The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis

Abstract

Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25-6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

“…Simulation exercises have been identified as useful adjuncts in the training of health care students in client communication skills in a well‐intentioned, detailed, and descriptive manner (Hennessy et al, ; Riley, ). Although this approach requires considerable patience and flexibility, studies have shown that it is feasible technique that is well appreciated by students (Cant and Cooper, ; Riley, ). Most significantly, simulation exercises offer unique opportunities for concurrent training in procedural (e.g.…”

“…Complementary studies have corroborated that providing effective feedback enabled students to experience a greater sense of volitional (Joshi et al, ; Oommen et al, ; Mestdagh et al, ) and psychological freedom (Cubi‐Molla et al, ), an increased sense of fulfillment of personal effectiveness (Holaday et al, ; Mahoney et al, ) and improved social relatedness (Fond et al, ), and interpersonal relationships (Ottenberg et al, ; Hill et al, ). In addition, effective feedback has been reported to augment feelings of self‐perceived academic competency (Younan, ; Brass et al, ; Everson et al, ), enhance defensive coping styles (Bhagat et al, ; Jacobs et al, ; Cant and Cooper, ), and increase IM to attend and participate in class (Bradley et al, ; Mabel and Britton, ).…”

“…Furthermore, there is the growing consensus among educational and psychological researchers that the characteristics of millennial students in the health care profession have been excessively generalized (DiLullo et al, ; Kong et al, ; Cant and Cooper, ; Khalil et al, ). It needs to be recognized that students enrolled in different health care disciplines, such as medicine, pharmacy, veterinary medicine, and nursing, will conceivably have unique learning predispositions (Marks, ; Archer, ; DiLullo et al, ; Zielezinski and Karlowski, ; O'Mahony et al, ; Hew and Lo, ).…”

Do Simulation Studies Measure up? A Simulation Study Quality Review

“…Simulation-based education (SBE) has become a ubiquitous component of nursing education and a strategy recognized for its potential to improve learners' competence and confidence (Motola, Devine, Chung, Sullivan & Issenberg, 2013). SBE offers a wide range of realistic and 'life-like' simulated clinical experiences where learners can engage with computerized 'patient' manikins, standardized patients (actor), or other simulation modalities, in preparation for practice (Cant & Cooper, 2017;Cantrell, Franklin, Leighton, & Carlson, 2017).…”

“…The strength of evidence for the contribution of SBE to learning is under scrutiny. In nursing, reviews of literature have regularly cited a lack of studies with comparative research designs as a limiting factor in reporting overall effectiveness (Cant & Cooper, 2017;Doolen et al, 2017;Rutherford-Hemming & Alfes, 2017). In a review of simulation studies in nursing, Cantrell et al (2017) found the evidence relied too heavily on self-reported measures.…”