Physiotherapy students’ experiential learning through curriculum-integrated high-complexity simulation: a qualitative study

Abstract

Abstract Background Developing both technical and non-technical competencies is a core goal in physiotherapy education. While traditional clinical placements offer essential hands-on experience, they may not fully prepare students for the complexity and unpredictability of real-world clinical practice. Simulation-based education (SBE) can help bridge this gap by providing a safe, realistic, and structured learning environment. Objective To explore undergraduate physiotherapy (PT) students’ experiences of curriculum-integrated high-complexity SBE, through the lens of experiential learning theory. Design Qualitative descriptive study. Setting Faculty of Health Sciences and Wellbeing, University of Vic – Central University of Catalonia, Spain. Participants Twenty-eight undergraduate PT students from the second, third, and fourth academic years (fourth, sixth, and eighth semesters, respectively) participated in six focus groups conducted between June and October 2024. Participants were purposively sampled to ensure diversity in academic year and simulation roles (PT or observer). Exposure High-complexity simulation sessions embedded in the PT curriculum, involving trained simulated patients and structured facilitation. Main outcomes and measures Students’ experiences of learning processes during SBE. Data were analysed using reflexive thematic analysis and later interpreted in relation to experiential learning theory. ATLAS.ti software was used to support data management. Transcripts were returned to participants for member checking. Results Two overarching themes emerged: (1) Constructing non-technical skills through action , observation , and reflection , and (2) Experiencing safety and immersion . Students valued both performing and observing roles, reporting that observation fostered reflection, vicarious learning, and reduced performance anxiety. Structured debriefings, progressive exposure, and peer feedback reinforced learning, while facilitators’ guidance and psychological safety promoted confidence. The use of simulated patients enhanced emotional immersion and authenticity, and students highlighted their potential role in feedback. Conclusions High-complexity SBE was perceived as a meaningful and situated learning experience that supported reflection, knowledge integration, and application, contributing to the development of non-technical skills and confidence. Trial registration NCT06852482 (clinicaltrials.gov).