Early Development of Clinical Reasoning Through Virtual Patient Simulation: Nursing Students' Perceptions of Collaborative Decision-Making.

Simulation is increasingly recognised as a strategic approach in nursing education for developing clinical competencies within safe learning environments. However, there is limited understanding of how virtual patient simulation supports the early development of clinical reasoning from the perspecti...

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Publicado en:Nursing Reports Vol. 16; no. 5; pp. 152 - 168
Autores principales: Sales, Leila, Ferreira, Maria, Pereira, Raquel, Lucas, Isabel, Marques, Rita, Bento, Inês
Formato: research Journal Article
Publicado: MDPI May2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2026
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        atl: Early Development of Clinical Reasoning Through Virtual Patient Simulation: Nursing Students' Perceptions of Collaborative Decision-Making.
      aug:
        au:
          Sales, Leila
          Ferreira, Maria
          Pereira, Raquel
          Lucas, Isabel
          Marques, Rita
          Bento, Inês
        affil: Portuguese Red Cross Higher School of Health, 1300-125 Lisbon, Portugal
      sug:
        subj:
          Students, Nursing, Baccalaureate Psychosocial Factors
          Student Attitudes Evaluation
          Clinical Reasoning
          Decision Making, Shared
          Computer Simulation
          Patient Simulation
          Human
          Male
          Female
          Adult
          Purposive Sample
          Exploratory Research
          Qualitative Studies
          Descriptive Research
          Semi-Structured Interview
          Focus Groups
          Interview Guides
          Thematic Analysis
          Content Analysis
          Descriptive Statistics
          Collaboration
          Critical Thinking
          Patient Safety
          Education, Nursing
          Adult: 19-44 years
          Male
          Female
      ab: Simulation is increasingly recognised as a strategic approach in nursing education for developing clinical competencies within safe learning environments. However, there is limited understanding of how virtual patient simulation supports the early development of clinical reasoning from the perspective of nursing students. Aim: To explore the perceptions of first-year undergraduate nursing students regarding the development of clinical reasoning and collaborative decision-making through virtual patient simulation. Methods: A qualitative, descriptive, and exploratory design was adopted. Semi-structured focus groups were conducted with 73 first-year undergraduate nursing students. Data were analysed using thematic content analysis following Bardin's approach. Results: Students perceived virtual patient simulation as a meaningful and high-impact learning strategy. Realism, interactivity, and group collaboration emerged as key strengths. Engagement with dynamic clinical scenarios supported the integration of theoretical knowledge into practice, enhanced prioritisation skills, and promoted structured clinical reasoning. Collaborative learning facilitated shared reflection and collective problem-solving, while immediate feedback enabled learning through error within a psychologically safe environment. Participants also reported increased confidence and autonomy in decision-making. At the same time, students identified limitations related to software constraints and the alignment between automated assessment and their reasoning processes. Conclusions: Group-based virtual simulation appears to support the early structuring of clinical reasoning, extending beyond technical skill acquisition to foster reflective and collaborative practice. Its educational value, however, depends on intentional curricular integration and strong pedagogical alignment including structured facilitation, alignment between assessment and learning objectives, and opportunities for guided reflection. These findings contribute to a process-oriented understanding of how novice learners make sense of clinical reasoning in simulated contexts.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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