• Sok Ying Liaw, Sally Wai-chi Chan, Albert Scherpbier, Jan-Joost Rethans, and Gim Gim Pua.
• Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. nurliaw@nus.edu.sg
• Resuscitation. 2012 Mar 1;83(3):395-8.

BackgroundA simulation program was implemented in a pre-registration nursing curriculum for developing nursing students' performances in assessing, managing and reporting in relation to patients with physiological deterioration.AimTo explore nursing students' experiences of how a simulation programme has prepared them to transfer their performance to clinical practice, in their encounters with deteriorating patients in ward.MethodA qualitative study using a critical incident technique was conducted. After they had undertaken a simulation program, fifteen undergraduate nursing students, who had encountered deteriorating patients in their clinical practicum in wards were interviewed using semi-structured questionnaires. Content analysis was used to analyse the data.ResultsFour main themes emerged describing key factors influencing the transfer of simulation learning to clinical practice; memory, involving simulation learning enhanced storage and retrieval of knowledge; mnemonics as transfer tools for performing systematic physical assessment and reporting a patient's deterioration to a doctor; recognizing similar situations, where students used experiences from similar simulation situation to identify problems and initiate nursing interventions for their patients; and finally, emotional responses, that have both negative and positive impacts on transferring their simulation learning. Two other main themes emerged regarding strategies to facilitate transfer; self-directed learning for promoting the retention of simulation learning; and, realism, where simulated patients could be used to provide real-life clinical experiences.ConclusionThe findings provide an understanding of how a simulation program may impact on the nursing students' performances in clinical practice, which is useful information for future improvement of programmes to optimize learning and transfer effective care to patient care settings.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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