Unveiling the Challenges and Barriers: A Qualitative Inquiry Into Nursing Faculty Experiences With Simulation-based Education

Unveiling the Challenges and Barriers: A Qualitative Inquiry Into Nursing Faculty Experiences With Simulation-based Education | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Unveiling the Challenges and Barriers: A Qualitative Inquiry Into Nursing Faculty Experiences With Simulation-based Education Bhuvaneswari S, Bamini Devi N, Helen Shaji J C, Lakshmi L This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8359141/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Simulation-based education (SBE) has gained importance in nursing education as a tool for developing clinical skills and decision-making abilities in a safe environment. Aim of the study: This study aimed to explore the challenges and barriers faced by nursing faculty in implementing SBE within their teaching practices. Methods A qualitative descriptive design was used to gather data through semi-structured interviews and focus group discussions with nursing faculty members. Participants were selected based on their teaching experience and involvement in simulation activities. Data were analyzed using inductive thematic analysis. Results Key barriers identified included limited resources (financial and space constraints), time limitations due to heavy teaching loads, and resistance to change, including skepticism about the effectiveness of SBE and unfamiliarity with the technology. Additionally, faculty lacked formal training and institutional support for effective SBE integration. Technical issues, such as equipment malfunctions and insufficient expertise, further hindered successful implementation. Some faculty members also viewed SBE as irrelevant to the curriculum, leading to limited engagement. Conclusion The study highlights several barriers—resource limitations, time constraints, resistance to change, and lack of training—that impede the effective implementation of SBE. Addressing these challenges through enhanced support and training is crucial for successful integration into nursing education. simulation-based education nursing faculty barriers challenges qualitative study INTRODUCTION Simulation-Based Education (SBE) is widely recognized as a cornerstone of contemporary nursing education, offering a pedagogical approach that supports the development of clinical competence, clinical reasoning, and professional confidence within a psychologically safe learning environment. Extensive evidence demonstrates that well-designed simulation experiences—particularly those using high-fidelity modalities—facilitate experiential learning through deliberate practice, immediate feedback, and structured reflection, thereby enhancing preparedness for clinical practice and patient safety outcomes [ 1 , 2 ]. Consequently, SBE has been strongly advocated by accreditation bodies and educational policymakers as an essential component of pre-licensure nursing curricula. Notwithstanding its demonstrated educational benefits, the integration of SBE into nursing education remains uneven and frequently suboptimal. Prior research has identified persistent structural constraints, including limited access to simulation infrastructure, high acquisition and maintenance costs, inadequate technical support, and insufficient institutional funding [ 3 , 4 ]. These constraints not only restrict the frequency and quality of simulation activities but also influence faculty willingness and capacity to adopt simulation-based pedagogies consistently across programs. Faculty competence and preparedness represent another critical dimension influencing SBE implementation. Effective simulation pedagogy extends beyond technical operation of equipment to encompass scenario design, facilitation of learner engagement, and evidence-informed debriefing practices [ 5 ]. However, the literature suggests that many nursing educators enter academic roles with limited formal preparation in simulation methodology and minimal access to ongoing professional development, resulting in reduced confidence, variable instructional quality, and cautious or fragmented use of simulation [ 3 , 5 ]. Challenges related to curricular integration further compound these difficulties. Simulation activities are often insufficiently aligned with program-level learning outcomes or clinical competency frameworks, limiting their educational coherence and impact [ 6 ]. Faculty members also report difficulty embedding simulation within already dense curricula, exacerbated by large student cohorts and high student-to-faculty ratios that constrain individualized facilitation and meaningful debriefing [ 6 , 7 ]. At the institutional level, organizational culture and leadership commitment significantly shape the sustainability of SBE initiatives. Limited administrative recognition of simulation-based teaching within workload models, ambiguous consideration of simulation as scholarly activity, and resistance to pedagogical innovation have been identified as barriers to widespread adoption [ 8 , 9 ]. Such contextual factors highlight that SBE implementation is not solely a technical challenge but a complex organizational and cultural process. While these barriers have been documented in prior quantitative and mixed-methods studies, a notable gap remains in understanding how nursing faculty themselves experience and navigate these challenges in practice. Qualitative inquiry is particularly well-suited to explore these experiences, as it enables an in-depth examination of educators’ perceptions, meanings, and contextual influences—elements essential for understanding implementation processes in real-world educational settings. Accordingly, this study seeks to explore nursing faculty experiences with SBE implementation, to enlighten faculty development strategies, institutional policy, and sustainable simulation integration. AIM OF THE STUDY The study aimed to explore the challenges and barriers in implementing simulation-based education among nursing faculty. METHODOLOGY Study Design This study employed a qualitative descriptive design to explore the challenges and barriers faced by nursing faculty in implementing simulation-based education (SBE). Qualitative inquiry was chosen to capture the depth and complexity of faculty experiences and perceptions in their own words, providing rich, contextual insights into the phenomenon. Participants A purposive sampling method was used to recruit nursing faculty members who were actively involved in using simulation-based education across multiple nursing schools in Chennai, Tamilnadu, India. The inclusion criteria were faculty members with at least one year of teaching experience and involvement in simulation activities. A total of 40 samples were selected for the study. Data Collection Data were collected through semi-structured individual interviews and focus group discussions to encourage both personal reflection and interactive dialogue among participants. An interview guide was developed based on existing literature and expert input, focusing on experiences with simulation implementation, perceived barriers, institutional support, and faculty development needs. Interviews were audio-recorded and transcribed verbatim for accuracy. DATA ANALYSIS Inductive thematic analysis was conducted following the steps outlined by Braun and Clarke (2006). This process involved repeated reading of transcripts, generation of initial codes, theme identification, and refinement through constant comparison