Background
Simulation-based learning is a recognized teaching approach in nursing education.
However, research on the interplay of simulation and clinical reasoning development
is limited. It is assumed that the opportunity to develop skills and clinical reasoning
through simulation will contribute to patient safety.
Purpose
This scoping review aims to summarize the literature on the impact of high-fidelity
simulation (HFS) on students’ clinical reasoning and patients’ safety in undergraduate
nursing education and to use that information to provide recommendations to nursing
educators.
Methods
A scoping review of the literature published between 2011 and 2022 was conducted following
the guidelines of the Joanna Briggs Institute Manual for Evidence Synthesis and a
methodological framework for scoping studies.
Results
Of 155 studies identified, 21 were included in the final review. Based on these studies,
HFS may affect patient safety by stimulating clinical reasoning in a safe environment
for undergraduate nursing students. Exposure to HFS improves students’ readiness and
alleviates “transition shock” and anticipatory anxiety in the clinical setting. HFS
cannot replace but may be used in conjunction with real-life nursing practice to support
the development of clinical reasoning in students.
Conclusion
Simulation promotes active learning as students engage in lifelike scenarios. Repetitive
practice of nursing skills in simulation contributes to students’ dexterity, leading
to improved safety, clinical performance, and translation of theory to practice. In
addition, prebriefing and debriefing sessions after the HFS activity provide opportunities
for exploration of factors influencing patient safety.
Keywords
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References
- Systematic review of the literature related to the NLN/Jeffries Simulation Framework.Nursing Education Perspectives. 2015; 36: 281-291https://doi.org/10.5480/15-1655
- The impact of high-fidelity simulation on knowledge, critical thinking, and clinical decision-making for the management of pre-eclampsia.International Journal of Gynecology & Obstetrics. 2020; 150: 354-360https://doi.org/10.1002/ijgo.13243
- Comparing the effects of simulation-based and traditional teaching methods on the critical thinking abilities and self-confidence of nursing students.Journal of Nursing Research. 2018; 26: 152-157https://doi.org/10.1097/jnr.0000000000000231
- Nursing students’ satisfaction: A comparison between medium- and high-fidelity simulation training.International Journal of Environmental Research and Public Health. 2021; 18 (Article 804)https://doi.org/10.3390/ijerph18020804
- Debriefing in simulated-based learning: Facilitating a reflective discusssion.The Journal of Perinatal & Neonatal Nursing. 2010; 24: 302-309https://doi.org/10.1097/jpn.0b013e3181f6b5ec
- Scoping studies: Towards a methodological framework.International Journal of Social Research Methodology. 2005; 8: 19-32https://doi.org/10.1080/1364557032000119616
- Development of simulation education debriefing protocol with faculty guide for enhancement clinical reasoning.BMC Medical Education. 2019; 19 (Article 197)https://doi.org/10.1186/s12909-019-1633-8
Baptista, R., Pereira, F., & Martins, J. (2016). Perception of nursing students on high-fidelity practices: A phenomenological study. Journal of Nursing Education and Practice, 6(8), 10-21. http://dx.doi.org/https://doi.org/10.5430/jnep.v6n8p10
- Effects of high-fidelity simulation on the critical thinking skills of baccalaureate nursing students: A causal-comparative research study.Nurse Education Today. 2020; 92, Article 104494https://doi.org/10.1016/j.nedt.2020.104494
- Graduate nurses’ perception of the effect of simulation on reducing the theory-practice gap.SAGE Open Nursing. 2019; https://doi.org/10.1177/2377960819896963
Brown Tyo, M., & McCurry, M. K. (2019). An integrative review of clinical reasoning teaching strategies and outcome evaluation in nursing education. Nursing Education Perspectives, 40(1), 11–17. http://doi.org/https://doi.org/10.1097/01.NEP.0000000000000375
- Transfer of learning from university-based simulation experiences to nursing students’ future clinical practice: An exploratory study.Clinical Simulation in Nursing. 2019; 35: 17-24https://doi.org/10.1016/j.ecns.2019.06.003
- The how when why of high fidelity simulation.Stat Pearls Publishing, 2022
- High-fidelity simulation training programme for final-year medical students: implications from the perceived learning outcomes.Hong Kong Medical Journal. 2019; 25: 392-398https://doi.org/10.12809/hkmj197898
