Psychological Safety in Simulation at Bolivar Technical College

Step into today’s Simulation Lab at Bolivar Technical College with Sarah Colby, BSN, RN, Simulation & Skills Center Coordinator. 

Written by Sarah Colby, BSN, RN

For years, it was common for nursing students to have a fear of the simulation lab. Even when I was in school, I would get nervous on simulation days! Now as an educator, I see that the simulation lab is a place to practice, ask questions, build confidence, and prepare for real patient care before the stakes are high. 

Over the last couple of years, our team at BTC has taken a hard look at where the uneasiness and anxiety around simulation was coming from and how our students perceive simulation. We really wanted to understand their perspective so we could continue building on the strong foundation already in place and fully use simulation as a tool in their nursing education. 

Thanks to grant funding, our simulation team has been able to attend the International Meeting on Simulation in Healthcare (IMSH) and have learned so much about simulation, what we’re already doing well, and where we still have opportunities to grow. One of the biggest takeaways from IMSH was the concept of psychological safety and how intentionally creating that environment can make an even greater impact on student learning. 

Psychological safety sounds like a buzzword, but it really is a shift in mindset for both faculty and students in the simulation lab. Our goal is to create an environment where students feel comfortable practicing, asking questions, thinking out loud, and learning without fear of judgment. It’s a safe place to make mistakes, reflect on them, and leave with a better understanding than when they walked in. 

The Changes We Made 

The simulation lab is very different from the classroom at BTC. There are no grades attached to a simulation, which alleviates a lot of stress before students even walk through the door. We have objectives that we hope students meet during each scenario, but they’re really the starting point for reflection during the debrief. Together, students and faculty explore the clinical reasoning behind decisions, consider different perspectives, and connect the dots between knowledge and practice. That’s where real learning happens. 

One of the biggest changes we’ve made is implementing the Plus/Delta model during debrief. It’s a simple reflective process: the “plus” focuses on what went well during the simulation, while the “delta” focuses on what students wish they had done differently or what they’ll do differently next time. Instead of feeling like a review of what was right or wrong, it creates an open discussion where students evaluate their own performance, share their thought process, and learn from one another before faculty add their perspective. 

The response has been overwhelmingly positive. A couple of recent comments from students this semester showed us we’re on the right path: 

“I was very nervous going into the simulation lab; however, it was very relaxed and learning-oriented. I liked getting direct feedback right after we were done.” 

“The feedback after doing sim was most beneficial and delivered in a way that I didn’t lose any confidence in my ability but gained more knowledge.” 

Hearing feedback like that makes all the research and changes worth it to us. At the end of the day, our goal is simple: to create a simulation environment where students feel supported, safe to ask questions, confident in their clinical reasoning, and prepared to care for patients. Technology and equipment will continue to evolve in the BTC Simulation Lab, but creating that culture of learning will always be our highest priority. 

If you’d like to see our simulation lab firsthand, give us a call to schedule a tour 417-777-5062.