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Impact of simulation in Nursing Education: A Review Article

Article · February 2023

DOI: 10.6084/m9.figshare.22179904

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 Impact of simulation in Nursing Education: A Review Article

By: masooth mohamed.A

Doi: 10.6084/m9.figshare.22179904

Abstract

The goal of nursing practice encompasses the nurse's entire role and duties in dealing

with the full spectrum of human health and illness experiences as well as responses. Nursing

education is the theoretical and practical training given to nurses in order to prepare them for

their responsibilities as nursing care professionals. Nursing students' critical thinking and

clinical decision-making abilities, as well as their psychomotor skill performance, are heavily

influenced by the instructional methodologies used in clinical components of nursing education.

Simulation allows nursing students to practice their clinical and decision-making abilities in a

variety of real-life scenarios. Despite the fact that it is included in nursing curricula, its

effectiveness is mostly unknown.

Key words: simulation, high fidelity, low fidelity, psychomotor

Introduction

Science and technology are always changing and progressing in today's world. Parallel to

this, current nursing innovations are requiring adjustments in the nursing education system.

Nursing is a multidisciplinary field that necessitates knowledge and skills in the cognitive,

emotional, and psychomotor learning domains.

 It is especially important to keep the education systems linked with these professions up

to date on a regular basis in order to ensure the continuity of these professions. As a result, it is

critical to evaluate educational and professional education advancements in the contemporary

information age. (Eyikara and Baykara, 2017).

An important component in nursing education is simulation-based education, which aims

to bridge the gap between theory and practice through creative teaching methodologies (Tjoflåt,

Våga and Søreide, 2017). This pedagogical method has been found to be beneficial, useful, and

successful in the learning processes of students, with usually positive consequences. According

to research, simulation-based learning boosted students' knowledge and confidence. Students

have shared their satisfaction. This pedagogical method has been found to be beneficial, useful,

and successful in the learning processes of students, with usually positive consequences.

According to research, simulation-based learning boosted students' knowledge and confidence.

Students have shared their satisfaction (Tjoflåt, Våga and Søreide, 2017).

Simulation-based clinical education is a valuable training technique that allows nursing

students to practice their clinical and decision-making skills in a range of real-life scenarios

without risking the patient's health. It encompasses a wide range of activities including patient

simulators, such as technology, trained people, lifelike virtual environments, and role-playing.

Simulation-based educational interventions in nursing can help novice and experienced nurses

create successful non-technical skills, exercise rare emergency circumstances, and provide a

variety of actual life-threatening events by using realistic clinical scenarios(Kim, Park and Shin,

2016). Therefore, this review article could provide the path for analyzing the effectiveness of

simulation-based nursing education.

 Simulation

Simulation is defined as a strategy, not a technology, for replacing real-world experiences, which

are typically immersive in nature and duplicate significant parts of the real world in a fully

interactive manner. And it is the recreation of real-life tasks, connections, events, equipment,

behaviors, and cognitive functions (Midik & Kartal, 2010).

Eyikara and Baykara, (2017) noted that, In the field of nursing education, simulation is an

example of an interactive teaching and learning strategy. Simulators are now employed in a

variety of fields, including construction, molecular biology, aviation, the automotive industry,

industry, and healthcare. Furthermore, the World Health Organization's gold standards for

professional nursing education encourage the adoption of creative approaches in nursing school

training programs, such as simulations. Simulation is becoming more popular as a way of

learning, particularly in the field of healthcare.

Nursing students' learning and preparation for practice and professional life includes

simulation-based education, which aims to bridge the gap between theory and practice through

creative teaching methodologies (Tjoflåt, Våga and Søreide, 2017). In the history During World

War II, the first reported usage of higher-level simulators was with pilots. They are still used

today to educate pilots in simulated emergencies including power outages, engine breakdowns,

and bad weather. Simulators are also used in pilot training for safety reasons (Sanford, 2014).

And further Sanford, (2014) noted the simulation is used in nursing for a long time, it has been

used in nursing education in practical demonstrations such as using oranges to practice

intramuscular and subcutaneous injections, learning CPR on a static manikin, placing Foley
catheters in a manikin in a lab setting, or role-playing major mental diseases and mental health

communication skills.

According to Tosterud, (2015). Simulation is a strategy for “replacing or enhancing real

experiences with guided encounters that evoke or duplicate large parts of the real world in a fully

interactive manner.” Simulation can also be thought of as a progression from low-fidelity to

high-fidelity simulation. And Low-fidelity simulation, which might take the form of paper/pencil

case studies or the particular development of psychomotor skills, has a long history in nursing

education. However, advances in advanced technology have opened up new simulation

possibilities. The human patient simulator is a high-fidelity, that is utilized in a learning to set

with equipment and surroundings that are similar to those seen in a clinic, giving students

realistic learning possibilities (Tosterud, 2015).

Effectiveness of Simulation in Nursing

For a long time, simulation learning has been employed in nursing education. It is used to

enhance clinical competency and reflective-thinking abilities, and it is also utilized as a remedial

tool that allows students to practice skills, gain confidence, and reduce the risk of making an

error before working in a clinical context. Providing care and using simulation as a learning

approach allows you to achieve a level of expertise without involving humans. At the completion

of every simulation activity, the debriefing stage allows trainees to clarify and integrate the

insights and lessons learnt from the experience(Ghimire and Kachapati, 2020).

