The Effectiveness of Using Clinical Simulation Training to Improve the Critical Thinking Skills of Undergraduate Nursing Students Compared to Other Learning Strategies Quantitative systematic review

Abstract

Abstract Background The application of simulation-based education has been introduced widely among healthcare faculties; however, the effectiveness of using this approach, particularly in terms of improving students’ critical thinking (CT) skills compared to other learning methods such as lectures and paper-based case studies, is largely unknown. This systematic review aims to provide quality evidence on the advantages of using clinical simulation (CS) modalities over other learning strategies to improve nursing students’ CT abilities. Objective To examine the effect of high-fidelity simulation (HFS) or computer-based simulation on improving nursing students’ CT skills. Method Seven databases were searched (CINAHL, MEDLINE, COCHRANE, EMBASE, Wiley Online Library, ScienceDirect and Latin American Caribbean Health Science) for studies that investigated the effectiveness of using HFS and computer-based simulation in developing the CT skills of undergraduate nursing students. The search was limited to studies published between January 2008 and January 2019 that were written in English. Results This review included 12 research papers. The included studies were quasi experimental or Randomised Control Trials (RCTs). Data extraction was conducted vi

using the JBI-MASTARI data extraction tool, and a narrative synthesis approach was adopted as heterogeneity across the included studies was identified in terms of the type of outcome measures, the type of participants, the method and the duration of the simulation. Data from this review indicate that no statistically significant difference existed between the use of simulation-based education and other learning methods in terms of developing nursing students’ CT skills. However, the finding of this systematic review may be affected by heterogeneity among the included studies. Conclusion No clear difference was determined between the use of CS and other learning methods in terms of developing students’ CT skills. This finding implies that nursing educators may be guided to use either learning method, taking into consideration the content and objectives of the educational programme. Further research with a more explicit and rigorous design must be considered to clarify the effect of CS on the development of undergraduate nurses’ CT skills.