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Cited by 35Simulation-Based Education in HealthcareClinical Reasoning and Diagnostic SkillsPatient Safety and Medication Errors

High-Fidelity Simulation’s Impact on Clinical Reasoning and Patient Safety: A Scoping Review

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El Hussein, Mohamed Toufic, Hirst, Sandra P.·2023·Journal of Nursing Regulation
DOI 10.1016/s2155-8256(23)00028-5
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Abstract

Background Simulation-based learning is a recognized teaching approach in nursing education. However, research on the interplay of simulation and clinical reasoning development is limited. It is assumed that the opportunity to develop skills and clinical reasoning through simulation will contribute to patient safety. Purpose This scoping review aims to summarize the literature on the impact of high-fidelity simulation (HFS) on students' clinical reasoning and patients' safety in undergraduate nursing education and to use that information to provide recommendations to nursing educators. Methods A scoping review of the literature published between 2011 and 2022 was conducted following the guidelines of the Joanna Briggs Institute Manual for Evidence Synthesis and a methodological framework for scoping studies. Results Of 155 studies identified, 21 were included in the final review. Based on these studies, HFS may affect patient safety by stimulating clinical reasoning in a safe environment for undergraduate nursing students. Exposure to HFS improves students' readiness and alleviates "transition shock" and anticipatory anxiety in the clinical setting. HFS cannot replace but may be used in conjunction with real-life nursing practice to support the development of clinical reasoning in students. Conclusion Simulation promotes active learning as students engage in lifelike scenarios. Repetitive practice of nursing skills in simulation contributes to students' dexterity, leading to improved safety, clinical performance, and translation of theory to practice. In addition, prebriefing and debriefing sessions after the HFS activity provide opportunities for exploration of factors influencing patient safety.

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  • Virtual simulation games can provide psychological safety and lessen fear, anxiety, and embarrassment in new learners who worry about making mistakes in front of fellow students and instructors.

    “VSGs can also provide psychological safety and lessen fear, anxiety, and embarrassment in new learners who may worry about making mistakes in front of fellow students and instructors [16–18].”

    From Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion (2024) · cites this paper as [17]

    The Results section says high-fidelity simulation may alleviate students’ anxiety by letting them practice in a safe environment where mistakes do not cause harm. It does not establish this for virtual simulation games or address fear and embarrassment about making mistakes in front of peers and instructors. (LLM, conf=0.86)

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  • Healthcare providers are most likely to improve their confidence in communication skills through repeated practice with patients, and simulations are an effective way to emulate real patient scenarios.

    “Ultimately, HCPs are most likely to improve their confidence in communication skills through repeated practice with patients, and simulations are an effective way to emulate real patient scenarios.”

    From Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion (2024) · cites this paper as [17]

    The Abstract (page unavailable) describes lifelike simulation scenarios and says repetitive practice of nursing skills in simulation improves clinical performance. The Recommendations section (page unavailable) advocates communication-focused simulations. The paper does not establish that healthcare providers are most likely to gain confidence in communication skills through repeated practice with patients; its discussion of repetition concerns simulation practice, primarily among nursing students. (LLM, conf=0.86)

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Research works printed but not linked: 2

  1. Moya, R. P., Ruz, A. M., Parraguez, L. E., Carreño, E. V., Rodríguez, C. A., & Froes, M. P. (2017). Simulation in medical education from the perspec- tive of patients safety [Article in Spanish]. Revista Médica de Chile, 145(4), 514-526.
  2. Yueh-Chen, Y. (2016). Undergraduate nursing students' perceptions of high- fidelity simulation-based learning. International Archives of Nursing and Health Care, 2(3), Article 052. https://doi.org/10.23937/2469- 5823/1510052 · DOI

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Authors
El Hussein, M. T., & Hirst, S. P.
Affiliations
University of Calgary (CA)
ORCID
Hirst, Sandra P.
Venue
Journal of Nursing Regulation
Publisher
Elsevier BV
Published
2023-01
Volume
13
Issue
4
Pages
54-65
ISSN
2155-8256 (ISSN-L)
DOI
10.1016/s2155-8256(23)00028-5
OpenAlex
W4317937386
Cited by
35
References
61
Citations by year
2026: 11 · 2025: 9 · 2024: 12 · 2023: 3
FWCI
6.22
Type
journal article
Language
en
Open access
Licence
Locations
Journal of Nursing Regulation (publishedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Physiology › Simulation-Based Education in Healthcare
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
high-fidelity simulation, clinical reasoning, patient safety, undergraduate nursing education, simulation-based training, transition shock, anticipatory anxiety, debriefing, prebriefing, nursing students, active learning

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