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Nurse Educ Today. 2014 Jul;34(7):1112-8. doi: 10.1016/j.nedt.2014.03.009. Epub 2014 Mar 25.

Time to unravel the conceptual confusion of authenticity and fidelity and their contribution to learning within simulation-based nurse education. A discussion paper.

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Department of Nursing & Health Sciences, University of Huddersfield HD1 3DH, UK. Electronic address:
Centre for Health & Social Care Research, University of Huddersfield, UK. Electronic address:
University Teaching Fellow, Division of Psychology and Counselling, University of Huddersfield, UK. Electronic address:


High-fidelity patient simulation is a method of education increasingly utilised by educators of nursing to provide authentic learning experiences. Fidelity and authenticity, however, are not conceptually equivalent. Whilst fidelity is important when striving to replicate a life experience such as clinical practice, authenticity can be produced with low fidelity. A challenge for educators of undergraduate nursing is to ensure authentic representation of the clinical situation which is a core component for potential success. What is less clear is the relationship between fidelity and authenticity in the context of simulation based learning. Authenticity does not automatically follow fidelity and as a result, educators of nursing cannot assume that embracing the latest technology-based educational tools will in isolation provide a learning environment perceived authentic by the learner. As nursing education programmes increasingly adopt simulators that offer the possibility of representing authentic real world situations, there is an urgency to better articulate and understand the terms fidelity and authenticity. Without such understanding there is a real danger that simulation as a teaching and learning resource in nurse education will never reach its potential and be misunderstood, creating a potential barrier to learning. This paper examines current literature to promote discussion within nurse education, concluding that authenticity in the context of simulation-based learning is complex, relying on far more than engineered fidelity.


Authenticity; Education; Fidelity; Learning; Nursing; Simulation

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