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This study evaluates the impact of high-fidelity simulation on the acquisition and retention of competencies in nursing students. High-fidelity simulation provides a realistic and risk-free environment allowing students to practice, which potentially enhances the acquisition and retention of required competencies. A blinded, randomised clinical trial with three arms was conducted with a pretest and a follow-up at 6 months (post-test 1) and 12 months (post-test 2). This study was conducted with 105 s-year nursing students, divided into three groups: control (6 low-fidelity simulations), intervention 1 (3 high-fidelity and 3 low-fidelity) and intervention 2 (6 high-fidelity simulations). Competencies were assessed using the Objective Structured Clinical Examination at baseline, 6 and 12 months. Student satisfaction was measured with the Simulated Clinical Experiences Scale. Initial competency scores were similar across groups. At 6 months, both intervention groups showed significant improvements in critical thinking (6.2 and 6.0, p < 0.05), clinical skills (6.8 and 6.6, p < 0.05), communication (8.0 and 8.3, p < 0.05) and ethics (7.6 and 7.5, p < 0.05) compared with the control group. Intervention group 1 demonstrated better competency retention at 12 months. Overall satisfaction with highfidelity simulation was high (9.13/10), with particular praise for the practical dimension (8.95/10), realism (8.02/10) and the cognitive dimension (9.43/10). High-fidelity simulation has the potential to enhance nursing competencies effectively. This approach supports long-term skill retention, highlighting the importance of a well-structured curriculum that integrates different simulation levels for optimal student preparation for clinical practice.

The purpose of the current study was to determine if the amount of confidence in completing the Clinical Opiate Withdrawal Scale (COWS) varied among participants and whether consistency in scoring outcomes to patients occurred with COWS assessment among groups assigned to simulation and debriefing conditions. Sixty nursing staff were randomized into three groups: (a) scenario; (b) scenario and simulation; and (c) scenario, simulation, and debriefing. Staff were administered a questionnaire to assess their confidence before (i.e., pretreatment) and after (i.e., posttreatment) the simulation exercise and at 30-day follow up. The COWS assessment tool was completed by nursing staff during treatment and follow-up sessions. Significant improvements in confidence were found in all three treatment conditions. Highest consistency in scoring outcomes of the COWS to patients was found with the scenario, simulation, and debriefing condition. All participants reported having increased confidence completing the COWS. The amount of confidence among groups was not significant. Although nursing confidence did not differ among groups, increased scoring outcome reliability was found in groups using simulation and debriefing. [ Journal of Psychosocial Nursing and Mental Health Services, 56 (10), 27–35.]

Background Simulation has become integral to the training of both undergraduate medical students and medical professionals. Due to the increasing degree of realism and range of features, the latest mannequins are referred to as high-fidelity simulators. Whether increased realism leads to a general improvement in trainees’ outcomes is currently controversial and there are few data on the effects of these simulators on participants’ personal confidence and self-assessment. Methods One-hundred-and-thirty-five fourth-year medical students were randomly allocated to participate in either a high- or a low-fidelity simulated Advanced Life Support training session. Theoretical knowledge and self-assessment pre- and post-tests were completed. Students’ performance in simulated scenarios was recorded and rated by experts. Results Participants in both groups showed a significant improvement in theoretical knowledge in the post-test as compared to the pre-test, without significant intergroup differences. Performance, as assessed by video analysis, was comparable between groups, but, unexpectedly, the low-fidelity group had significantly better results in several sub-items. Irrespective of the findings, participants of the high-fidelity group considered themselves to be advantaged, solely based on their group allocation, compared with those in the low-fidelity group, at both pre- and post-self-assessments. Self-rated confidence regarding their individual performance was also significantly overrated. Conclusion The use of high-fidelity simulation led to equal or even worse performance and growth in knowledge as compared to low-fidelity simulation, while also inducing undesirable effects such as overconfidence. Hence, in this study, it was not beneficial compared to low-fidelity, but rather proved to be an adverse learning tool.

