The overall aim was to investigate bachelor nursing students’ experiences with simulation as a learning approach conducted under various conditions. Additionally, the aim was to translate and validate questionnaires for the evaluation of simulation in a Norwegian context.

Methods: Quantitative and qualitative methods were used. Nursing students responded to three questionnaires after attending either low- or high-fidelity simulation. Data were analyzed with statistics (I). Two evaluation questionnaires were subjected to a principal components analysis (II, III). Data were obtained from nursing students through focus group interviews, and analyzed with a qualitative content analysis (IV).

Main findings: Independent of the fidelity level in the simulation and educational level, the students reported satisfaction and that the emphasized features in learning were present. Those who had used a paper/pencil case study were the most satisfied (I). Debriefing was reported to be crucial for learning, but in particular by attending the large groups, also as a stressful and intrusive situation (IV).The Norwegian version of the questionnaire, the Student Satisfaction and Self-Confidence Scale, revealed no stable factor solution (II). The translated version of the Debriefing Experience Scale was shown to hold a good potential for evaluating debriefing, but benefited from reducing the subscales (III). To ensure safety and security were reported to be a prerequisite for learning, with the students requesting a more frequent use of simulation and a higher degree of familiarity with active learning in their program in general (IV).

Conclusions: Simulation at all fidelity levels should be used in nursing education. To exploit the potential, the learning approaches should be integrated into the program in general through a systematic and structured building of a learning community. A further validation and testing of the questionnaires in different programs and contexts is needed.