La signification de l’expérience vécue d’une relation pédagogique de caring en contexte de simulation clinique haute-fidélité

Nowadays, the high-fidelity clinical simulation (HFCS) is an outstanding pedagogical strategy, which is increasingly being adopted by several national and international nursing institutions in order to prepare students for their future practice. Despite countless advantages pertaining to HFCS, it appears that many students may feel a sense of stress, anguish, and humiliation if they do not receive the necessary support from their educator in this academic context.  Notwithstanding the fact that many nursing researchers emphasize the importance of the educator’s role within the context of simulation, their works did not study the aspect of the educator-students relationship. However, its added value has been highlighted by a large amount of scientific papers, but in other academic contexts, notably classroom, clinical and online environments. Moreover, these studies did not specify the nature of the educator-students relationship, nor did they explore it from a humanistic perspective. Consequently, it was appropriate to add the term “pedagogical” to emphasize the educational aspect of this relationship, and the term “caring” to refer to its humanistic approach. Based on the literature and to our knowledge, no nursing study has explored this type of relationship within the context of HFCS. Thus, this doctoral research was interested in describing and understanding the meaning of the lived experience of a caring pedagogical relationship (CPR) according to the perception of undergraduate nursing students in the context of high-fidelity clinical simulation. In addition, this phenomenological descriptive research aimed to explore its facilitators, barriers, as well as contributions from the students’ perspective.  The Relational Caring Inquiry (Cara, 1997; Cara et al., 2017), a descriptive phenomenological method, has been selected to meet the purpose and questions of this research. Individual semi-structured interviews were realized with 19 nursing students, who also participated in a second interview to validate the narrative synthesis. Being inspired by the relational emancipatory pedagogy (Hills & Watson, 2011; Hills et al., 2021), as a disciplinary perspective, the analysis and interpretation of the data collected have allowed the following five eidos-themes to emerge: (1) authentic engagement of the educator toward students, (2) Educator’s conscientization regarding barriers to the development of the CPR, (3) implementation of a safe learning space for students, (4) cocreation of a caring collaboration between educator-students and, finally, (5) pedagogical and caring nature of the relationship contributing to the transformation of learning process. They subsequently facilitated the emergence of the essential structure of the studied phenomenon (CPR), which corresponds to: “an authentic engagement of the educator fostering a safe academic space in order to cocreate a humanistic collaboration with students to transform their learning process within the context of high-fidelity clinical simulation”.  This research adds to the body of nursing knowledge a new understanding in regard to the meaning of the CPR by highlighting its characteristics, facilitators, barriers, as well as its contributions in the context of simulation. Our results show that educators play a vital role to promote enriching learning experiences among students in the aforementioned context. Various recommendations arising from our findings have been proposed in different domains of nursing, notably education, research, clinical, management, and sociopolitical. Finally, these aim to provide stakeholders with concrete avenues to advance students’ learning and, more broadly, to humanize nursing education in simulation settings.

Keyphrases: Caring pedagogical relationship, Humanistic-caring philosophy, Educator-students collaboration, Authentic engagement, Relational caring inquiry, Phenomenology, high-fidelity clinical simulation, Transformation of learning process, Nursing education