Student-instructed simulation: Bridging theory and practice within a large classroom in nursing education

Background This article presents Student-Instructed Simulation (SIS), an innovative approach to large classroom simulation, designed to promote active learning and bridge the theory-practice gap in nursing education. Inspired by principles from virtual simulation, SIS engages students in verbally instructing faculty members who role play a nurse delivering care to a standardized patient in real time. Method SIS was implemented in a theoretical course on acute and critical illness with a large cohort of students. An evaluative qualitative approach was used to explore the students' perceptions of learning outcomes, engagement and challenges through an anonymous open-ended questionnaire. Results The students described SIS as a visual, engaging and low-pressure learning experience that supported clinical reasoning, integration of theoretical knowledge, and understanding of the professional nursing role. Peer learning and the low-pressure environment were highlighted as key strengths, while limitations related to debriefing time and opportunities to participate. Conclusion Although SIS does not provide hands-on skills training, it represents a scalable and resource-efficient approach that may complement traditional simulation by supporting students in verbalization, clinical reasoning, and preparation for clinical practice.