handle anaphylaxis associated with vaccines. Conclusion:The public health nurse students experienced simulation as a realistic and effective educational method. Simulation made them reflect on the public health nurse's area of responsibility. Kolb's learning theory and Schön's theory of knowledge-in-action, may explain how simulation as a didactic method develops competence to act in a concrete situation of anaphylaxis by vaccination of children. K E Y W O R D Sacute situations, anaphylaxis, public health nurse education, simulation, skills, vaccination

Background In the national education plan for Bachelor of Nursing in Norway, it is emphasized that focus areas for practical studies must include experience related to paediatric nursing. However, given the paucity of children’s wards in Norwegian hospitals, few students are offered this. The purpose of this study is to explore undergraduate nursing student’s perception of using simulation as a learning method to obtain knowledge and skills in delivering quality healthcare to children and their parents in emergencies. Method A total of 36 students participated in focus groups. The students were asked to reflect on their learning outcomes regarding the educational method during the simulation. In addition, the students were encouraged to discuss whether this pedagogical method was useful in preparing them to deal with critical medical situations in relation to children and their parents. The interviews were transcribed and analyzed using qualitative content analysis. Results Three subjects emerged from the analysis. The first, simulation as an educational method, showed that the students thought that simulation gave a greater degree of realism and seriousness than other learning activities. The second subject, preparedness for later practice, showed that the students perceived simulation as one of the ways in which they were best prepared for the profession as a nurse. The students emphasized the benefit of having concentrated on children and their parents. The third subject, stress and leadership, showed that simulation as a method was stressful to most students, and lack of knowledge and anxiety about conducting other students kept them from taking the lead. However, the students experienced that they learned a lot about themselves and how they appear as nurses. Conclusion The bachelor-level student nurses experienced simulation as a realistic and effective educational method for gaining knowledge in the critical healthcare of children and their parents. Simulation made them reflect on a nurse’s area of responsibility in emergencies. When offered practical experience in children’s wards, the use of simulation as a didactic method may help students develop sufficient competence to act appropriately and expediently in critical paediatric nursing settings. Trial registration The study (number 52776) was approved by the Norwegian Centre for Research Data.

In this chapter, results from three different studies about simulation as a learning method are presented and discussed alongside relevant pedagogical theory and other research. These studies were conducted at a university in Norway from 2018 to 2020. The studies used a qualitative approach, and reflection notes and focus group interviews were used to collect data. The participants (81 students in total) were bachelor of nursing students 2nd year public health nursing students, and students in teacher training (healthcare). The interviews were conducted shortly after the students had performed the simulation activity. The students expressed that the simulation provided a higher degree of realism and seriousness than skill training did. They felt that the simulation was an educational method in which they experienced realistic feelings and stress in a serious situation. The students learned that in an emergency, good communication is important to make the right decision. The simulation was perceived as one of the most effective ways to prepare themselves for the profession of nursing. They experienced learning through describing the course of events during the debriefing process and obtaining feedback from other students to reveal the gaps in their knowledge.

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