Debriefing is one of the most significant components of the high-fidelity simulation

experience, according to a qualitative study undertaken by Lasater, (2007). to learn more about

the students' experiences. Author noted, during debriefing, students can reflect on their
experiences and think critically about them. Although simulated experience will never be exactly

like patient care, it allows students to experience a critical event before they are accountable for

one in a real-world setting. Another study Related High-fidelity simulation, was introduced into

the stroke unit for nurse practitioners during their orientation at a large tertiary care institution,

according to a study done with stroke unit nurses. Nurses took part in three scenarios for

providing effective care for stroke unit patients. Just after simulation and debriefing, nurse

practitioners gave it a very positive review; 100% of the participants rated the simulation's

performance as excellent (Ghimire and Kachapati, 2020).

According to Kim, Park and Shin, (2016). The meta-analysis conducted to evaluate the

effectiveness of simulation-based nursing education focused on fidelity indicated that simulation-

based nursing education was advantageous in several learning domains, with a combined

random-effects standardized significant difference of 0.70. therefore, these findings indicate that

simulation-based nursing training interventions have significant educational impacts, particularly

in the psychomotor area. Furthermore, according to a study of a systematic review of the impact

of simulation-based Crisis Resource Management teaching on transfer of learning to the

workplace, Boet et al., (2014) noted that the skills learned at the simulation center are transferred

to clinical settings, and the acquired skills may translate to improved patient outcomes, including

a reduction in mortality and consequent changes in patient outcomes.

Leonard, Shuhaibar and Chen, (2010) recruited 48 undergraduate nursing students from

various levels into inter-professional teams, and where they all participated in the identical acute

pediatric and adult simulation scenarios. Students of various educational levels were able to

recognize their typical nursing function. First-year students, for example, concentrated on

professional skills such as fundamental assessment and communication, whereas senior nursing
students focused on advanced or administrative abilities, such as those required in a management

role. To find the simulation effectiveness on knowledge and confidence effect of simulation

training on knowledge and confidence, Boling and Hardin-Pierce, (2016) reviewed 17 research

articles and synthesized from two literature databases, among the seventeen studies, 13 showed a

significant improvement in knowledge and confidence respectively among the nursing students.

Even though in contrast to above studies few studies are available with contradictory

findings. In a comparison study, the authors discovered that students' clinical performance did

not change between the test and comparison groups. A more recent study evaluated the

educational results of students who spent 10%, 25%, or 50% of their time in simulation instead

of clinical time and found no differences in clinical competency or nursing knowledge

assessments (Lee et al., 2019). And also in another study conducted by Feingold, Calaluce, and

Kallen, (2004). In this study, two clinical scenarios were created and integrated into a 65-nursing

student advanced acute care adult course. According to their findings, about half of the

respondents acknowledged that they could transfer skills acquired in scenarios to a real-life

clinical situation.

Discussion

In a restricted and safe environment, simulation is quickly becoming a vital and effective

method in nursing education. Multiple learning objectives can be taught in a realistic therapeutic

setting without causing harm to patients. Simulators are unaffected by mistakes made during

simulation (Eyikara and Baykara, 2017). When technologies are brought into clinical

environments, simulation can also help to improve patient care. It also allows students to repeat
their tasks so that when they come back to work, they can immediately apply what they have

learned.

From the literature review, it could be found that the effectiveness of simulation-based

nursing education focused on fidelity indicated positive advantages in several learning domains.

And also, simulation-based nursing training interventions have significant educational impacts,

particularly in the psychomotor area (Lasater, 2007). In contrast, only a few studies show that

there are no specific changes in simulation-based learning. But anyhow, from the major part of

the literature, we can draw the decision that simulation-based learning approach in nursing has a

greater impact on nursing skills.

Simulation has a significant impact on the learner-centered approach to nursing practice.

It also allows students to begin learning and developing a nursing habit, allowing them to

develop the "skilled know how" essential for competent practice (Kelly et al., 2016). Simulation

influence in clinical and decision-making skills in a range of real-life scenarios without risking

the patient's health. It encompasses a wide range of activities including patient simulators, such

as technology, trained people, lifelike virtual environments, and role-playing (kim et al, 2016).

Therefore, Simulation aids in the development of a comprehensive understanding of a clinical

condition that demands particular responses and professional contacts, as well as the

development of professional identity.

Conclusion

Nursing education is undergoing rapid changes and advancements. When it comes to

developing professional skills, simulation creates a realistic setting. In nursing education,

simulation can help to create a more realistic environment for learning. Throughout the nursing
profession, elevated levels of skills and knowledge are expected. Simulation is significant since

it leads to the creation of more competent and skilled nursing professionals. The use of

simulation technology in nursing education can help to develop cognitive, emotional, and

psychomotor skills. As a result, simulation in nursing education provides a secure learning

environment. And according to the context, method and topic simulation learning method allow

the learner for learning opportunity, and provide a practical confidence in the patient care in a

safe and controlled environment Nursing education based on simulations is beneficial,

specifically in the psychomotor domain. As a result, it's essential to use appropriate simulations

to achieve all of the objectives and outcomes.

References

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