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AIM: This study sought to explore how simulation-based nursing education equips undergraduate nursing students with systems thinking competence. BACKGROUND: Working definition of systems thinking for undergraduate nursing students is the ability to assess and gather relevant information pertaining to a clinical situation. It is a challenge for nurse educators to design a course to cultivate system thinking competence in nursing students and to understand students' metacognition regarding this development. A six-scenario simulation education program, guided by cognitive load theory, was designed to cultivate systems thinking. Learning concepts of systems thinking must be accumulated and paired with reflection. DESIGN: The study applied content analysis to the reflective journals of students to identify concepts that emerged during their learning journey. METHODS: Following the approval from the institutional review board's full review, Secondary data on 294 reflective journals were analyzed. We used an affinity diagram to determine the development trajectory of competence. RESULTS: The analyses provide qualitative evidence regarding pathways in developing systems thinking. This includes their responses to events, the identification of learning needs related to systems thinking, and their progression toward action in future situations. Students also displaying a growth mindset exhibited resilience and a proactive approach to learning from their experiences. CONCLUSIONS: The analysis demonstrated that a deliberated-designed simulation educational program has several benefits in competence development, contextualization, and motivation to learn new concepts.
Chiou-Fang Liou (Sat,) studied this question.
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