To examine the correlation between undergraduate nursing students’ personality and high-fidelity simulation learning effectiveness. Simulation is a fundamental approach in nursing education, with learning outcomes associated with various factors. Personality, reflecting on one’s way of learning, thinking and behaving, is a potential factor associated with simulation learning. A descriptive correlational study was conducted. 68 final year undergraduate nursing students completed an online survey following a high-fidelity nursing simulation. The five personality traits of neuroticism, extraversion, openness, conscientiousness and agreeableness were examined using the Neuroticism-Extraversion-Openness Five-Factor Inventory 3 (NEO-FFI-3). To investigate the relationship between personality and learning effectiveness, the revised English version of the Simulation Learning Effectiveness Inventory (SLEI) was also completed. No significant association was found between the five personality traits and students’ simulation learning effectiveness. However, the SLEI subscale of ‘resources’ was positively correlated with the trait of conscientiousness (r = 0.248, p = 0.04). In addition, students’ nursing work experience was associated with their learning effectiveness in high- fidelity simulation. Nursing students scored the highest in the personality trait of agreeableness (35.04 SD 5.28) and the lowest in that of neuroticism (26.53 SD 7.33). Understanding personality assists in the application of best practice simulation for undergraduate nursing students. The design and implementation of high-fidelity simulation needs to consider students’ previous nursing work experience. •In undergraduate nursing students, agreeableness is the predominant personality trait.•Experienced students reported a lower learning effectiveness in simulation than inexperienced students.•Students’ personalities are not related to their learning effectiveness in face-to-face simulation.•Neuroticism tendency for undergraduate nursing students was higher than general population and maybe linked to future burnout

This study aimed to evaluate the effects of the psychoacoustic learning method and high-fidelity simulation on the cardiac auscultation competence of nursing students. Cardiac auscultation is a crucial skill for nursing students, yet many struggle to develop proficiency. Simulation-based training has emerged as a potential solution, but the effectiveness of different simulation modalities remains unclear. A randomized controlled experimental study. A total of 52 s-year nursing students were randomly assigned to one of three groups: psychoacoustic learning (n = 18), high-fidelity simulation (n = 17) and control (n = 17). Cardiac auscultation competence was assessed through a success test administered at three-time points: pre-test, post-test and follow-up (four weeks later). Learning satisfaction and self-confidence in learning were measured post-intervention. The psychoacoustic learning group significantly improved cardiac auscultation scores from pre-test to post-test and follow-up (p < 0.05). The high-fidelity simulation group improved from pre- to post-test (p < 0.05) but not at follow-up. The control group showed no significant changes. No significant between-group differences in auscultation scores (p > 0.05), but high-fidelity simulation had higher learning satisfaction (p = 0.013) and total scale scores (p = 0.017) than psychoacoustic learning. Group-time interaction was not significant (p = 0.547). Psychoacoustic learning boosts short- and medium-term cardiac auscultation skills, while high-fidelity simulation enhances short-term performance and learning satisfaction. Combining psychoacoustic methods with simulation or traditional teaching may improve sustainable learning outcomes, balancing effectiveness, accessibility and cost.

To compare the effectiveness of high- and low-fidelity simulation, combined with theoretical foundations, in acquiring theoretical and practical knowledge, as well as in self-perceived gains from simulation. The administration of medication to critically ill patients is a complex and high-risk process that requires specialized knowledge and vigilance to prevent medication errors. In response, educational interventions have been widely implemented to enhance patient safety, with simulation-based education emerging as a key strategy. Randomized clinical trial, based on the CONSORT guidelines for simulation studies. Sixty nursing students were randomly assigned to either the experimental group (high-fidelity simulation) or the control group (low-fidelity simulation). Both groups received theoretical instruction, followed by simulation exercises. The study assessed theoretical knowledge, perceived gains from the simulation, practical performance and the evaluation of the simulation design. The study found significant improvements in theoretical knowledge and perceived gains in both groups, with the experimental group showing more substantial progress. Interestingly, practical performance was higher in the low-fidelity group. No significant differences were observed in the evaluation of the simulation design between the two groups. Both high- and low-fidelity simulations are effective in nursing education, though their impacts vary. High-fidelity simulations are more effective for enhancing theoretical understanding, while low-fidelity simulations tend to improve immediate practical skills.

To evaluate the effect of simulator fidelity on procedure skill training through a review of existing studies. MEDLINE, OVID and EMBASE databases were searched between January 1990 and January 2019. Search terms included \"simulator fidelity and comparison\" and \"low fidelity\" and \"high fidelity\" and \"comparison\" and \"simulator\". Author classification of low- and high-fidelity was used for non-laparoscopic procedures. Laparoscopic simulators are classified using a proposed schema. All included studies used a randomized methodology with two or more groups and were written in English. Data was abstracted to a standard data sheet and critically appraised from 17 eligible full papers. Of 17 studies, eight were for laparoscopic and nine for other skill training. Studies employed evaluation methodologies, including subjective and objective measures. The evaluation was conducted once in 13/17 studies and before-after in 4/17. Didactic training only or control groups were used in 5/17 studies, while 10/17 studies included two groups only. Skill acquisition and simulator fidelity were different for the level of training in 1/17 studies. Simulation training was followed by clinical evaluation or a live animal evaluation in 3/17 studies. Low-fidelity training was not inferior to training with a high-fidelity simulator in 15/17 studies. Procedure skill after training with low fidelity simulators was not inferior to skill after training with high fidelity simulators in 15/17 studies. Some data suggest that the effectiveness of different fidelity simulators depends on the level of training of participants and requires further study.