within and across transcripts. Two researchers independently coded the data and met regularly to discuss discrepancies and reach consensus, enhancing the credibility and trustworthiness of the findings. Methodological Rigor and Trustworthiness (COREQ) Researcher Positionality Data collection was conducted by the principal investigator, a nursing educator with formal experience in simulation-based education. The interviewer had no direct supervisory or evaluative relationship with the participants, minimizing potential power imbalances. Co-researchers contributed to data analysis but were not involved in the interviews or focus group discussions. Data Saturation Data collection continued until thematic saturation was achieved, defined as the point at which no new codes or themes emerged. Saturation was observed after approximately 35 participants, and five additional interviews were conducted to confirm stability of themes. Reflexivity The research team engaged in reflexive discussions throughout the analytic process to examine assumptions and potential biases arising from their professional backgrounds. Analytic decisions were documented, and consensus meetings were used to ensure that interpretations remained grounded in participants’ accounts. RESULTS Table 1 Demographic variable of the participants Demographic Characteristic Category Frequency (f) Percentage (%) Gender Male 10 25% Female 30 75% Age 25–34 years 8 20% 35–44 years 12 30% 45–54 years 10 25% 55 + years 10 25% Clinical Experience (Years) 1–5 years 6 15% 6–10 years 12 30% 11–15 years 12 30% 16 + years 10 25% Level of Education Bachelor's Degree 5 12.5% Master's Degree 25 62.5% Doctorate 10 25% Table 1 presents the demographic characteristics of the study participants, detailing their gender, age, clinical experience, and education level. The majority of participants were female (75%), with males accounting for 25%. Age-wise, most participants were between 35 and 44 years (30%), followed by those aged 45–54 years and 55 + years (both 25%), and 25–34 years (20%). In terms of clinical experience, participants were fairly distributed across categories, with the largest group having 6–10 years (30%) and 11–15 years (30%) of experience, followed by those with over 16 years (25%) and 1–5 years (15%). Regarding education, the majority held a master’s degree (62.5%), while 25% had a doctorate, and 12.5% had a bachelor’s degree. Table 2 Challenges and Barriers in Implementing Simulation-Based Education among Nursing Faculty Theme Sub-theme(s) Description Participant Quotes Lack of Resources Financial Constraints Faculty report inadequate funding for simulation equipment and resources, limiting the ability to run effective SBE programs. "We just don’t have the budget to purchase the necessary simulation tools we need." Insufficient Space The physical space available for simulation activities is limited, impacting the ability to conduct simulations effectively. "The space we have is small, so it's hard to set up all the equipment and allow enough students to participate at once." Time Constraints Heavy Teaching Load Many faculty members struggle to find time in their busy schedules to plan, implement, and reflect on simulation activities due to their heavy teaching load. "There’s no time to integrate simulations effectively. My teaching schedule is already packed." Limited Class Time Limited class time hinders the ability to implement extensive simulation activities, as they require more time for setup, execution, and debriefing. "Our class hours don’t allow for extended simulation sessions. We’re always in a rush." Resistance to Change Skepticism About Effectiveness Some faculty members express doubt about the effectiveness of simulation in improving student learning outcomes. "I’m not sure simulations really add value compared to traditional teaching methods." Lack of Familiarity Some faculty are hesitant to adopt SBE because they are unfamiliar with the technology and its integration into the curriculum. "I’m not comfortable with the technology. I haven’t been trained on it." Inadequate Training and Support Lack of Professional Development Faculty indicate insufficient training on how to use simulation technology effectively and integrate it into their courses. "There’s no formal training offered on how to use the simulators or run these sessions effectively." Insufficient Institutional Support A lack of institutional support (in terms of funding, training, and mentorship) is a significant barrier to implementing SBE successfully. "We don’t have enough institutional backing, and it’s hard to make changes without support from higher-ups." Technical Barriers Lack of Technical Expertise Faculty express concerns about the need for technical expertise to operate simulation technology, which many do not possess. "The technology is complex, and we don’t have the expertise to troubleshoot when something goes wrong." Equipment Reliability Simulation equipment is often unreliable or outdated, causing disruptions and frustrations for faculty and students during simulation activities. "The simulators break down frequently, which disrupts the entire learning experience." Faculty Buy-in Perceived Lack of Relevance Some faculty members do not see the relevance of simulation-based education for their students and feel that it does not align with their teaching philosophy. "Simulation seems unnecessary for our curriculum. We have always done fine with traditional methods." Limited Engagement Faculty report limited engagement with simulation among some colleagues, either due to disinterest or perceived difficulty in using the approach. "Some of my colleagues just aren’t interested in using simulations, and that makes it hard to get everyone on board." Table 2 represents the various challenges and barriers faced by nursing faculty in implementing Simulation-Based Education (SBE). These challenges are grouped into key themes. Lack of Resources includes financial constraints and insufficient space, with faculty highlighting budget limitations for necessary simulation equipment and limited physical space for simulations. Time Constraints arise from faculty's heavy teaching load and limited class time, both of which hinder the integration of extensive simulation sessions. Resistance to Change is reflected in skepticism about the effectiveness of simulation compared to traditional teaching methods and a lack of familiarity with the technology involved. Inadequate Training and Support includes the absence of formal professional development for using simulation technology effectively and insufficient institutional support, such as funding and mentorship, to facilitate implementation. Technical Barriers involve a lack of technical expertise among faculty to operate and troubleshoot simulation equipment and the frequent unreliability of the equipment itself. Finally, Faculty Buy-in reveals a perceived lack of relevance of simulation-based education for the curriculum and limited engagement among faculty members who are not interested in using this method. These findings underscore a range of logistical, financial, and educational obstacles that impede the widespread adoption of simulation-based teaching methods among nursing faculty. DISCUSSION The nursing faculty members in this study identified several barriers to the implementation of Simulation-Based Education (SBE), including insufficient resources (limited funding, space, and equipment), excessive teaching loads, resistance to adopting innovative teaching methods, lack of