Improving performance amongst nursing students through the discovery of discrepancies during simulation

• Discrepancy discovery can aid learning by identifying aspects of performance which requires development.
• Discrepancy may be identified either by comparing performance with an occupational standard or by direct comparison with peers.
• Discrepancy discovery can occur in any context it is especially useful in simulation as this allows the learner and the teacher to explore areas for development.

Discrepancy creation is a form of self-regulated learning which can be used to improve individual performance. Discrepancy can be created as a result of comparison against an occupational standard or when an individual strives to achieve higher personal goals. This study explores the process of discrepancy discovery and reduction following simulation sessions. Second year under-graduate nursing students undertook three simulation sessions over a one year period. After each session the participants completed a series of visual analogue scales to rate their own performance and the perceived performance of peers, final year student and a newly registered nurse. Once discrepancy had been identified, participants were asked to produce a short written action plan on how the discrepancy could be addressed and to work on this action plan between sessions.A total of 70 students completed discrepancy scores for all three scenarios. The most common areas of discrepancy were understanding physiology, understanding medicines and pharmacology, patient assessment and handover (hand off). Wilcoxon Signed Ranks suggested a statistically significant difference between student scores in all areas with the exception of team-work. All of the participants used peers as their comparator when identifying discrepancy. There was also a statistically significant difference in the scores following each simulation session suggesting improved performance.