CRITICAL REFLECTION ON PRACTICE DEVELOPMENT Confounding expectations: reflection on simulation with learning disability service users

Background and context: Recent reports have highlighted deficits in care that some people with a learning disability receive when they are admitted to acute care settings. This may be related to the questionable learning offered to pre-registration adult nursing students in this field of practice, since these may not equip the students with the level of skills and knowledge required to deliver safe and effective care to these people. Simulation has become a core component of pre-registration nursing education. Involving service users in simulated learning could be regarded as logical progression towards enhancing the student experience and the subsequent delivery of care. Aims and objectives: To reflect on the impact that simulation involving learning disability service users may have on pre-registration adult nursing students and the facilitator, in terms of personal and professional development. Conclusions: Involving learning disability service users in pre-registration education can provide valuable learning opportunities for the students and the facilitator. Implications for practice: • The learning associated with simulation for the facilitator can be unexpected and unintended • Collaborative working with other health professionals and service users can facilitate personal and professional development • Reviewing Benner’s theory (Benner, 1984) in the light of this learning revealed that I may not recognise the level of expertise I have until the tacit knowledge becomes explicit through