Background The training of neonatal resuscitation is an important part in the clinical teaching of neonatology. This study aimed to identify the educational efficacy of high-fidelity simulation compared with no simulation or low-fidelity simulation in neonatal resuscitation training. Methods The PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov, Chinese databases (CBM, CNKI, WanFang, and Weipu), ScopeMed and Google Scholar were searched. The last search was updated on April 13, 2019. Studies that reported the role of high-fidelity simulation in neonatal resuscitation training were eligible for inclusion. For the quality evaluation, we used the Cochrane Risk of Bias tool for RCTs and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCTs. A standardized mean difference (SMD) with a 95% confidence interval (CI) was applied for the estimation of the pooled effects of RCTs. Results Fifteen studies (10 RCTs and 5 single arm pre-post studies) were ultimately included. Performance bias existed in all RCTs because participant blinding to the simulator is impossible. The assessment of the risk of bias of single arm pre-post studies showed only one study was of high quality with a low risk of bias whereas four were of low quality with a serious risk of bias. The pooled results of single arm pre-post studies by meta-analysis showed a large benefit with high-fidelity simulation in skill performance (SMD 1.34; 95% CI 0.50–2.18). The meta-analysis of RCTs showed a large benefit in skill performance (SMD 1.63; 95% CI 0.49–2.77) and a moderate benefit in neonatal resuscitation knowledge (SMD 0.69; 95% CI 0.42–0.96) with high-fidelity simulation when compared with traditional training. Additionally, a moderate benefit in skill performance (SMD 0.64; 95% CI 0.06–1.21) and a small benefit was shown in knowledge (SMD 0.39; 95% CI 0.08–0.71) with high-fidelity simulation when compared with low-fidelity simulation. Conclusions Improvements of efficacy were shown both in resuscitation knowledge and skill performance immediately after training. However, in current studies, the long-time retention of benefits is controversial, and these benefits may not transfer to the real-life situations.

ObjectiveThe purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students’ learning outcomes.DesignA systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.Data sourcesPubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references.Study selectionTo be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis.Review methodThree independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria.Synthesis methodFor each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen’s d with a 95% CI.ResultsThirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95% CI [0.17 to 0.81]) and performance (d=0.50, 95% CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected.ConclusionsCompared with other teaching methods, HFPS revealed higher effects sizes on nursing students’ knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students’ competence and patient outcomes.

To conduct an umbrella review of the effectiveness of using high-fidelity simulation in nursing student teaching, thereby supporting continuous improvement in teaching practitioners' implementation of high-fidelity simulation intervention strategies. Several systematic reviews have investigated the effectiveness of high-fidelity simulation in nursing student teaching in recent years. However, conclusions vary and a systematic assessment is lacking. This review encompasses an umbrella review. A search of PubMed, Embase, Cochrane Library, Web of Science and OVID databases was conducted to retrieve data on an umbrella review of high-fidelity simulation effectiveness in nursing student teaching from database inception to November 2023. The quality of the included systematic reviews was independently assessed by two reviewers using the AMSTAR 2 and PRISMA scales. Outcome indicators from the included systematic reviews were graded using the GRADE system. Twelve systematic reviews focusing on high-fidelity simulation effectiveness in nursing student teaching were included. Notably, all 12 systematic reviews exhibited very-low methodological quality, with 9 exhibiting some degree of reporting deficiencies, 2 exhibiting severe information deficiencies and 1 reporting relatively complete information. A total of 22 outcome indicators and 53 pieces of evidence were included. The results revealed 15 pieces of low-quality evidence and 38 pieces of very-low-quality evidence. Mounting evidence suggests that high-fidelity simulation teaching effectively enhances nursing students' theoretical performance, practical skills and various clinical comprehensive abilities, highlighting a positive teaching effect. However, further validation through high-quality, large-sample studies is warranted. The overall evidence quality of the current systematic reviews evaluating high-fidelity simulation effectiveness in nursing student teaching is low. Additionally, the methodological quality and the degree of reporting standardization require further improvement. Therefore, high-quality, large-sample randomized controlled trials are essential for further substantiating high-fidelity simulation effectiveness in nursing student teaching.