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

OBJECTIVE: High-fidelity simula-tion-based learning, which mimics situation, en-vironmental, and psychological exposure in the clinical setting, potentially helps nursing stu-dents acquire knowledge, confidence, and skills in learning clinical skills during the transition from pre-clinical to clinical practice. However, inconsis-tent 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 ex-perimental studies. A literature search was con-ducted 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 significant-ly increased nursing students' knowledge acquisi-tion (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 ac-ademic institution may consider enculturating the involvement of high-fidelity simulation as part of an innovative teaching strategy in nurs-ing curricula. Therefore, when graduates en-ter the workforce, they can function quickly and practice confidently in clinical settings without bringing potential harm.