Unpacking the Influence of Fidelity, Learner Type, and Study Design on Simulation Outcomes in Nursing
DOI:
https://doi.org/10.61978/curatio.v2i4.1408Keywords:
Simulation-Based Learning, Nursing Education, Clinical Skills, Moderator Analysis, Instructional Design, Meta-AnalysisAbstract
Simulation-based learning (SBL) is a widely used instructional method in nursing education, valued for enhancing clinical competence, decision-making, and engagement, though outcomes vary considerably. This study synthesized findings from four meta-analyses to examine how simulation fidelity, participant type, and study design influence SBL effectiveness. Pooled effect sizes, confidence intervals, and heterogeneity metrics were analyzed, comparing moderator variables—simulation type (high/low fidelity, standardized patients, virtual), participant profile (students vs. clinical staff), and study design (quasi-experimental vs. RCT)—using stratified tables and standardized mean differences (SMD). Results showed consistently positive SBL outcomes across all simulation types (SMD: 0.52–1.20). High-fidelity simulations produced the strongest effects, while well-designed low-fidelity and virtual simulations also showed moderate effectiveness; standardized patients particularly benefited communication skill development. Clinical staff and advanced nurses achieved slightly better outcomes than undergraduate students, and RCTs yielded stronger, more reliable findings than quasi-experimental designs. Structured debriefing, contextual realism, and reflective practice were identified as key instructional elements supporting engagement and skill retention. These findings highlight the need for a moderator-aware approach when implementing SBL in nursing curricula. Thoughtful integration using evidence-based instructional design can maximize educational impact, and future research should prioritize isolating moderator effects and assessing long-term skill retention.
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