From team-based cardiopulmonary resuscitation simulation training to clinical practice: a qualitative study

Team-based cardiopulmonary resuscitation (CPR) simulation is widely used in nursing education to prepare students for clinical emergencies. Although simulation provides opportunities to practise CPR procedures, teamwork, and clinical decision-making, less is known about how nursing interns experience applying what they have learned when they encounter real resuscitation events. This study aimed to explore nursing interns’ experiences of transferring learning from team-based CPR simulation training to clinical practice. A qualitative descriptive design was used. Semi-structured, in-depth interviews were conducted with 22 purposively selected nursing interns after team-based CPR simulation training. Participants’ clinical exposure to resuscitation varied from direct or supporting participation to observation. Data were analysed using qualitative content analysis. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Three themes and nine subthemes were identified: (1) physical and emotional experiences of clinical resuscitation; (2) perceived learning from team-based CPR simulation training; and (3) factors affecting the transfer of simulated CPR skills to clinical practice. Participants described standardized procedures and clearly defined team roles as easier to recall and apply than responses requiring interpretation and adaptation to changing clinical situations. They also described emotional pressure, uncertainty about their role as interns, and a perceived mismatch between performing well in simulation and feeling prepared for real resuscitation. Clinical mentors were valued for explaining clinical reasoning and helping interns understand aspects of practice that were difficult to capture in standardized simulation. Nursing interns described the transfer of learning from simulation to clinical CPR as uneven. Standardized procedures appeared easier to carry into practice than responses requiring rapid interpretation and adaptation in unpredictable situations. Real resuscitation also introduced emotional and role-related challenges that were difficult to reproduce in simulation. Participants valued clinical mentors for helping them understand how procedural knowledge was adapted to particular patients and situations. These findings suggest that structured simulation and supervised clinical learning may play complementary roles in CPR education, particularly when preparing nursing interns to respond to uncertainty and context-dependent clinical demands.