Exploring nursing students' transfer of peripheral venous cannulation from skills centre to the clinical setting

TLDR: Low-fidelity simulation was found both to be effective, as it provided familiarity with equipment used in theclinical setting, and inadequate due to lacking opportunity to discern differences encountered in the clinical setting.

Abstract: Background: It is assumed that practical skills learned through simulation can be transferred to the clinical setting, but little is known about students’ skill performance on real patients after simulation-based learning. The literature shows that newly qualified nurses lack proficiency in skill performance, implying that transfer of learning is challenging. The aim is to explore practical skill transfer from skill centre to clinical setting. Method: A qualitative descriptive observational study of five undergraduate nursing students practicing peripheral venous cannulation (PVC) in the skills centre and clinical setting. Performances were compared using content analysis. Findings: There were similarities and differences in the students’ performance accuracy  in the skills centre and the clinical setting. Many steps were performed correctly, though some were performed incorrectly, and several were not performed or not relevant to perform in either setting. Practicing on a mannequin and on actual patients gave different learning opportunities. Practicing on a mannequin gave the students the opportunity to perform most of the PVC steps even if the vein was missed. When students missed the vein on real patients, they had to terminate the attempt, with no opportunity to perform subsequent steps of the skill. Conclusion: Low-fidelity simulation was found both to be effective, as it provided familiarity with equipment used in the clinical setting, and inadequate due to lacking opportunity to discern differences encountered in the clinical setting. The simulation must be improved to ensure that students learn what is needed for safe practice on real patients in the clinical setting.