professional development and institutional support, technical issues, and doubts about the relevance of SBE in the nursing curriculum. These challenges align with those reported in broader research. For example, Naismith et al. [ 10 ] found that the most significant barriers among nurse educators were space limitations, financial constraints, resistance to change, and time pressures, echoing the findings of this study. Similarly, Ismail et al. [ 11 ] highlighted heavy curricula, a shortage of simulation-trained faculty, and high equipment costs as significant obstacles to implementing SBE. In addition, Najjuma et al. [ 12 ] pointed out teacher shortages, inadequate supplies, and resistance to moving away from traditional teaching methods as major barriers to simulation adoption. Benchadlia et al. [ 13 ] also identified logistical challenges and lack of training as primary obstacles to integrating SBE into nursing programs. Mwalabu et al. [ 14 ] similarly concluded that traditional teaching practices, limited simulation exposure, and insufficient institutional support were key factors preventing successful adoption of SBE. These studies collectively underscore the multifaceted nature of the challenges facing the implementation of simulation-based education, with resource issues, faculty attitudes, lack of expertise, and institutional priorities all contributing to the difficulty in incorporating SBE into nursing curricula. While these findings are consistent with prior international literature, their significance lies in how these challenges intersect within the local simulation culture. The findings demonstrate that barriers are not merely technical but deeply embedded within organizational structures and academic cultures. Faculty resistance reflected perceived misalignment between simulation pedagogy and curriculum priorities, rather than opposition to innovation itself. This highlights the importance of leadership endorsement, workload recognition, and structured faculty development to enhance simulation adoption. IMPLICATIONS FOR SIMULATION PRACTICE AND FACULTY DEVELOPMENT The findings underscore that effective simulation integration requires a shift from viewing simulation as an ‘add-on’ teaching strategy to recognizing it as a core pedagogical practice. Institutions must move beyond episodic workshops toward longitudinal faculty development models that include mentorship, peer observation, and structured debriefing training. In resource-constrained environments, low- and medium-fidelity simulation, case-based simulation, and hybrid models may offer pragmatic pathways for sustainable implementation. Importantly, faculty need support in aligning simulation scenarios with learning outcomes and assessment frameworks to enhance perceived relevance and educational coherence. Cultural and Contextual Considerations Within the Indian nursing education context, hierarchical academic structures and examination-driven curricula may inadvertently discourage pedagogical risk-taking. Addressing these cultural dynamics requires leadership engagement, policy-level endorsement of simulation-based teaching, and recognition of simulation facilitation as scholarly and academic work. These insights are transferable to many Western and non-Western contexts where similar organizational cultures exist. Future Directions Future research should focus on implementation-focused studies that evaluate institution-wide simulation strategies, faculty development interventions, and leadership models. Mixed-methods and longitudinal designs would be particularly valuable in examining how faculty confidence, learner outcomes, and organizational culture evolve over time. At a practical level, the next step is the development of context-sensitive simulation implementation frameworks that explicitly address faculty workload, training pathways, and infrastructure planning according to Indian Curricula. Such frameworks would support sustainable simulation integration rather than fragmented or individual-led efforts. CONCLUSION This study reinforces existing evidence that simulation-based education is a pedagogically powerful approach for nursing education while simultaneously highlighting the persistent and interrelated barriers that hinder its effective implementation [ 1 – 9 ]. Consistent with prior research, challenges related to infrastructure, faculty preparedness, curricular alignment, and institutional support continue to shape how simulation is enacted in educational practice. By centering the voices and experiences of nursing faculty, this qualitative inquiry extends the literature beyond descriptive accounts of barriers to provide deeper insight into the contextual and organizational dynamics influencing SBE adoption. Revisiting the literature in light of the study findings underscores the necessity of moving beyond isolated faculty training initiatives toward comprehensive, institutionally supported strategies. These include structured faculty development in simulation pedagogy, deliberate curricular integration aligned with competency frameworks, and administrative policies that recognize simulation-based teaching as core academic work [ 5 , 8 ]. Such approaches align with calls in the simulation literature for systemic, faculty-centered models of implementation rather than technology-driven solutions alone. The findings contribute to a more nuanced understanding of how simulation is experienced and operationalized within nursing education contexts. Addressing the barriers identified in this study is essential not only for optimizing educational outcomes but also for ensuring that simulation-based education fulfills its broader goal of enhancing clinical readiness and patient safety. Declarations Ethical Clearance Declaration The study was conducted after obtaining ethical clearance (Ref: 405/IHEC-IBSEC/SIST dated 16th April 2025) from the Institutional Human Ethics Committee (IHEC) - Institutional BioSafety & Ethical Committee (IBSEC), Sathyabama Institute of Science and Technology, Chennai. Ethical clearance was obtained based on the committee’s approval, and informed consent was secured from the participants in accordance with the Declaration of Helsinki. Participant Declaration An informed consent, which consisted of the participant information (kept confidential) and a declaration stating that, “ I voluntarily give consent to take part in this study. I have fully discussed and understood the benefits, risks, and procedures of the study. This study has been explained to me in a language that I understood. I have been given enough time to ask any questions that I have about the study, and all my questions have been answered to my satisfaction. I know that no compensation/honorarium will be provided to participate in this study. I also consented for the data obtained from the study to be used for publication, which was obtained from every participant, and then the study was conducted as approved by the ethical committee. Consent for Publication by Authors: All authors have reviewed and approved the final version of the manuscript and consent to its publication. Conflict of Interest The authors declare that they have no conflicts of interest relevant to the content of this manuscript. Source of Funding Self-funding Data Availability The data supporting the conclusions of this article will be made available by the authors, without undue reservation. Author Contributions BS designed the study and collected the data. NB & LL analyzed the data and drafted the manuscript. BS revised the manuscript. All authors read and approved the final manuscript. Acknowledgements The authors are grateful to all the participants in this study. References Rauen CA. The history of simulation in nursing education and practice. Clin Simul Nurs. 2004;43(3):123–7. Cant RP, Cooper SJ. Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Educ Today. 2017;49:63–71. https://doi.org/10.1016/j.nedt.2016.11.015 . Al-Ghareeb A, Cooper S. Evaluating the impact of simulation training on nursing students’ critical thinking skills: A systematic review. Nurse Educ Today. 2016;36:295–301. https://doi.org/10.1016/j.nedt.2015.10.015 . Luctkar-Flude M, Groll D. Nurse educator perspectives on simulation: Benefits and challenges. Clin Simul Nurs. 2019;27:12–9. https://doi.org/10.1016/j.ecns.2018.09.006 . Brown D, Fraser K, Wong C, Kothari A, Krewulak K, Nuspl M, Dainty KN. The effectiveness of simulation-based education on novice nurses’ confidence, knowledge and skills: A systematic review. Int J Nurs Stud. 2020;103:103487. https://doi.org/10.1016/j.ijnurstu.2019.103487 . Foronda C, Fernandez-Burgos M, Nadeau C, Kelley CN, Henry MN. Simulation in nursing education: A systematic review. J Nurs Educ. 2020;59(1):17–23. https://doi.org/10.3928/01484834-20191218-04 . Neill MA, Wotton K. The role of simulation in undergraduate nursing education: An integrative review. Nurse Educ Today. 2011;31(7):741–8. https://doi.org/10.1016/j.nedt.2011.01.001 . Harder BN, Ross L, Paul P. Obstacles and facilitators for implementing simulation-based learning in nursing: An integrative review. Nurse Educ Today. 2013;33(9):964–9. https://doi.org/10.1016/j.nedt.2013.01.011 . O’Regan S, Molloy E, Watterson L. Organizational factors influencing simulation integration in undergraduate nursing curricula: An exploratory mixed methods study. J Nurs Educ. 2016;55(3):161–6. https://doi.org/10.3928/01484834-20160217-03 . Benchadlia F, Benchadlia S, Belkebir A. Simulation in basic nursing student education: Uses and barriers. Open Nurs J. 2023;17:e187443462307030. Ismail FW et al. (2024). Challenges and opportunities in the uptake of simulation in healthcare education. BMC Med, 22(1), Article 240. Mwalabu G, Cheraghi F, Baayd J. (2024). Factors influencing implementation of simulation in nursing and midwifery education in Malawi. BMC Nurs, 23(1), Article 127. Naismith J, et al. Exploring simulation-based education in pre-registration nurse training: Barriers and facilitators. J Nurs Educ Pract. 2025;15(7):135–44. Najjuma JN, et al. Barriers and facilitators of simulation-based education in stroke nursing: Experiences from Uganda. Adv Med Educ Pract. 2025;16:1–12. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8359141","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":593714933,"identity":"685c4af6-db66-434d-a4d1-62cf42938501","order_by":0,"name":"Bhuvaneswari S","email":"","orcid":"","institution":"SRM Institute of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Bhuvaneswari","middleName":"","lastName":"S","suffix":""},{"id":593714935,"identity":"2ab13622-b8fc-44c0-917c-501d6aabf659","order_by":1,"name":"Bamini Devi N","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIie2OMQrCQBBFB4TYBNJq4xkGBINYeJUMgmlUAl4gVWwE2xwjIojlQsBGxXbttNBKKxuFLRyj2Kirdhb7YAY+zOMPgMHwhyCPAMyBc00e3Lf3jVIMs2P8TmFygOKRdfeMm59RGgS1Tnm52CZrpcDJtxA2k/dKtd9O0hj9bkX6FUkRQrG/R6C55jHBio0pjaVlSQoRUHILRRplebgpo8HUkp5CqH9U5L0lgSYrFrcUPijVOGvxKZasUFS2C/NdIHSK67RHR1vVaMCPrU6qVHJ6jeHmrFGesK9L/CAYDAaD4QUXj3tWelKKZdcAAAAASUVORK5CYII=","orcid":"","institution":"SRM Institute of Science and Technology","correspondingAuthor":true,"prefix":"","firstName":"Bamini","middleName":"Devi","lastName":"N","suffix":""},{"id":593714940,"identity":"61445a4b-2859-4172-8914-611951bc6018","order_by":2,"name":"Helen Shaji J C","email":"","orcid":"","institution":"SRM Institute of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Helen","middleName":"Shaji J","lastName":"C","suffix":""},{"id":593714942,"identity":"b88878c1-2d6d-4968-a69e-810d90a857c5","order_by":3,"name":"Lakshmi L","email":"","orcid":"","institution":"Sathyabama Institute of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Lakshmi","middleName":"","lastName":"L","suffix":""}],"badges":[],"createdAt":"2025-12-14 15:53:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8359141/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8359141/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105002917,"identity":"fce41c9b-880f-4705-ba69-2f0170d2bd1d","added_by":"auto","created_at":"2026-03-19 17:25:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":977672,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8359141/v1/35acd0d7-18c8-47f3-a51b-4b6f5c522fe2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eUnveiling the Challenges and Barriers: A Qualitative Inquiry Into Nursing Faculty Experiences With Simulation-based Education\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eSimulation-Based Education (SBE) is widely recognized as a cornerstone of contemporary nursing education, offering a pedagogical approach that supports the development of clinical competence, clinical reasoning, and professional confidence within a psychologically safe learning environment. Extensive evidence demonstrates that well-designed simulation experiences\u0026mdash;particularly those using high-fidelity modalities\u0026mdash;facilitate experiential learning through deliberate practice, immediate feedback, and structured reflection, thereby enhancing preparedness for clinical practice and patient safety outcomes [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Consequently, SBE has been strongly advocated by accreditation bodies and educational policymakers as an essential component of pre-licensure nursing curricula.\u003c/p\u003e \u003cp\u003eNotwithstanding its demonstrated educational benefits, the integration of SBE into nursing education remains uneven and frequently suboptimal. Prior research has identified persistent structural constraints, including limited access to simulation infrastructure, high acquisition and maintenance costs, inadequate technical support, and insufficient institutional funding [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. These constraints not only restrict the frequency and quality of simulation activities but also influence faculty willingness and capacity to adopt simulation-based pedagogies consistently across programs.\u003c/p\u003e \u003cp\u003eFaculty competence and preparedness represent another critical dimension influencing SBE implementation. Effective simulation pedagogy extends beyond technical operation of equipment to encompass scenario design, facilitation of learner engagement, and evidence-informed debriefing practices [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. However, the literature suggests that many nursing educators enter academic roles with limited formal preparation in simulation methodology and minimal access to ongoing professional development, resulting in reduced confidence, variable instructional quality, and cautious or fragmented use of simulation [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eChallenges related to curricular integration further compound these difficulties. Simulation activities are often insufficiently aligned with program-level learning outcomes or clinical competency frameworks, limiting their educational coherence and impact [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Faculty members also report difficulty embedding simulation within already dense curricula, exacerbated by large student cohorts and high student-to-faculty ratios that constrain individualized facilitation and meaningful debriefing [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAt the institutional level, organizational culture and leadership commitment significantly shape the sustainability of SBE initiatives. Limited administrative recognition of simulation-based teaching within workload models, ambiguous consideration of simulation as scholarly activity, and resistance to pedagogical innovation have been identified as barriers to widespread adoption [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Such contextual factors highlight that SBE implementation is not solely a technical challenge but a complex organizational and cultural process.