- The impact of simulation based education on nursing confidence, knowledge and patient outcomes on general medicine units.Nurse Education in Practice. 2018; 29: 70-75https://doi.org/10.1016/j.nepr.2017.11.017
- Nursing education in a pandemic: Academic challenges in response to COVID-19.Nurse Education Today. 2020; 92, Article 104471https://doi.org/10.1016/j.nedt.2020.104471
- Pre-brief in simulation-based experiences: A scoping review of the literature.Clinical Simulation in Nursing. 2021; 61: 86-95https://doi.org/10.1016/j.ecns.2021.08.003
- Clinical judgment conceptualization scoping review protocol.Teaching and Learning in Nursing. 2021; 17: 84-101https://doi.org/10.1016/j.teln.2021.10.003
- Impact of high-fidelity simulation on the development of clinical judgment and motivation among Lebanese nursing students.Nurse Education Today. 2016; 46: 36-42https://doi.org/10.1016/j.nedt.2016.08.026
- Using simulation to teach patient safety behaviors in undergraduate nursing education.Journal of Nursing Education. 2010; 49: 48-51https://doi.org/10.3928/01484834-20090918-10
- The influence of journaling on nursing students: A systematic review.Journal of Nursing Education. 2022; 61: 29-35https://doi.org/10.3928/01484834-20211203-01
- The effects of using high-fidelity simulation in undergraduate nursing education: A multicenter randomized controlled trial with a process evaluation.International Journal of Educational Research. 2021; 109, Article 101813https://doi.org/10.1016/j.ijer.2021.101813
- Correlations between clinical judgement and learning style preferences of nursing students in the simulation room.Global Journal of Health Science. 2016; 8: 1-13https://doi.org/10.5539/gjhs.v8n6p1
- Simulation in nursing education: Current regulations and practices.Journal of Nursing Regulation. 2014; 5: 25-30https://doi.org/10.1016/s2155-8256(15)30084-3
- INACSL standards of best practice: SimulationSM simulation glossary.Clinical Simulation in Nursing. 2016; 12: S39-S47https://doi.org/10.1016/j.ecns.2016.09.012
- Education of student nurses – A systematic literature review.Nurse Education Today. 2017; 55: 112-121https://doi.org/10.1016/j.nedt.2017.05.005
- Perceived benefits and challenges of repeated exposure to high fidelity simulation experiences of first degree accelerated bachelor nursing students.Nurse Education Today. 2016; 36: 298-303https://doi.org/10.1016/j.nedt.2015.07.014
- High-fidelity simulation and nursing students’ anxiety and self-confidence: A systematic review.Nursing Forum. 2019; 54: 358-368https://doi.org/10.1111/nuf.12337
- Simulation in preparation or substitution for clinical placement: A systematic review of the literature.Journal of Nursing Education and Practice. 2015; 5: 132-140https://doi.org/10.5430/jnep.v5n9p132
- Simulation in nursing education.Nursing. 2017; 47: 18-20https://doi.org/10.1097/01.nurse.0000520520.99696.9a
- The influence of simulation experiences on new nurses’ clinical judgment.Clinical Simulation in Nursing. 2018; 25: 22-27https://doi.org/10.1016/j.ecns.2018.10.008
- Nursing students’ perceptions of learning after high fidelity simulation: Effects of a three-step post-simulation reflection model.Nurse Education Today. 2016; 40: 219-224https://doi.org/10.1016/j.nedt.2016.03.011
- Easing student transition to graduate nurse: A simulated professional learning environment (SIMPLE) for final year student nurses.Nurse Education Today. 2014; 34: 349-355https://doi.org/10.1016/j.nedt.2013.04.026
- Healthcare simulation dictionary.2nd ed. AHRQ Publication No. 20-0019, 2020https://doi.org/10.23970/simulationv2
- Improving students’ safety practice behaviors through a simulation-based learning experience.Journal of Nursing Education. 2015; 54: S35-S38https://doi.org/10.3928/01484834-20150218-05
- Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence.Academic Medicine. 2011; 86: 706-711https://doi.org/10.1097/ACM.0b013e318217e119
- Clinical reasoning in nursing students: A concept analysis.Nursing Forum. 2021; 56: 1008-1014https://doi.org/10.1111/nuf.12628
- Simulation in medical education from the perspective of patients safety [Article in Spanish].Revista Médica de Chile. 2017; 145: 514-526
- Nursing students’ experiences with high-fidelity simulation.International Journal of Nursing Education Scholarship. 2015; 12: 27-35https://doi.org/10.1515/ijnes-2015-0010
- A review: Using simulation-based education to substitute traditional clinical rotations.Teaching and Learning in Nursing. 2019; 14: 274-278https://doi.org/10.1016/j.teln.2019.03.006
