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

Abstract

BackgroundSimulation-based nursing education is an increasingly popular pedagogical approach. It provides students with opportunities to practice their clinical and decision-making skills through various real-life situational experiences. However, simulation approaches fall along a continuum ranging from low-fidelity to high-fidelity simulation. The purpose of this study was to determine the effect size of simulation-based educational interventions in nursing and compare effect sizes according to the fidelity level of the simulators through a meta-analysis.MethodThis study explores the quantitative evidence published in the electronic databases EBSCO, Medline, ScienceDirect, ERIC, RISS, and the National Assembly Library of Korea database. Using a search strategy including the search terms “nursing,” “simulation,” “human patient,” and “simulator,” we identified 2279 potentially relevant articles. Forty studies met the inclusion criteria and were retained in the analysis.ResultsThis meta-analysis showed that simulation-based nursing education was effective in various learning domains, with a pooled random-effects standardized mean difference of 0.70. Subgroup analysis revealed that effect sizes were larger for high-fidelity simulation (0.86), medium-fidelity simulation (1.03), and standardized patients (0.86) than they were for low-fidelity and hybrid simulations. In terms of cognitive outcomes, the effect size was the largest for high-fidelity simulation (0.50). Regarding affective outcome, high-fidelity simulation (0.80) and standardized patients (0.73) had the largest effect sizes.ConclusionsThese results suggest that simulation-based nursing educational interventions have strong educational effects, with particularly large effects in the psychomotor domain. Since the effect is not proportional to fidelity level, it is important to use a variety of educational interventions to meet all of the educational goals.

Metodologias ativas no ensino de enfermagem em doenças transmissíveis

“…5 A metaanalysis published in 2016 showed that the use of simulation improved learner satisfaction and selfconfidence. 13 It was used in the discipline: in HIV and tuberculosis.…”

From Medicine to Education: Adapting Simulation-Based Training to the Professional Development Training Models for Educators

“…Meta-analytic studies find simulationbased medical education to be effective with moderate to large effects [15][16][17]. In the educational setting, teachers may feel less prepared to implement interventions due to lack of opportunity to implement the model, noting supports such as video and practice would be the most effective in implementation skills [18].…”

Psychometric Testing of the Chinese Simple Version of the Simulation Learning Effectiveness Inventory: Classical Theory Test and Item Response Theory

“…To achieve clinical competence, the traditional model of school nursing education combined with clinical placements is often considered the gold standard (Pai, 2016). However, nursing students' direct experience with or opportunities for patient care have been reduced (Kim et al, 2016) due to rapid changes in clinical placements, ethical concerns, and patient safety issues (Yip and Hsiao, 2014). As a useful pedagogical approach, simulation-based education provides nursing students with opportunities to handle various problem-based clinical situations by using patient simulators, such as handling manikins, engaging in roleplaying, and practicing on trained persons.…”

“…Simulation involves a range of types and methods, from low-fidelity simulation to high-fidelity simulation (HFS) (Kim et al, 2016). There has been an increasing utilization of HFS in nursing education since the 1990s (Au et al, 2016).…”