\u003c/p\u003e \u003cp\u003eWhile these barriers have been documented in prior quantitative and mixed-methods studies, a notable gap remains in understanding how nursing faculty themselves experience and navigate these challenges in practice. Qualitative inquiry is particularly well-suited to explore these experiences, as it enables an in-depth examination of educators\u0026rsquo; perceptions, meanings, and contextual influences\u0026mdash;elements essential for understanding implementation processes in real-world educational settings. Accordingly, this study seeks to explore nursing faculty experiences with SBE implementation, to enlighten faculty development strategies, institutional policy, and sustainable simulation integration.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eAIM OF THE STUDY\u003c/h3\u003e\n\u003cp\u003eThe study aimed to explore the challenges and barriers in implementing simulation-based education among nursing faculty.\u003c/p\u003e "},{"header":"METHODOLOGY","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eThis study employed a qualitative descriptive design to explore the challenges and barriers faced by nursing faculty in implementing simulation-based education (SBE). Qualitative inquiry was chosen to capture the depth and complexity of faculty experiences and perceptions in their own words, providing rich, contextual insights into the phenomenon.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eA purposive sampling method was used to recruit nursing faculty members who were actively involved in using simulation-based education across multiple nursing schools in Chennai, Tamilnadu, India. The inclusion criteria were faculty members with at least one year of teaching experience and involvement in simulation activities. A total of 40 samples were selected for the study.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003e Data were collected through semi-structured individual interviews and focus group discussions to encourage both personal reflection and interactive dialogue among participants. An interview guide was developed based on existing literature and expert input, focusing on experiences with simulation implementation, perceived barriers, institutional support, and faculty development needs. Interviews were audio-recorded and transcribed verbatim for accuracy.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eDATA ANALYSIS\u003c/h2\u003e \u003cp\u003eInductive thematic analysis was conducted following the steps outlined by Braun and Clarke (2006). This process involved repeated reading of transcripts, generation of initial codes, theme identification, and refinement through constant comparison within and across transcripts. Two researchers independently coded the data and met regularly to discuss discrepancies and reach consensus, enhancing the credibility and trustworthiness of the findings.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eMethodological Rigor and Trustworthiness (COREQ)\u003c/h2\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eResearcher Positionality\u003c/h2\u003e \u003cp\u003eData collection was conducted by the principal investigator, a nursing educator with formal experience in simulation-based education. The interviewer had no direct supervisory or evaluative relationship with the participants, minimizing potential power imbalances. Co-researchers contributed to data analysis but were not involved in the interviews or focus group discussions.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eData Saturation\u003c/h3\u003e\n\u003cp\u003eData collection continued until thematic saturation was achieved, defined as the point at which no new codes or themes emerged. Saturation was observed after approximately 35 participants, and five additional interviews were conducted to confirm stability of themes.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eReflexivity\u003c/h2\u003e \u003cp\u003eThe research team engaged in reflexive discussions throughout the analytic process to examine assumptions and potential biases arising from their professional backgrounds. Analytic decisions were documented, and consensus meetings were used to ensure that interpretations remained grounded in participants\u0026rsquo; accounts.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic variable of the participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDemographic Characteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (f)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55\u0026thinsp;+\u0026thinsp;years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eClinical Experience (Years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u0026ndash;15 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u0026thinsp;+\u0026thinsp;years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster's Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctorate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the demographic characteristics of the study participants, detailing their gender, age, clinical experience, and education level. The majority of participants were female (75%), with males accounting for 25%. Age-wise, most participants were between 35 and 44 years (30%), followed by those aged 45\u0026ndash;54 years and 55\u0026thinsp;+\u0026thinsp;years (both 25%), and 25\u0026ndash;34 years (20%). In terms of clinical experience, participants were fairly distributed across categories, with the largest group having 6\u0026ndash;10 years (30%) and 11\u0026ndash;15 years (30%) of experience, followed by those with over 16 years (25%) and 1\u0026ndash;5 years (15%). Regarding education, the majority held a master\u0026rsquo;s degree (62.5%), while 25% had a doctorate, and 12.5% had a bachelor\u0026rsquo;s degree.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eChallenges and Barriers in Implementing Simulation-Based Education among Nursing Faculty\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTheme\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSub-theme(s)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDescription\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eParticipant Quotes\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLack of Resources\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinancial Constraints\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFaculty report inadequate funding for simulation equipment and resources, limiting the ability to run effective SBE programs.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"We just don\u0026rsquo;t have the budget to purchase the necessary simulation tools we need.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInsufficient Space\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThe physical space available for simulation activities is limited, impacting the ability to conduct simulations effectively.