Peters, M., Godfrey, C., McInerney, P., Munn, Z., Trico, A., & Khalil, H. (2020). Chapter 11: Scoping reviews. In E. Aromataris & Z. Munn (Eds.), JBI Manual for Evidence Synthesis. JBI. 10.46658/jbimes-20-12
- High-fidelity simulation and clinical judgment of nursing students in a maternal–newborn course.Western Journal of Nursing Research. 2020; 42: 829-837https://doi.org/10.1177/0193945920907395
- The effect of formative capstone simulation scenarios on novice nursing students’ anxiety and self-confidence related to initial clinical practicum.Clinical Simulation in Nursing. 2017; 13: 116-120https://doi.org/10.1016/j.ecns.2016.11.001
- The effect of simulation nursing education using the outcome-present state-test model on clinical reasoning, the problem-solving process, self-efficacy, and clinical competency in Korean nursing students.Healthcare. 2021; 9https://doi.org/10.3390/healthcare9030243
- Effectiveness of patient simulation in nursing education: meta-analysis.Nurse Education Today. 2015; 35: 176-182https://doi.org/10.1016/j.nedt.2014.09.009
- Debriefing: The most important component in simulation?.Clinical Simulation in Nursing. 2011; 7 (https://escholarship.org/uc/item/5ss5z4b7): e105-e111
Small, S. P., Colbourne, P. A., & Murray, C. L. (2018). High-fidelity simulation of pediatric emergency care: An eye-opening experience for baccalaureate nursing students. Canadian Journal of Nursing Research, 50(3), 145–154. 10.1177%2F0844562118767786
- Using critical care simulations to prepare nursing students for capstone clinical experiences.Dimensions of Critical Care Nursing. 2018; 37: 69-77https://doi.org/10.1097/DCC.0000000000000283
- The effect of multiple exposures in scenario-based simulation—A mixed study systematic review.Nursing Open. 2021; 8: 380-394https://doi.org/10.1002/nop2.639
- High-fidelity simulation among bachelor students in simulation groups and use of different roles.Nurse Education Today. 2013; 33: 1599-1604
- Exploration into how simulation can effect new graduate transition.Clinical Simulation in Nursing. 2017; 13: 465-470https://doi.org/10.1016/j.ecns.2017.05.013
- Analysis of the effects of high-fidelity simulation on nursing students’ perceptions of their preparedness for disasters.International Emergency Nursing. 2018; 38: 3-9https://doi.org/10.1016/j.ienj.2018.03.002
- Challenges nurse educators experience with development of student nurses’ clinical reasoning skills.Nurse Education in Practice. 2019; 40, Article 102623https://doi.org/10.1016/j.nepr.2019.102623
- Nursing students first experience on high fidelity simulation: A phenomenological research study.Nurse Education in Practice. 2021; 55, Article 103162https://doi.org/10.1016/j.nepr.2021.103162
- Exploring perceptions and barriers in developing critical thinking and clinical reasoning of nursing students: A qualitative study.Nurse Education Today. 2020; 95, Article 104600https://doi.org/10.1016/j.nedt.2020.104600
- Improving clinical judgment by simulation: a randomized trial and validation of the Lasater clinical judgment rubric in Chinese..BMC Medical Education. 2019; 19 (Article 20)https://doi.org/10.1186/s12909-019-1454-9
- The terminology of clinical reasoning in health professions education: Implications and considerations.Medical Teacher. 2019; 41: 1277-1284https://doi.org/10.1080/0142159X.2019.1635686
- Undergraduate nursing students’ perceptions of high-fidelity simulation-based learning. International Archives of.Nursing and Health Care. 2016; 2 (Article 052, 10.23937/2469-5823/1510052)
- Evaluating best educational practices, student satisfaction, and self-confidence in simulation: A descriptive study.Nurse Education Today. 2018; 60: 28-34https://doi.org/10.1016/j.nedt.2017.09.006
- Prelicensure nursing students’ perspectives on video-assisted debriefing following high fidelity simulation: A qualitative study.Nurse Education Today. 2019; 79: 1-7https://doi.org/10.1016/j.nedt.2019.05.001
- The learning effectiveness of high-fidelity simulation teaching among Chinese nursing students: A mixed-methods study.Journal of Nursing Research. 2021; 29e141https://doi.org/10.1097/JNR.0000000000000418
- Baccalaureate nursing students’ experiences with high-fidelity simulation: Protocol for a qualitative systematic review..BMJ Open. 2020; 10 (Article e040171)https://doi.org/10.1136/bmjopen-2020-040171
- Simulation-based medical education: An ethical imperative.Academic Medicine. 2003; 78: 783-788https://doi.org/10.1097/00001888-200308000-00006
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Conflicts of Interest: None.
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© 2023 National Council of State Boards of Nursing. Published by Elsevier Inc. All rights reserved.
