Factors that influence student performance during professional experience placement in the Emergency Department

Elicia L. Kunst1, Associate Professor Marion Mitchell2,3, Dr Amy N.B. Johnston2,4

1 Southern Cross University, Gold Coast campus, Southern Cross Drive, Bilinga, QLD 4225 Australia
2 Menzies Health Institute Queensland, Griffith University QLD 4222 Australia
3 Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba Qld 4102 Australia
4 Department of Emergency Medicine, Gold Coast University Hospital, D Block, LG096 1 Hospital Blvd, Southport, QLD 4215 Australia

Horizons for education and training for emergency department (ED) nurses are expanding as technology enables development and use of new and enhanced teaching methods. Simulation is an example of this and is now widely used in nurse education, however there has been little evaluation of the transference of capabilities developed in a simulated setting into student nurses’ clinical practices. As part of a broader project, we examined whether simulation training enhanced student nurses’ perception of their engagement with acute mental health care patients and also whether such training translated into meaningful therapeutic care benefits in acute care settings.

Students with, and without experience of the mental health care simulation activity participated in focus group interviews after attending clinical placements in EDs.Content analysis of the focus group interviews with 22 nursing students, 15 who participated in simulation in mental health care in the ED and 7 who did not, was undertaken by two independent researchers to enhance dependability of data (Polit & Beck, 2014). This revealed a real and noticed benefit from the simulation activities for student self-rated performance in mental health care in the ED. Students who participated in the simulation learning activity reported a greater propensity to engage with mental health care in the ED clinical environment, enhancing their self-efficacy in managing mental health patients in acute care environments and reporting greater confidence with their own capacity.

The support available to students to engage in mental health care in the ED was varied, with students who felt supported by their clinical supervisor/ preceptor reporting that they were more likely to engage in mental health care of patients in the ED. The other key theme that emerged from the focus group interviews was the students’ awareness of being ‘protected’ from complex care situations. Across both groups, those with and without simulation training, students felt that they were excluded from the more challenging clinical situations. Some participants acknowledged that exclusion from these situations may be to protect patients.

As ED patient load, patient acuity, and staff workload increases, more cost & time effective and patient-sensitive training needs to be implemented to support quality ED nursing care. Here we present evidence suggesting that training simulation scenarios maybe one method to upskill graduate nurses to help ensure they are more ‘practice-ready’.


Polit, D. F., & Beck, C. T. (2014). Essentials of Nursing Research: Appraising evidence for nursing practice (8th ed.). Philadelphia: Lippincott Williams & Wilkins.


Elicia Kunst is a Senior Lecturer at Southern Cross University on the Gold Coast, and an Emergency Nurse at John Flynn Hospital. She is currently undertaking a higher degree research program, which was the genesis for this study. Elicia is passionate about delivering innovative education that prepares graduates for the realities of clinical practice, especially in acute care, and also about providing effective care so that patients can achieve their best outcomes.