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"The space we have is small, so it's hard to set up all the equipment and allow enough students to participate at once.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime Constraints\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeavy Teaching Load\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMany faculty members struggle to find time in their busy schedules to plan, implement, and reflect on simulation activities due to their heavy teaching load.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"There\u0026rsquo;s no time to integrate simulations effectively. My teaching schedule is already packed.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLimited Class Time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLimited class time hinders the ability to implement extensive simulation activities, as they require more time for setup, execution, and debriefing.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"Our class hours don\u0026rsquo;t allow for extended simulation sessions. We\u0026rsquo;re always in a rush.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eResistance to Change\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkepticism About Effectiveness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSome faculty members express doubt about the effectiveness of simulation in improving student learning outcomes.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I\u0026rsquo;m not sure simulations really add value compared to traditional teaching methods.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLack of Familiarity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSome faculty are hesitant to adopt SBE because they are unfamiliar with the technology and its integration into the curriculum.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"I\u0026rsquo;m not comfortable with the technology. I haven\u0026rsquo;t been trained on it.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInadequate Training and Support\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLack of Professional Development\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFaculty indicate insufficient training on how to use simulation technology effectively and integrate it into their courses.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"There\u0026rsquo;s no formal training offered on how to use the simulators or run these sessions effectively.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInsufficient Institutional Support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eA lack of institutional support (in terms of funding, training, and mentorship) is a significant barrier to implementing SBE successfully.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"We don\u0026rsquo;t have enough institutional backing, and it\u0026rsquo;s hard to make changes without support from higher-ups.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTechnical Barriers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLack of Technical Expertise\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFaculty express concerns about the need for technical expertise to operate simulation technology, which many do not possess.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"The technology is complex, and we don\u0026rsquo;t have the expertise to troubleshoot when something goes wrong.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEquipment Reliability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSimulation equipment is often unreliable or outdated, causing disruptions and frustrations for faculty and students during simulation activities.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"The simulators break down frequently, which disrupts the entire learning experience.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFaculty Buy-in\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePerceived Lack of Relevance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSome faculty members do not see the relevance of simulation-based education for their students and feel that it does not align with their teaching philosophy.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"Simulation seems unnecessary for our curriculum. We have always done fine with traditional methods.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLimited Engagement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFaculty report limited engagement with simulation among some colleagues, either due to disinterest or perceived difficulty in using the approach.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\"Some of my colleagues just aren\u0026rsquo;t interested in using simulations, and that makes it hard to get everyone on board.\"\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e \u003cb\u003erepresents the various challenges and barriers faced by nursing faculty in implementing Simulation-Based Education (SBE).\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThese challenges are grouped into key themes. \u003cb\u003eLack of Resources\u003c/b\u003e includes financial constraints and insufficient space, with faculty highlighting budget limitations for necessary simulation equipment and limited physical space for simulations. \u003cb\u003eTime Constraints\u003c/b\u003e arise from faculty's heavy teaching load and limited class time, both of which hinder the integration of extensive simulation sessions. \u003cb\u003eResistance to Change\u003c/b\u003e is reflected in skepticism about the effectiveness of simulation compared to traditional teaching methods and a lack of familiarity with the technology involved. \u003cb\u003eInadequate Training and Support\u003c/b\u003e includes the absence of formal professional development for using simulation technology effectively and insufficient institutional support, such as funding and mentorship, to facilitate implementation. \u003cb\u003eTechnical Barriers\u003c/b\u003e involve a lack of technical expertise among faculty to operate and troubleshoot simulation equipment and the frequent unreliability of the equipment itself. Finally, \u003cb\u003eFaculty Buy-in\u003c/b\u003e reveals a perceived lack of relevance of simulation-based education for the curriculum and limited engagement among faculty members who are not interested in using this method. These findings underscore a range of logistical, financial, and educational obstacles that impede the widespread adoption of simulation-based teaching methods among nursing faculty.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe nursing faculty members in this study identified several barriers to the implementation of Simulation-Based Education (SBE), including insufficient resources (limited funding, space, and equipment), excessive teaching loads, resistance to adopting innovative teaching methods, lack of professional development and institutional support, technical issues, and doubts about the relevance of SBE in the nursing curriculum. These challenges align with those reported in broader research. For example, Naismith et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] found that the most significant barriers among nurse educators were space limitations, financial constraints, resistance to change, and time pressures, echoing the findings of this study. Similarly, Ismail et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] highlighted heavy curricula, a shortage of simulation-trained faculty, and high equipment costs as significant obstacles to implementing SBE. In addition, Najjuma et al. