Balancing between challenges and trust: Nursing students’ experiences of participating in a course in wilderness medicine

Abstract

Newly graduated nurses are expected to have acquired the knowledge and skills necessary to be safe and accountable practitioners (Maartensson and Lofmark, ¨ 2013). Hence, nursing students should not only develop cognitive knowledge about the what and how of nursing skills, but also about using evidence-based nursing practice. Bergen and Santo (2018, p. 362) defines action competence as having self-awareness and “deeming oneself qualified and capable of working through a problem to obtain a solution”. Action competence naturally starts with critical thinking, but focuses on actions and may be defined as the perceived capability to select and perform actions. When action competence is acquired, students can approach a clinical situation by seeking information, analyzing data, evaluating and reflecting with peers and deciding on appropriate actions to solve a specific problem. However, newly graduated nurses report that they lack the necessary skills to feel confident in their work (Chesser-Smyth and Long, 2013; Milton-Wildey et al., 2014; Ortiz, 2016) and that the transition from student to registered nurse can be experienced as a shock (Duchscher, 2009; Murray et al., 2019). In this article, we will describe how simulations based on the concept of wilderness medicine can be used to enhance students’ development of action competence. We will also reflect on the possibilities to use similar teaching-learning strategies in other outdoor contexts than those traditionally associated with wilderness medicine.