Nursing education increasingly relies on simulation-based learning (SBL) to bridge the gap between theoretical knowledge and practical application, particularly in contexts where traditional clinical placements are limited or where access to high-fidelity simulation technologies is restricted (Albagawi et al., 2024). An earlier study by Zakari et al. (2017) provided phenomenological insight into Saudi simulation educators’ experiences within the cultural and institutional context. They reported that effective simulation requires clear educator roles and processes. The study by Almotairy et al. (2023) serves as an environmental scan of SBL, highlighting the gaps in training and preparation for faculty facilitators and the lack of professional development and institutional support. This study lacked the explanatory and narrative depth of the “lived experience” of educators’ decision-making in the bachelor of nursing program.

Simulation educators’ decisions affect the creation of realism and the effectiveness of simulation. Educators’ decisions often involve determining the dimensions and levels of fidelity, designing and delivering a cue, and ensuring cost efficacy (Jeffries, 2020). Expert educators frequently rely on their accumulated experience and implicit knowledge to make rapid, effective instructional choices, often preceding more analytical considerations (Okoli & Watt, 2018). Such intuitive judgments, akin to "gut feelings" in other professional domains, enable educators to quickly recognize situational demands and operationalize competencies into effective learning experiences (Dexter, 2023; Vincent, 2021). For simulation to be an evidence-based practice, the decision-making approach used by educators needs to be understood, which is beyond the current published data (Cant et al., 2022). Hammond argued that decision-making is neither rational nor intuitive but rather exists on a continuum. Cognitive continuum theory (CCT) is a unified decision-making theory that recognizes the application of knowledge for research purposes and for educators (Hammond, 1996). An educator, the decision maker, may shift along the continuum depending on the task environment, ill- or well-structured; cues available; time available; and level of expertise. The CCT consists of six dimensions, including the modes of cognition. A decision maker may use any of the cognitive modes ranging from intuition to analysis during decision-making processes, depending on the other dimensions. In the context of this study, the CCT was used to interpret the findings.

This study used van Manen’s hermeneutic phenomenology qualitative (van Manen, 1997) and explorative study with a semistructured interview method to collect data about SBL in a bachelor’s degree nursing program at Saudi Arabian University.

The semistructured interview method was carried out by the principal researcher to ensure the validity of the questions asked. The interviews were conducted for 45–60 minutes in a quiet room located at the College of Nursing. A digital audio recorder was used to record information provided confidentially. The following questions were asked: How do you feel about SBL? How do you train students in SBL for essential procedures and clinical skills? What do you think about the students participating in SBL? How do you evaluate the students’ performance in SBL? How do you measure the effectiveness of simulation practices?

To maintain rigor, a semistructured interview guide was utilized to ensure consistent questioning and allow the participants to elaborate on topics that resonated with them.

The purpose of this study was to explore the lived experiences of nursing educators as they make decisions in the context of SBL. In keeping with van Manen’s hermeneutic phenomenology, the focus of analysis was on uncovering the meaning of decision-making as it was experienced by the educators. Through immersion in narratives, thematic reflection, and iterative writing can occur. The five structures of decision-making that emerged were deliberate craft of preparation; responsive attunement in the moment; negotiating readiness and challenge; shaping the flow of feedback and reflection; and curriculum and programmatic influences. These aspects do not stand as rigid categories but as interpretive insights that illuminate the essence of what it is like to make pedagogical decisions in simulations. Together, these themes portray decision-making as a lived tension between planning and spontaneity, analysis and intuition, responsibility and care.

Educators described preparation as a deliberate act of decision-making in which each choice carried responsibility for shaping the learning experience. The process of selecting modalities, setting expectations, and arranging the environment was experienced as an intentional craft, balancing pedagogical goals with available resources. One facilitator reflected on the responsibility of choosing the right modality: “Planning the simulation by choosing the correct modality or equipment on the basis of learning objectives, task trainers, fidelity manikins, etc.… Preparation for simulation in prebriefing includes role expectations, preparing the simulation area, introducing the setting and equipment, and setting rules for debriefing prior to the simulation” (Educator 2). Preparation was also lived as an act of establishing psychological and procedural readiness. Educators made decisions about how much orientation to provide, what rules to set, and how to reduce students’ uncertainty: “We gave instruction to students about the location of medication, supplies, limitation of manikins, normal sounds, and how to call the supervisor” (Educator 6). Another facilitator emphasized how the physical setup itself was part of preparation and decision-making: “We are considered as a simulated session… because we already set up the table, the bed, the manikins… if we want, for example, heart sound… there is a compound, computer, and a manikin.” (Educator 3). These accounts reveal that preparation decisions were experienced as purposeful acts of crafting the conditions for learning. Choosing modalities, orienting students, and arranging the physical and psychological environment were expressions of professional responsibility in ensuring that the simulation would unfold meaningfully.