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] pointed out teacher shortages, inadequate supplies, and resistance to moving away from traditional teaching methods as major barriers to simulation adoption. Benchadlia et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] also identified logistical challenges and lack of training as primary obstacles to integrating SBE into nursing programs. Mwalabu et al. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] similarly concluded that traditional teaching practices, limited simulation exposure, and insufficient institutional support were key factors preventing successful adoption of SBE.\u003c/p\u003e \u003cp\u003eThese studies collectively underscore the multifaceted nature of the challenges facing the implementation of simulation-based education, with resource issues, faculty attitudes, lack of expertise, and institutional priorities all contributing to the difficulty in incorporating SBE into nursing curricula. While these findings are consistent with prior international literature, their significance lies in how these challenges intersect within the local simulation culture. The findings demonstrate that barriers are not merely technical but deeply embedded within organizational structures and academic cultures.\u003c/p\u003e \u003cp\u003eFaculty resistance reflected perceived misalignment between simulation pedagogy and curriculum priorities, rather than opposition to innovation itself. This highlights the importance of leadership endorsement, workload recognition, and structured faculty development to enhance simulation adoption.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eIMPLICATIONS FOR SIMULATION PRACTICE AND FACULTY DEVELOPMENT\u003c/h2\u003e \u003cp\u003eThe findings underscore that effective simulation integration requires a shift from viewing simulation as an \u0026lsquo;add-on\u0026rsquo; teaching strategy to recognizing it as a core pedagogical practice. Institutions must move beyond episodic workshops toward longitudinal faculty development models that include mentorship, peer observation, and structured debriefing training.\u003c/p\u003e \u003cp\u003eIn resource-constrained environments, low- and medium-fidelity simulation, case-based simulation, and hybrid models may offer pragmatic pathways for sustainable implementation. Importantly, faculty need support in aligning simulation scenarios with learning outcomes and assessment frameworks to enhance perceived relevance and educational coherence.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eCultural and Contextual Considerations\u003c/h2\u003e \u003cp\u003eWithin the Indian nursing education context, hierarchical academic structures and examination-driven curricula may inadvertently discourage pedagogical risk-taking. Addressing these cultural dynamics requires leadership engagement, policy-level endorsement of simulation-based teaching, and recognition of simulation facilitation as scholarly and academic work. These insights are transferable to many Western and non-Western contexts where similar organizational cultures exist.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eFuture Directions\u003c/h2\u003e \u003cp\u003eFuture research should focus on implementation-focused studies that evaluate institution-wide simulation strategies, faculty development interventions, and leadership models. Mixed-methods and longitudinal designs would be particularly valuable in examining how faculty confidence, learner outcomes, and organizational culture evolve over time.\u003c/p\u003e \u003cp\u003eAt a practical level, the next step is the development of context-sensitive simulation implementation frameworks that explicitly address faculty workload, training pathways, and infrastructure planning according to Indian Curricula. Such frameworks would support sustainable simulation integration rather than fragmented or individual-led efforts.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study reinforces existing evidence that simulation-based education is a pedagogically powerful approach for nursing education while simultaneously highlighting the persistent and interrelated barriers that hinder its effective implementation [\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7 CR8\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Consistent with prior research, challenges related to infrastructure, faculty preparedness, curricular alignment, and institutional support continue to shape how simulation is enacted in educational practice. By centering the voices and experiences of nursing faculty, this qualitative inquiry extends the literature beyond descriptive accounts of barriers to provide deeper insight into the contextual and organizational dynamics influencing SBE adoption.\u003c/p\u003e \u003cp\u003eRevisiting the literature in light of the study findings underscores the necessity of moving beyond isolated faculty training initiatives toward comprehensive, institutionally supported strategies. These include structured faculty development in simulation pedagogy, deliberate curricular integration aligned with competency frameworks, and administrative policies that recognize simulation-based teaching as core academic work [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Such approaches align with calls in the simulation literature for systemic, faculty-centered models of implementation rather than technology-driven solutions alone.\u003c/p\u003e \u003cp\u003eThe findings contribute to a more nuanced understanding of how simulation is experienced and operationalized within nursing education contexts. Addressing the barriers identified in this study is essential not only for optimizing educational outcomes but also for ensuring that simulation-based education fulfills its broader goal of enhancing clinical readiness and patient safety.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Clearance Declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted after obtaining ethical clearance (Ref: 405/IHEC-IBSEC/SIST dated 16th April 2025) from the Institutional Human Ethics Committee (IHEC) - Institutional BioSafety \u0026amp; Ethical Committee (IBSEC), Sathyabama Institute of Science and Technology, Chennai. Ethical clearance was obtained based on the committee’s approval, and informed consent was secured from the participants in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipant Declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn informed consent, which consisted of the participant information (kept confidential) and a declaration stating that,\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e“\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eI voluntarily give consent to take part in this study. I have fully discussed and understood the benefits, risks, and procedures of the study. This study has been explained to me in a language that I understood. I have been given enough time to ask any questions that I have about the study, and all my questions have been answered to my satisfaction. I know that no compensation/honorarium will be provided to participate in this study.\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cem\u003eI also consented for the data obtained from the study to be used for publication, which\u003c/em\u003e was obtained from every participant, and then the study was conducted as approved by the ethical committee.