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By: Dr. Pamela Jeffries In her responses to the questions that follow, Dr. What are the significant milestones in your work as a leader in nursing?

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The simulated clinical experience in nursing education: a historical review

Scora October 6, pm. Leave a Reply Cancel reply Enter your comment here Fill in your details below or click an icon to log in:. Email required Address never made public. Name required. A systematic search of the literature resulted in 40 published studies that were eligible for inclusion in this meta-analysis. These primary studies provided evidence of the effects of simulation-based nursing education in various evaluation and learning environments. Random assignment studies accounted for The medium-to-large effect size 0. This is consistent with the findings of a study on health professional education [ 16 ], which reported that technology-enhanced simulation training produced moderate to large effects.

Regarding simulator fidelity level, HFS 0. This result supports the findings of a previous meta-analysis of simulation in health professions, showing that HSF offers benefits over LFS [ 17 ]. However, these findings should be interpreted with caution. Recent studies suggest that the degree of realism required of a simulation is a function of the learning task and context, and can therefore vary widely for different areas of educational outcomes [ 17 ].

Satisfaction levels are high among students participating in simulation learning that utilizes human simulators or SP [ 18 ]. Considering that problem-based learning PBL lessons were found to enhance student attitudes more than traditional lectures [ 19 ], student participation and actual activity appear to have positive effects on satisfaction and learning attitudes. In the sub-group analysis for learning outcome according to fidelity level, the effect size was the largest for psychomotor outcome, followed by affective and cognitive outcomes.

This result differs somewhat from the meta-analysis on the effects of PBL [ 19 ], in which effect sizes were the largest for psychomotor outcomes, followed by the cognitive and affective domains. Specifically, the effect size of cognitive outcome was the largest for HFS 0.

Effectiveness of simulation-based nursing education depending on fidelity: a meta-analysis

In the psychomotor domain, the order was MFS 1. These results demonstrate that HFS and SP are effective in producing cognitive and affective outcomes; however, to achieve psychomotor learning outcomes, technical training using MFS would be more helpful, which concurs with the lack of positive association between fidelity and process skills [ 17 ]. However, the present study has the limitation of not considering learning-related factors in the analyses based on the fidelity level of simulators.

Even though debriefing has become more crucial in simulation-based learning and the methods have diversified over the years, a few selected studies do not indicate the methods of debriefing they had used, making it difficult to categorize and discuss the effects of each debriefing method. This may be because it is customary to omit debriefing while learning from low fidelity simulations, especially for training simple nursing skills.

In addition, we did not include studies published in languages other than English or Korean. Despite such limitations, this study demonstrated that simulation-based nursing education has an educational effect, with particularly strong effects in the psychomotor domain. Since the effects are not proportional to fidelity level, educational interventions should be broad enough to satisfy educational goals, all of which are supported by the results presented above.

In addition, a recent study reported that debriefing was the most important factor in simulation, with positive effects from self-debriefing and video-facilitated instructor debriefing [ 20 ]. Based on these findings, the clinical reflection process needs to be improved to increase the learning effects in the cognitive domain.

Our results indicated that simulation-based nursing educational interventions were effective with particularly large effects in the psychomotor domain. In addition, the effect of simulation-based nursing education was not proportional to fidelity level. Therefore, it is important to use an appropriate level of simulation to meet all of the educational goals and outcomes.

All authors contributed to the design of the study. JK performed the statistical analysis and wrote the first draft. JP carried out data collection and data coding.

Simulation in Nursing Education: From Conceptualization to Evaluation

SS participated in its design and coordination, helped to draft the manuscript, and revised the manuscript. All authors read and approved the final manuscript. Ethical approval and consent from participate are not applicable for this study.


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National Center for Biotechnology Information , U. BMC Med Educ. Published online May Author information Article notes Copyright and License information Disclaimer. Sujin Shin, Email: rk. Corresponding author. Received Sep 25; Accepted May This article has been cited by other articles in PMC.

Simulation in Nursing Education From Conceptualization to Evaluation

Associated Data Data Availability Statement Data from journals used in this work found on publicly available repositories. Abstract Background Simulation-based nursing education is an increasingly popular pedagogical approach. Results This meta-analysis showed that simulation-based nursing education was effective in various learning domains, with a pooled random-effects standardized mean difference of 0. Conclusions These results suggest that simulation-based nursing educational interventions have strong educational effects, with particularly large effects in the psychomotor domain.

Keywords: Nursing education, Patient simulation, Educational models, Meta-analysis. Background Clinical education in nursing aims to integrate theoretical knowledge from books into practical knowledge in real-life situations and to help students develop their problem-solving skills. Open in a separate window. Flow of study analysis through different phases of the meta-analysis. Criteria for considering studies for this review In this study, assessment of the methodological quality of 40 selected studies was performed by using the Case Control Study Checklist developed by the Critical Appraisal Skills Programme CASP [ 7 ].

The inclusion criteria for this review were as follows: Study participants This study sampled pre-licensure nursing students, licensed nurses, or nurse practitioners.