Effectiveness of using high-fidelity simulation on learning outcomes in undergraduate nursing education: systematic review and meta-analysis

S.I. Tonapa, M. Mulyadi, K.H.M. Ho, F. Efendi

College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan. ferry-e@fkp.unair.ac.id

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• Medical Education

OBJECTIVE: High-fidelity simulation-based learning, which mimics situation, environmental, and psychological exposure in the clinical setting, potentially helps nursing students acquire knowledge, confidence, and skills in learning clinical skills during the transition from pre-clinical to clinical practice. However, inconsistent evidence on its effect on learning outcomes was presented across the studies. The aim of our study was to review and analyze the effectiveness of high-fidelity simulation on learning outcomes in undergraduate nursing education.

MATERIALS AND METHODS: This study was a systematic review and meta-analysis of experimental studies. A literature search was conducted in four databases (CINAHL, SocINDEX, PubMed, and Web of Science) until July 2021. The Cochrane Risk of Bias Tool was used to appraise the studies’ quality. The random-effect model was used to conduct a meta-analysis.

RESULTS: Fourteen studies were eligible for quantitative synthesis. The pooled effect indicated high-fidelity simulation-based learning significantly increased nursing students’ knowledge acquisition (standardized mean difference [SMD]: 1.73, p < 0.001), self-confidence (SMD: 0.56, p= 0.019) and skills performance (SMD: 1.71, p= 0.006).

CONCLUSIONS: Stakeholders within the academic institution may consider enculturating the involvement of high-fidelity simulation as part of an innovative teaching strategy in nursing curricula. Therefore, when graduates enter the workforce, they can function quickly and practice confidently in clinical settings without bringing potential harm.

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