An investigation of knowledge, attitude and practice towards simulation among clinical nursing teachers in China: A cross-sectional study

Aim: This study aimed to investigate the knowledge, attitude and practice towards simulation among CNTs in China and analyze the influencing factors. Background: In China, simulation is now increasingly used by Clinical Nursing Teachers (CNTs) who are mainly responsible for nurses' continuing education, novice nurses training and nursing students practice in clinical settings. Over the past 20 years, enrolment scale of nursing education was expanded greatly, and the number of registered nurses increased from 1.22 to 4.10 million in China. To contribute to nurses' or nursing students' professional development and successful transition to competent practitioners, CNTs are now being challenged to use simulation to develop more learner-centered educational programs, which could better facilitate learner engagement. As faculty preparation is a prerequisite for conducting quality simulation, it is critical that CNTs have the requisite knowledge and skills to use simulation to its full potential. However, data on CNTs' knowledge, attitude and practice towards simulation is limited. Design: A cross-sectional study. Methods: A total of 342 CNTs from six tertiary affiliated teaching hospitals of a medical university in Beijing, China, participated in the study. Electronic questionnaire of Nurse Educators' Knowledge, Attitude and Practice towards Simulation (NEKAPS) was delivered to CNTs. Analysis of variance, t-test were used to analyze data. Results: The mean score of knowledge and attitude for all participants was 60.01 +/- 13.42 and 81.40 +/- 19.99, respectively. The mean practice score was 70.65 +/- 22.05 for 162 participants (47.4 %) who had conducted simulation in their hospitals. Participants with higher educational level (F=3.476, p = 0.032) and nursing career length <= 15 years (t = 2.676, p = 0.008) had higher knowledge scores. However, there were no significant differences among different groups for attitudes. Participants with age <= 35 years old (t = 3.355, p = 0.001), nursing teaching length <= 10 years (t = 2.073, p = 0.041) and advanced beginner nurses (t = 3.212, p = 0.002) presented higher practice scores. Conclusions: CNTs had a low level of knowledge on simulation. Their attitudes towards simulation were positive, whereas their practices were still lacking. It is highlighted an urgent need for standardized training of CNTs to improve their knowledge and practice towards simulation, so that they can optimize the simulation programs they provide for nurses or nursing students.