“…In one systematic review on the effectiveness of simulation-based education in NP programmes on learners' knowledge, skill performance, confidence and attitudes, high-fidelity simulation led to an increase in the students' knowledge, confidence and satisfaction (Warren, Luctkar-Flude, Godfrey, & Lukewich, 2016). Nevertheless, there is a lack of evidence to support the replacement of clinical hours with simulation in NP education (Rutherford-Hemming, Nye, & Coram, 2016). All of the studies included in both of the systematic reviews were performed in the US.…”