Strategies for the Academic Nursing Environment

1. Safety

Creating emotionally and physically safe spaces for students in high-pressure, real-world simulations and clinicals.

• Begin each session with a brief overview of what to expect, including content advisories.

  1. Evidence: (Jennings, 2018; Najjar & Ackerman-Barger, 2024; Stromberg, 2023)

• Ask students how they prefer feedback.

  1. Evidence: (Appel et al., 2024; Jennings, 2018)

• Allow students to opt out or step away from emotionally overwhelming scenarios.

  1. Evidence: (Jennings, 2018; Stromberg, 2023)

• Maintain predictable routines (e.g., pre-brief, simulation, debrief).

  1. Evidence: (Bosse et al., 2021; Jennings, 2018)

• Clearly state behavioral expectations and objectives.

  1. Evidence: (Bosse et al., 2021; Stromberg, 2023)

• Avoid using shaming language or public correction.

  1.  Evidence: (Jennings, 2018; Stromberg, 2023)

• Choose inclusive debrief spaces.

  1. Evidence: (Appel et al., 2024; Stromberg, 2023)

2. Trustworthiness & Transparency

Be consistent, clear, and honest about expectations, evaluations, and outcomes.

• Explain your grading process and provide rubrics.

  1. Evidence: (Bosse et al., 2021; Stromberg, 2023)

• Be clear about what success looks like.

  1. Evidence: (Jennings, 2018; Stromberg, 2023)

• Debrief with honest, respectful, behavior-based feedback.

  1. Evidence: (Appel et al., 2024; Stromberg, 2023)

• Explain clinical policies and rationales clearly.

  1. Evidence: (Clark, 2023; Stromberg, 2023)

• Follow through on promises (e.g., remediation sessions).

  1. Evidence: (Craig, 2008; Jennings, 2018)

• Acknowledge your own mistakes—model trustworthiness

  1. Evidence: (Jennings, 2018; Najjar & Ackerman-Barger, 2024)

3. Peer Support

Encourage student-to-student connection in stressful learning environments.

• Use peer partners or small teams.

  1. Evidence: (Jennings, 2018; Stromberg, 2023)

• Encourage peer processing of difficult clinical events.

  1. Evidence: (Appel et al., 2024; Stromberg, 2023)

• Incorporate structured peer feedback (e.g., post-sim reflection).

  1. Evidence: (Craig, 2008; Stromberg, 2023)

• Create peer mentoring/buddy systems.

  1. Evidence: (Craig, 2008; Jennings, 2018)

• Support a culture of student-to-student assistance.

  1. Evidence: (Bosse et al., 2021; Stromberg, 2023)

4. Collaboration & Mutuality

Share power with students through co-created learning and feedback.

• Set group goals together for lab or clinical days.

  1. Evidence: (Bosse et al., 2021; Stromberg, 2023)

• Invite students to identify personal goals for improvement.

  1. Evidence: (Craig, 2008; Stromberg, 2023)

• Use check-in/check-out to reflect and share emotions (optionally).

  1. Evidence: (Appel et al., 2024; Stromberg, 2023)

• Co-create ground rules for behavior.

  1. Evidence: (Bosse et al., 2021; Stromberg, 2023)

• Use student-led debriefing (“What went well? What could improve?”).

  1. Evidence: (Jennings, 2018; Stromberg, 2023)

5. Empowerment, Voice & Choice

Give students autonomy and recognize their strengths.

• Let students choose clinical goals.

  1. Evidence: (Jennings, 2018; Stromberg, 2023)

• Allow multiple methods to demonstrate competency.

  1. Evidence: (Craig, 2008; Stromberg, 2023)

• Highlight strengths in evaluations.

  1. Evidence: Jennings (2018); Stromberg (2023)

• Offer revision opportunities for skills checkoffs.

  1. Evidence: (Craig, 2008; Stromberg, 2023)

• Use reflective journaling or guided prompts.

  1. Evidence: (Bosse et al., 2021; Stromberg, 2023)

• Empower students to ask for help without judgment.

  1. Evidence: (Appel et al., 2024; Najjar & Ackerman-Barger, 2024)

6. Cultural, Historical & Gender Issues

Recognize and respond to identity, background, and systemic inequity.

• Acknowledge content may trigger past trauma (e.g., code, violence).

  1. Evidence: (Stromberg, 2023; Wholeben et al., 2023)

• Offer accommodations for trauma history (e.g., shadowing instead of direct care).

  1. Evidence: (Jennings, 2018; Stromberg, 2023)

• Don’t assume emotional readiness—check in.

  1. Evidence: (Appel et al., 2024; Patton & Caffrey, 2023)

• Respect cultural norms in simulation (e.g., modesty, eye contact).

  1. Evidence: (Najjar & Ackerman-Barger, 2024; Stromberg, 2023)

• Avoid stereotyping; invite students to self-identify.

  1. Evidence: (Najjar & Ackerman-Barger, 2024; Patton & Caffrey, 2023)

• Model inclusive patient care and acknowledge bias.

  1. Evidence: (Najjar & Ackerman-Barger, 2024; Stromberg, 2023)