Navigating professional identities: nursing faculty as embedded simulation participants in medical student simulations

Background:
Nursing trained faculty often work as embedded simulated participants (ESPs) in interprofessional simulations. Blending and switching their professional identities as educators, nurses, and role players in ESP roles can be challenging. How they balance tensions in their role portrayal is poorly understood. New and experienced faculty may benefit from clearer guidance about how to approach this task.

Methods:
Using a descriptive phenomenological approach, we explored the experience of nurses working as ESPs in a medical student simulation-based education program. We were sensitised by Dace’s ‘blended boundaries’ model of professional identity for simulation educators. We performed 9 semi-structured interviews with nurses who work as ESPs in our simulation program and undertook a thematic analysis of the transcribed data employing Braun and Clarke’s (2006) six phase approach.

Results:
We identified five themes: 1) Role complexity, 2) Influences and tensions in role portrayal, 3) Judgement and flexibility, 4) Perceived interprofessional outcomes, and 5) Personal and professional impacts.

Discussion:
Role portrayal of ESP nurses, by nurses, in interprofessional simulations is a complex and nuanced task. Carefully planned and reflected upon role portrayal offers powerful opportunities for medical students to gain a deeper understanding of interprofessional healthcare teamwork and the unique role of nurses in those teams. Thoughtful role portrayal supports highly authentic scenario delivery and clinical learning outcomes and can have positive professional impacts for the nurses undertaking this role. We suggest simulation programs should be highly intentional when recruiting, training, and supporting nurses to work as faculty in interprofessional simulations.