This study explored the lived experiences of nursing educators as they made pedagogical decisions in SBL. The analysis revealed decision-making as a dynamic and multifaceted phenomenon expressed through four interrelated aspects: deliberate preparation, responsive attunement in facilitation, the negotiation of readiness and challenge, and the shaping of assessment and feedback, all within the broader constraints of the curriculum and institutional context. Taken together, these experiences portray decision-making not as a series of isolated acts but as an ongoing balancing of responsibility and care in the service of student learning. These findings echo earlier research that emphasized the complex and situated nature of simulation pedagogy (Dieckmann et al., 2012; Jeffries, 2020). Like Benner et al. (2009) work on clinical judgment, educators in this study described their decisions as influenced by both explicit knowledge and tacit, experiential understanding. This study extends the prior literature by placing the focus not on students or simulation outcomes but rather on educators’ own lived experiences in decision-making. By highlighting the perspectives of educators, the findings contribute to an understanding of how educators themselves navigate simulation as a pedagogical practice.

In light of CCT (Hammond, 1996), decision-making is not confined to either purely analytical or purely intuitive modes but rather occurs along a continuum, with many professional judgments occupying a quasirational middle ground. Educators in this study demonstrated movement along this continuum: in scenario design, they relied on structured, analytical planning aligned with curricular goals; in facilitation, they described intuitive judgments guided by experience and responsiveness to students; and in assessment, they combined formal tools such as checklists with interpretive readings of student cues, reflecting quasirational decision-making. These shifts illustrate that pedagogical decisions in simulations are fluid, context dependent, and embedded in professional responsibility. The ability of educators to create a context for learning and contribute to good judgment is considered an effective facilitator (Maestre & Rudolph, 2015). Mulli et al. (2022) argued that adequate preparation for simulation is key to reflection-in-action during students’ performance. Preparation may involve familiarizing students with the technology and equipment and prereading and assignment activities before the simulation (Mulli et al., 2022). The lived experience of decision-making in simulation was revealed as a continuous movement between responsibility, attunement, negotiation, and care. Educators did not speak of decision-making as isolated choices but as an ongoing orientation toward shaping the conditions of student learning. In preparation, decision-making was lived as a deliberate craft, a careful weighing of modalities, equipment, and expectations, where each choice carried the responsibility of setting the stage for authentic engagement (Leigh & Steuben, 2018). Educators spoke of reading students’ cues, listening for silence or hesitation, and deciding whether to intervene or step back. Recognizing these nonverbal cues is essential for identifying potential areas of confusion or disengagement, enabling timely interventions (Ghafar & Ali, 2023). These were not technical acts but embodied judgments guided by intuition and professional wisdom. Decision-making also included negotiating to calibrate complexity to student readiness, walking the fine line between challenge and overwhelm, and ensuring that learning remained possible. Educators decide to adjust SBL according to student pace and promote self-direct learning, thus allowing students to correct their cognitive errors while learning from their failure and mistakes (Yeo & Jang, 2023).

In assessment, decisions carry the weight of reinforcing or redirecting growth. Educators moved between formal tools such as checklists and rubrics and informal readings of nonverbal cues, making choices about when to correct, when to allow repetition, and when to let students struggle toward competence (Meylani, 2024). Beyond the immediate encounter, decision-making extended to the programmatic level, where educators navigated institutional gaps, relied on rubrics where available, and at times turned to student evaluations as imperfect but meaningful measures of impact. This necessitates a rigorous examination of various methodologies to evaluate program effectiveness, ensuring that budgetary decisions are informed by robust evidence rather than anecdotal perceptions (Hollands et al., 2024). In sum, the essence of educators’ decision-making in simulations was not a linear process but rather a lived balancing act between analysis and intuition, structure and spontaneity, formal frameworks and embodied wisdom.

This study reveals decision-making in simulation as a lived experience of balancing preparation and responsiveness, analysis and intuition, structure and flexibility. Interpreted through CCT, educators’ accounts illustrate how their judgments shift fluidly along a continuum, depending on context and pedagogical goals, with implications for faculty development and curriculum design. Ultimately, decision-making was experienced not as a technical task but as an ethical and pedagogical responsibility: the crafting of creating meaningful, safe, and challenging learning environments for nursing students. Facilitators who share their lived experiences with SBL have offered better insight into decision-making routines and challenges in simulation practices among women at the College of Nursing.