# An immersive mirror: a descriptive study of peer observer and active participant experiences in simulation

## TL;DR

This study explores how nursing students experience simulations as peer observers and active participants, highlighting the role of empathy and immersive learning in improving nursing practice.

## Contribution

The study provides new insights into peer observer experiences in nursing simulations and emphasizes empathy as a key learning component.

## Key findings

- Peer observers experience simulation as immersive and emotive, indicating active learning.
- Empathy experienced by observers should be integrated into simulation debriefing and nursing theory.
- Simulation design should prioritize observer empathy and cognitive processing.

## Abstract

There is limited evidence and humanistic thinking about the thoughts and reactions of peer observers during nursing simulation. An increased understanding may provide new insights and opportunities to advance therapeutic relationships and holistic care. This study explored peer observer and active participant thoughts during simulation to better understand how shared learning experiences transform and improve nursing practice.

A qualitive descriptive design generated data via peer observers and active participants’ self-reported experiences from pre-registration second-year, nursing students. Responses were synthesized and analyzed using reflexive thematic analysis.

From 175 peer-observer accounts, four codes were generated and synthesized into three themes: Observer self-critique and critique of others; observer empathy and affect; and observers’ outsider perspective. Six codes were generated from the analysis of 234 active participant accounts analysis and synthesized into three themes: participant affect; participant cognition and participant confidence.

The peer observer role can experience simulation as an immersive and emotive encounter that may indicate active and deep learning is occurring. Simulation learning design should prioritize the identification of empathy experienced by observers for the participants and explicitly include it in cognitive processing undertaken during simulation debrief. Linking the experience of empathy with nursing theory in simulation is a powerful learning tool.

The online version contains supplementary material available at 10.1186/s41077-025-00395-7.