Exploring post-registration nursing students' perceptions and learning experiences of peer-led simulation: A qualitative study

Background: In nursing education, often dominated by instructor-led simulations (ILS), there is a growing demand to explore alternative approaches, such as peer-led simulation (PLS), in the training of post-registration nursing students. PLS shifts learners into leadership roles, fostering scenario design and facilitation among peers. Despite existing literature on ILS versus PLS, there remains a gap in the effectiveness of combined PLS and ILS for post-registration nursing students. This study aims to investigate the factors influencing the learning experience of post-registration nursing students and their perceptions of PLS as an instructional strategy. Methods: This qualitative study was implemented from October 2022 to April 2023. The entire student cohorts (n n = 20) were recruited from the Advanced Diploma in Nursing (Peri-anaesthesia) programme. The students underwent both ILS (14h) and PLS (11h) as part of the mandatory activities within a 60-h module on "Crisis Management in Anaesthesia". Three semi-structured focus group discussions (FGDs) with 16 participants were conducted. The FGDs were guided by six questions on students learning experiences that were validated using the Delphi method. Results: The thematic analysis revealed four major themes concerning their learning experiences: the learning journey, enablers, barriers and perceived benefits of including PLS. Among the enablers, one notable finding was learners' appreciation for their ability to apply evidence-based practice (EBP) principles, which played a significant role in achieving conceptual fidelity in their developed scenarios. Conclusion: The qualitative findings underscore the importance of PLS in fostering dynamic learning environments, vital for educators across disciplines. By actively participating in scenario design and facilitation, students enhance their understanding of theoretical concepts and clinical competency. PLS implementation provides insights into students' learning needs and challenges, benefiting educators in refining teaching strategies and enhancing educational effectiveness.