How Learners Transition from Simulation-Based Learning Environments to Clinical Practice

Allied healthcare students face ill-structured problems as they transition from higher education to authentic clinical practice. CBR offers a framework towards understanding expertise development as students leverage cases to retrieve, reuse, revise, and retain knowledge from past experiences. From an instructional strategy perspective, simulation-based learning environments (SBLEs) align with elements of CBR as it affords a structured environment for students to engage in experiential learning, allowing them to develop problem-solving skills needed for domain practice. Despite the documented learning outcomes of SBLE in research, research is often situated within classroom or clinical settings, with limited exploration of how students directly transfer knowledge from simulations to authentic practice. This study addresses this gap as it explores how learners transition from a SBLE and their initial transition to the cases encountered within a clinic. As learners engaged in the SBLE, themes included the following: (a) Adaptation to Perceived Authenticity in SBLE and (b) Continued Dialogue Through Questioning in SBLE. Alternatively, the clinical experiences identified the following themes: (a) Recall and Reuse from Simulation towards Clinical Experiences, (b) Expanded Case Library from Clinical Experiences, (c) Faded Scaffolding Through the Clinical Instructor in Clinical Experiences, and (d) Self-Efficacy and Expertise Development from Clinical Experiences. Implications for theory and practice are discussed.