Simulation as a pedagogy is used extensively to educate healthcare professionals in both academic and clinical arenas with the intent to improve the delivery of care and patient outcomes. Advanced practice nursing (APN) programs use simulation as a pedagogy even though APN accreditation and certification organizations prohibit substituting simulation hours for the minimum 500 clinical hours. The purpose of this qualitative study was to explore faculty perceptions of educating APN students using simulation. Focus groups were conducted with a convenience sample of APN simulation faculty. Disruptive innovation theory was used by the researchers to guide the data analysis. Themes emerging during analysis included: 1) extrinsic tension and pressure in the midst of chaos, 2) internal vulnerability, and 3) passion and tenacity to remain resilient. The study results provide clarity to understand integration of APN simulation in the current environment, and introduce the impact of simulation as a disruptive innovation.

Simulation is an effective pedagogy and is used extensively in prelicensure nursing education. Advanced practice nursing (APN) programs also use simulation as a component of their curriculum even though APN accreditation and certification organizations do not allow students to substitute simulation hours for the minimum 500 clinical hours. There is a lack of rigorous research studies supporting the benefits or describing the outcomes of using simulation in APN programs. This article presents the results of a descriptive survey on the use of simulation in APN programs in the United States and Canada. Data obtained from the survey provide a base for current simulation use, so do data on the use of the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice as an organizing framework for the implementation of simulations in APN programs. The results of the survey include courses in which simulation is used, modalities of simulation used, purposes for simulation use, and the number of hours of simulation. Data on barriers to simulation use and faculty educational needs are provided. Key findings include the following: 98% of respondents report using simulation in their APN programs, and 77% of respondents support the replacement of a percentage of clinical hours with simulation. The results from this study provide a base to build further rigorous research on how simulation can enhance the education of APN students, improve knowledge transfer, impact behaviors, and improve outcomes. In addition, the outcomes of this study may help educators develop training and support systems that can enhance the quality of APN simulations.