Simulation-Based Training of Nurses in Critical and Emergency Care: A Literature Review

Abstract

Introduction: Simulation-based education, which has the advantage of allowing easy verification of learning outcomes in the form of actions, has been suggested to improve the competency of learners by functioning as a bridge between didactic classroom instruction that mainly consists of lectures and clinical settings where it is difficult to anticipate critical events. Despite those advantages, scenario simulation as an efficient approach for nursing education has not gained sufficient acceptance. The aim of this article was to review the current body of literature regarding the effectiveness of simulation-based education in critical and emergency care nurses' education.
Methods: An inclusive literature search strategy was employed and carefully documented. It involved comparisons of subject heading, advanced and basic, keywords, index-and MeSH terms searches with appropriate permutations, done in association with a library information specialist. Study selection was performed in three stages to minimize the risk of errors and bias and ensure that all relevant studies were included. Data collection comprised baseline observations and initial postintervention observations. The findings of this review were summarized in a qualitative approach and not meta-analysis was performed.
Results: Many studies showed mixed results for simulation effectiveness, and effect sizes were smaller for nurses than those recorded for students. Improvement in medication administration and review showing improvement in pediatric intensive care unit nurses' emergency technical and nontechnical team performance after simulation training. The quality of study reporting varied from 64% (good) to 81% (excellent) according to assessments made using simulation-based training. Many reviewed studies suggest variable outcomes for qualified nurses compared with nursing students, and a need to seek additional contemporary evidence for simulation-based education CPD approaches.
Conclusions: Th findings of this review suggest variable outcomes for qualified nurses compared with nursing students, and a need to seek additional contemporary evidence for simulation-based approaches. Education programs should be designed to measure longer-term impacts such as a change in practice, effect on patient care, or organizational benefits, to justify the allocated resources.