The evidence presented in the 19 articles indicates that the use of SPs to teach nurse-patient communication skills targets more challenging clinical interactions. Engaging SPs in both CST program facilitation and course evaluation provides nurse educators with a strong foundation to develop further pedagogical and research capacity. Expanding the utilisation of SPs to augment nurses' communication skills and ability to engage with patients in a broader range of clinical contexts with increased methodological rigor is recommended.

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Background: Research examining how perceived realism and presence affects participants' learning experiences and outcomes is limited. Method: A convergent mixed-methods design was used, with quantitative data assigned as the primary method. After engaging in a communication training simulation, 141 undergraduate nursing students completed the Concept of Presence, Simulation Design, and the Quality of Discharge Teaching scales. A subsample of 12 participants were interviewed to provide qualitative data, as the secondary method, on their learning experience. Hierarchical multiple regression analysis was performed on the quantitative data and thematic analysis for qualitative data. Results: Differences in participants' perceived realism and level of presence were not affected by the communication-based learning interventions. A positive, fully mediated relationship between realism, presence, and learning outcomes in discharge communication skills was found. The quality of the simulation experience gave participants the opportunity to reflect on their knowledge and capacity to transfer skills into clinical practice. Conclusion: The convergence of findings supports the theory that perceived realism and presence positively affected learning outcomes. [ J Nurs Educ. 2019;58(6):330–338.]

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