Perceptions of nursing students after a simulated educational intervention on neonatal pain: qualitative study

Braga, Diana Abreu Costa; de-Souza, Isabella Pavarine; da-Silva, Rubinéia Stefania; Rocha, Nylze Helena Guillarducci; Silva, Maria Paula Custódio; Contim, Divanice

doi:10.63231/2595-0118.202667-en

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ORIGINAL ARTICLE • BrJP 9 • 2026 • https://doi.org/10.63231/2595-0118.202667-en linkcopy

Perceptions of nursing students after a simulated educational intervention on neonatal pain: qualitative study

Percepções de discentes de enfermagem após intervenção educativa simulada sobre dor neonatal: estudo qualitativo

Authorship SCIMAGO INSTITUTIONS RANKINGS

BACKGROUND AND OBJECTIVES Pain results in immediate, significant, and sometimes permanent consequences for the health of the newborn. Its assessment and management are necessary responsibilities in the care of this population; therefore, educational and awareness initiatives are fundamental within the academic setting to ensure effective and safe clinical practice. The objective of this study were to describe nursing students perceptions of newborn pain through an educational intervention with sensory simulation.

METHODS This exploratory, descriptive, qualitative study involved 22 nursing undergraduates who underwent a sensory simulation during an elective course in an undergraduate program at a federal public university in the countryside of Minas Gerais, Brazil. Data collection was conducted between April and August 2023 through a virtual platform, using self-assessment questions. The data were subjected to content analysis, as proposed by Bardin.

RESULTS Participants considered the educational intervention timely and satisfactory, perceiving it as a new way of learning and assigning meaning to the care of newborns in pain.

CONCLUSION The educational intervention enabled students to construct knowledge about neonatal pain in a critical and reflective manner, contributing to the improvement of care provided in the neonatal context.

Keywords:
Newborn; Nursing students; Pain perception; Teaching

Robust teaching methods combined with theoretical lectures, practical training and simulations of real-life situations, and assessment. The innovative method of this study used empathy to immerse students in the role of a neonatal patient, which transcended intellectual reasoning and established effective and emotional learning

The active teaching methods applied emerge as a strategic alternative for learning good clinical practices, redefined in line with the Sustainable Development Goals (SDGs), which encourage safe and qualified care, minimizing the negative repercussions of long-term unrelieved pain experiences in newborns

Innovative strategies for undergraduates can facilitate the dissemination of technologies aimed at scientific empowerment, promoting a careful look at neonatal pain management, minimizing the tendency to address the topic only in the professional field

Stage I: Theory
Made available to students via the Moodle platform one week before the content was offered.
A pre-test on pain in NBs was made available via an online form to assess participants' prior knowledge. After the responses were submitted, supplementary material on the topic was made available on the student portal to support independent study before the class.
Content:
• Concepts about neonatal pain;
• Approach of stress and pain intensity caused by procedures in neonatal units;
• Pain assessment tools and their applicability in neonatal clinical practice;
• Non-pharmacological and pharmacological measures for pain and stress relief in NBs and possible combinations of strategies;
• Impacts of pain on child development and its repercussions in adulthood.
Stage 2 – Practice
In the laboratory of skills, a simulated scenario was created to develop skills related to pain assessment and management, as well as clinical decision-making.
The students were organized into groups, and one student from each group was assigned to act as the nurse in charge, who was to assess and decide on strategies for pain and stress relief in the face of a heel prick on the NB to measure blood glucose in the presence of the mother (clinical actor).
After the scenario was performed, the participants were guided to a debriefing, in which they were able to rethink each moment of the scenario, what they thought needed improvement, and the strengths, and they were able to reflect on and express the feelings generated by the plot and their own participation.
Activity:
• Practice pain assessment and management in a simulated neonatal environment.
Stage 3 – Sensory Simulation
The room temperature was lowered, and background noises such as crying, telephones, and hospital equipment whistles were played to simulate the conditions commonly found in neonatal units.
The students sat in chairs arranged in a circle and were blindfolded in an attempt to create a sense of the unknown and unpredictability of the procedures.
For sensory stimulation, ice packs were applied to exposed areas of skin to simulate the thermal sensation of the touch of healthcare professionals' hands, stethoscopes, and other equipment used in NB care.
Tourniquets and light touches with sharp objects were used to represent procedures such as venous catheterization, lack of care during certain interventions, and multiple punctures.
After two minutes of these unpleasant sensations, the background audio was changed to a calm and serene environment, the students were covered with blankets to remind them of the warmth and comfort that comes from being wrapped up, they were rocked with gentle touches of the hands, and offered a sweet treat to remind them of the sweet solutions and relief they can bring.
During the reflection period, the participants shared their experiences in the activity. Awareness was raised again about the proper assessment of pain and its relief, the frequency and intensity of invasive procedures, the inability of NBs to consciously understand what is happening around them, and, finally, the impact that the individual decisions of health professionals, including students in training, can have on the quality of care provided.
Experience:
• Experience the stress and pain to which NBs admitted to neonatal units are exposed through sensory simulation.
Stage 4 – Assessment
The online post-test form was sent to students, with questions related to the assessment of knowledge acquisition and an additional question about their experience and satisfaction with participating in the sensory simulation for further analysis.

Categories	Subcategories	Indicators	Operational definition
Learn about NB pain	Sensations and feelings	Agony	Gain an in-depth understanding of NB pain through sensory simulation.
		Feeling of alertness
		Anxiety
		Disturbance
	Empathetic learning	Perceive and understand the NB
		Put yourself in someone else's place
		Feel like you are in that situation
		Perception of intensity
	Reflections about the practice	Qualified information
		Reception during care assistance
		Guided conduct after training
		Perceived changes in oneself
Qualified strategies for learning about the NB	Innovative teaching strategies	Concrete idea after the experiment	The contrast between learning with traditional methods and learning with innovative, qualified, and satisfying strategies.
		Qualified practice
		Effective and didactic practice
		Interest
	Perception of realism	Simulation of a NICU
	Perception of realism	Concept of reality
	Impact of ambience	Discomfort caused by a non-harmonious environment
	Impact of ambience	Induction and potentiation of environment-related pain
	Satisfaction	Unforgettable experience
		Exceeding expectations
		A stimulating and enjoyable experience

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