“Better a one-dimensional image than no image at all” – an interview study on nursing educators’ views on patient-perspective simulations

TL;DR

This study explores how nursing educators in Germany use and perceive patient-perspective simulations in teaching, highlighting their educational value and limitations.

Contribution

The study provides new insights into nursing educators' perspectives on patient-perspective simulations, emphasizing their role in fostering reflection and sensitivity.

Findings

Educators see simulations as valuable for encouraging reflection and creating relevant learning experiences.

Psychological safety and group dynamics are crucial for effective implementation.

Simulations are seen as approximations, not full imitations of patient experiences.

Abstract

Patient-perspective simulations are frequently implemented in nursing education to help students reflect on the lived realities of those they will care for. However, little is known about how educators who design and facilitate these exercises perceive and implement them.

We conducted 16 semi-structured interviews with nursing educators from eight nursing schools in Germany, covering both vocational and academic programmes. Data were analysed using grounded theory methodology to explore educators’ perspectives on the purpose, implementation, and perceived impact of patient-perspective simulations.

Through the process of coding, three themes with subthemes were identified. Theme 1 Educational purposes of patient-perspective simulations highlights educators’ views on the value of these exercises, what their aims are, making learning enjoyable, and creating relevant experiences. Theme 2 Creating an environment of trust demonstrates that psychological safety and group dynamics are important. Theme 3 “It’s approximation – not imitation” reflects educators’ awareness that such exercises cannot replicate patients’ lived experiences completely, but can serve as valuable entry points for reflection if appropriately guided and debriefed.

Overall, educators regarded patient-perspective simulations as an effective means of encouraging reflection, and greater sensitivity to the patients’ experiences, while also acknowledging their limitations. Educators play an important role in framing and guiding these exercises to prevent oversimplification, manage group dynamics, and create meaningful learning.

The online version contains supplementary material available at 10.1186/s12912-026-04397-2.