Students and simulation facilitators' experiences and perceptions of a distraction and interruption simulation: a mixed-methods study.

Background: While distractions and interruptions are leading causes of errors during medication preparation, most nursing students are not taught how to manage distractions in a highly-interruptive environment. To help prepare nursing students to manage distractions and interruptions in clinical practice, we developed, implemented, and evaluated a medication preparation distraction and interruption simulation.

Objectives: To explore student and simulation facilitators experiences and perceptions of a distraction and interruption simulation.

Design: A sequential explanatory mixed-methods design was adopted including surveys, interviews, and focus groups.

Setting: A mid-sized research intensive western Canadian university.

Participants: A total of 112 third year nursing students who engaged in the distraction and interruption simulation, and five simulation facilitators who facilitated the distraction and interruption simulation, participated in this study.

Methods: Students were invited to complete a cross sectional survey following the distraction and interruption simulation and were then invited to participate in focus groups. Simulation facilitators were invited to participate in one-on-one interviews following facilitating the distraction and interruption simulation. All data were collected between June and December 2020.

Results: Data from surveys, interviews, and focus groups were delineated into 4 themes related to the phases of the simulation. The prebriefing provided an overview of the simulation and helped create psychological safety that was imperative for learning about potential medication errors when being distracted and interrupted. The simulation scenario had a high degree of fidelity and helped students implement strategies to manage distractions and interruptions. The structured debrief provided an opportunity for meaningful reflection. The impact of the simulation was apparent as students articulated the balance between speed versus safety and new strategies developed to manage distractions and interruptions in clinical practice.

Conclusion: This study supports the use of simulation to develop key skills for managing distractions and interruptions during medication preparation in clinical practice.