High-fidelity simulation in undergraduate nursing education: A meta-analysis

Nurse Educ Today. 2022 Apr:111:105291. doi: 10.1016/j.nedt.2022.105291. Epub 2022 Feb 3.


Objectives: To explore the effectiveness of high-fidelity simulation (HFS) in undergraduate nursing education.

Design: A meta-analysis of randomized controlled trials and quasi-experiment.

Data sources: Web of Science, PubMed, Embase, Cochrane Library, WANFANG, and CNKI were searched for eligible articles published in English and Chinese until May 28, 2021.

Review methods: The Quality Appraisal Check-list for Quantitative Intervention Studies was applied to the quality evaluation. Standard mean differences (SMD) were pooled using a random effects model. The results of the individual and combined intervention effects estimation of was displayed in a forest plot, with weight, SMD, its corresponding 95% confidence interval (CI), Z-test, p, I2.

Results: Thirty-eight studies were included and 37 were analyzed. High-fidelity simulation (HFS) revealed significantly larger effect sizes for knowledge (SMD = 0.89, 95% CI [0.54 to 1.23]), skill (SMD = 0.93, 95% CI [0.69 to 1.17]), collaboration (SMD = 0.52, 95% CI [0.26 to 0.78]), caring (SMD = 1.40, 95% CI [0.23 to 2.58]) and learning interest (SMD = 0.85, 95% CI [0.00 to 2.04]) when compared with other teaching methods. However, no significant difference between HFS and other teaching methods in critical thinking (SMD = 0.46, 95% CI [-1.12 to 1.58]), self-confidence (SMD = 0.22, 95% CI [-0.32 to 0.75]) and learning satisfaction (SMD = 0.58, 95% CI [-0.25 to 1.41]) was shown.

Conclusions: High-fidelity simulation (HFS) can more effectively cultivate knowledge, skills, collaboration, caring, and learning interest of undergraduate nursing students. Since the effect of HFS is equivalent to other teaching methods in cultivating undergraduate nursing students' critical thinking, self-confidence and learning satisfaction, nursing educators can choose the most appropriate methods to achieve the intended learning outcomes according to the actual situation.

Keywords: High-fidelity simulation; Meta-analysis; Undergraduate nursing students.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Education, Nursing, Baccalaureate*
  • High Fidelity Simulation Training*
  • Humans
  • Learning
  • Students, Nursing*
  • Thinking