Undergraduate nursing simulation facilitators lived experience of facilitating reflection-in-action during high-fidelity simulation: A phenomenological study.

Background: Reflective practice is an essential step to learning in high-fidelity simulation, yet, reflection-in-action is an often overlooked yet important opportunity to support student learning.

Objectives: To explore and describe the lived experience of undergraduate nursing simulation facilitators use of reflection-in-action during high-fidelity simulation.

Design: A descriptive phenomenological study.

Setting: A western Canadian province.

Participants: Undergraduate nursing simulation facilitators with experience in nursing education and simulation facilitation.

Methods: We conducted 11 semi-structured interviews and utilized Colaizzi's seven step process of analysis to discover the essence of undergraduate nursing simulation facilitators use of reflection-in-action during high-fidelity simulation.

Results: Simulation facilitators were able to identify reflection-in-action during high-fidelity simulation when students paused, collaborated, shared their thinking aloud, and changed their course of action. Barriers to reflection-in-action included learner fear and anxiety, poor simulation design, and inadequately prepared students and facilitators. Simulation facilitators supported reflection-in-action through prebriefing, facilitator curiosity, and providing cue, prompts, and facilitated paused. Some of the noted benefits to reflection-in-action include promoting collaborative learning, building confidence and critical thinking, and embedding reflection into practice.

Conclusions: The insights from this research can be used to guide reflection-in-action strategy development and future research in high-fidelity simulation.