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication by Authors:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have reviewed and approved the final version of the manuscript and consent to its publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest relevant to the content of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSource of Funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSelf-funding\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the conclusions of this article will be made available by the authors, without undue reservation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBS designed the study and collected the data. NB \u0026amp; LL analyzed the data and drafted the manuscript. BS revised the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to all the participants in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eRauen CA. The history of simulation in nursing education and practice. Clin Simul Nurs. 2004;43(3):123\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCant RP, Cooper SJ. Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review. Nurse Educ Today. 2017;49:63\u0026ndash;71. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nedt.2016.11.015\u003c/span\u003e\u003cspan address=\"10.1016/j.nedt.2016.11.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Ghareeb A, Cooper S. Evaluating the impact of simulation training on nursing students\u0026rsquo; critical thinking skills: A systematic review. Nurse Educ Today. 2016;36:295\u0026ndash;301. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nedt.2015.10.015\u003c/span\u003e\u003cspan address=\"10.1016/j.nedt.2015.10.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuctkar-Flude M, Groll D. Nurse educator perspectives on simulation: Benefits and challenges. Clin Simul Nurs. 2019;27:12\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ecns.2018.09.006\u003c/span\u003e\u003cspan address=\"10.1016/j.ecns.2018.09.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrown D, Fraser K, Wong C, Kothari A, Krewulak K, Nuspl M, Dainty KN. The effectiveness of simulation-based education on novice nurses\u0026rsquo; confidence, knowledge and skills: A systematic review. Int J Nurs Stud. 2020;103:103487. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijnurstu.2019.103487\u003c/span\u003e\u003cspan address=\"10.1016/j.ijnurstu.2019.103487\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eForonda C, Fernandez-Burgos M, Nadeau C, Kelley CN, Henry MN. Simulation in nursing education: A systematic review. J Nurs Educ. 2020;59(1):17\u0026ndash;23. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3928/01484834-20191218-04\u003c/span\u003e\u003cspan address=\"10.3928/01484834-20191218-04\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNeill MA, Wotton K. The role of simulation in undergraduate nursing education: An integrative review. Nurse Educ Today. 2011;31(7):741\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nedt.2011.01.001\u003c/span\u003e\u003cspan address=\"10.1016/j.nedt.2011.01.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarder BN, Ross L, Paul P. Obstacles and facilitators for implementing simulation-based learning in nursing: An integrative review. Nurse Educ Today. 2013;33(9):964\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.nedt.2013.01.011\u003c/span\u003e\u003cspan address=\"10.1016/j.nedt.2013.01.011\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO\u0026rsquo;Regan S, Molloy E, Watterson L. Organizational factors influencing simulation integration in undergraduate nursing curricula: An exploratory mixed methods study. J Nurs Educ. 2016;55(3):161\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3928/01484834-20160217-03\u003c/span\u003e\u003cspan address=\"10.3928/01484834-20160217-03\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBenchadlia F, Benchadlia S, Belkebir A. Simulation in basic nursing student education: Uses and barriers. Open Nurs J. 2023;17:e187443462307030.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIsmail FW et al. (2024). Challenges and opportunities in the uptake of simulation in healthcare education. BMC Med, 22(1), Article 240.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMwalabu G, Cheraghi F, Baayd J. (2024). Factors influencing implementation of simulation in nursing and midwifery education in Malawi. BMC Nurs, 23(1), Article 127.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaismith J, et al. Exploring simulation-based education in pre-registration nurse training: Barriers and facilitators. J Nurs Educ Pract. 2025;15(7):135\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNajjuma JN, et al. Barriers and facilitators of simulation-based education in stroke nursing: Experiences from Uganda. Adv Med Educ Pract. 2025;16:1\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"simulation-based education, nursing faculty, barriers, challenges, qualitative study","lastPublishedDoi":"10.21203/rs.3.rs-8359141/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8359141/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSimulation-based education (SBE) has gained importance in nursing education as a tool for developing clinical skills and decision-making abilities in a safe environment.\u003c/p\u003e\u003ch2\u003eAim of the study:\u003c/h2\u003e \u003cp\u003eThis study aimed to explore the challenges and barriers faced by nursing faculty in implementing SBE within their teaching practices.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA qualitative descriptive design was used to gather data through semi-structured interviews and focus group discussions with nursing faculty members. Participants were selected based on their teaching experience and involvement in simulation activities. Data were analyzed using inductive thematic analysis.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eKey barriers identified included limited resources (financial and space constraints), time limitations due to heavy teaching loads, and resistance to change, including skepticism about the effectiveness of SBE and unfamiliarity with the technology. Additionally, faculty lacked formal training and institutional support for effective SBE integration. Technical issues, such as equipment malfunctions and insufficient expertise, further hindered successful implementation. Some faculty members also viewed SBE as irrelevant to the curriculum, leading to limited engagement.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe study highlights several barriers\u0026mdash;resource limitations, time constraints, resistance to change, and lack of training\u0026mdash;that impede the effective implementation of SBE. Addressing these challenges through enhanced support and training is crucial for successful integration into nursing education.\u003c/p\u003e","manuscriptTitle":"Unveiling the Challenges and Barriers: A Qualitative Inquiry Into Nursing Faculty Experiences With Simulation-based Education","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-23 18:02:27","doi":"10.21203/rs.3.rs-8359141/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b9a86459-accb-49c3-bee7-f5d6adb1e074","owner":[],"postedDate":"February 23rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-15T03:38:48+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-23 18:02:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8359141","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8359141","identity":"rs-8359141","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}