A three-level complex of support activities represents a promising solution to prevent and treat post-traumatic stress disorder among emergency room nurses. A further study to test its effectiveness is currently underway.

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This review highlighted the fact that few studies examined the use of simulation in nursing education through learning theories and via assessment of core competencies. It also identified observational tools used to assess competencies in action, as holistic and context-dependent constructs.

To provide adequate support for nurses, ER managers should be on the alert for these conditions. Interventions should be adapted to these findings.

It is important to reduce psychological demand among intensive care nurses in order to prevent psychological distress. The exploration of the connection between empathy and psychological distress should be advanced. This study suggests that SCSs provide an innovative approach that is useful for research.