Jul 2026· International Journal of Drug Delivery Technology· 0 citations· 18 references
TL;DR
The findings support the integration of simulation-based strategies into nursing curricula as an effective approach to bridging the theory-practice gap and preparing students for safe and competent clinical practice.
Abstract
Introduction: Simulation - Based Learning (SBL) provides a safe, controlled, and realistic environment where nursing
students can practice clinical skills, develop clinical reasoning, and enhance decision-making abilities. Recent studies
report that over 80% of nursing students demonstrate improved clinical competence following simulation-based training.
As nursing education increasingly integrates technological tools such as high-fidelity manikins and virtual simulation,
SBL has shown significant potential to improve students’ problem-solving competencies, confidence, and patient-care
readiness.
Objectives: To assess the impact of Simulation-Based Learning on problem-solving skills among nursing students.
Methodology: A systematic review was conducted following PRISMA-2020 guidelines. Electronic databases including
PubMed/MEDLINE, CINAHL, and Scopus were searched for studies published between January 2018 and August 2025.
Eligible studies included undergraduate and postgraduate nursing students exposed to simulation-based learning
interventions. Randomized controlled trials, quasi-experimental studies, systematic reviews, and meta-analyses were
included. Data were extracted and synthesized narratively due to methodological heterogeneity among studies.
Results: A total of 45 studies met the inclusion criteria, comprising 15 randomized controlled trials, 20 quasi-experimental
studies, and 10 systematic reviews/meta-analyses. Approximately 84.4% of studies reported significant improvements in
nursing students’ problem-solving skills following simulation-based learning interventions. Improvements in clinical
reasoning and critical thinking were reported in 88.9% and 82.2% of studies, respectively. Compared with traditional
teaching methods, SBL demonstrated superior outcomes in problem-solving competency (86% vs. 68%), clinical
reasoning (89% vs. 70%), critical thinking (84% vs. 66%), student confidence (91% vs. 62%), and learning satisfaction
(93% vs. 65%). High-fidelity and virtual simulation modalities were particularly effective in enhancing cognitive and
clinical competencies.
Conclusion: Simulation-Based Learning significantly improves problem-solving skills, clinical reasoning, critical
thinking, decision-making ability, confidence, and learning satisfaction among nursing students. The findings support the
integration of simulation-based strategies into nursing curricula as an effective approach to bridging the theory-practice
gap and preparing students for safe and competent clinical practice
: Clinical reasoning is a core competence in nursing education. It helps nursing students collect patient cues, interpret clinical information, make safe decisions, and reflect on nursing actions. In recent years, technology-enhanced learning has been widely used in nursing education, including simulation, virtual simulation, virtual patients, online learning, virtual reality, and artificial intelligence-supported learning. These methods may provide safe, repeatable, and interactive learning contexts for students to practise clinical reasoning before entering real clinical settings. This systematic review aims to summarize current evidence on clinical reasoning in technology-enhanced nursing education. The review focuses on three questions: what technologies have been used, how these technologies support clinical reasoning, and what problems still exist in current research. The reviewed literature shows that simulation-based learning and virtual simulation are the most common approaches. These methods can improve students’ clinical reasoning, knowledge retention, self-efficacy, confidence, and satisfaction. Structured debriefing and reflection are important mechanisms that link technology use with reasoning development. However, current studies still have limitations, such as small samples, short intervention periods, inconsistent outcome measures, and limited long-term follow-up. Future research should use stronger designs, clearer theoretical models, and more direct measures of clinical reasoning.
Nanxiang Zhang· Curriculum and Teaching Meth...· 0 citations
Background: Nursing education faces unprecedented challenges in preparing competent, future-ready practitioners capable of addressing complex healthcare demands. Innovative pedagogical strategies have emerged as critical tools for enhancing clinical competence, critical thinking, and professional readiness.
Objective: To systematically review and synthesize evidence on innovative teaching strategies in nursing education, examining their effectiveness on critical thinking, clinical competence, decision making, and student satisfaction compared to traditional methods.
Methods: A systematic review was conducted following PRISMA 2020 guidelines. Comprehensive searches were performed across PubMed, and Google Scholar databases for studies published between 2019 and 2026. Studies examining simulation-based learning, virtual reality (VR), augmented reality (AR), artificial intelligence (AI), flipped classroom, problem-based learning (PBL), case-based learning (CBL), gamification, e-learning, interprofessional education (IPE), mobile learning, and competency-based education (CBE) were included. Data ex-traction focused on study design, sample characteristics, teaching strategies, outcomes, and student satisfaction. Thematic synthesis was performed to identify patterns and effectiveness across pedagogical approaches.
Results: Thirty studies met inclusion criteria, representing diverse geographical contexts including global and Indian nursing education settings. Simulation-based learning and VR/AR technologies demonstrated significant improvements in clinical competence, self-confidence, and knowledge retention. AI-enhanced pedagogies showed promise in personalized learning and competency scaffolding. Flipped classroom and PBL approaches enhanced critical thinking and student engagement. Student satisfaction was consistently higher with technology-enhanced and active learning strategies compared to traditional lecture-based methods. Indian nursing education reforms, including the National Nursing and Midwifery Commission (NNMC) Act, are driving curriculum modernization and competency-based frameworks.
Conclusion: Innovative teaching strategies significantly enhance nursing education outcomes across multiple domains. Technology-enhanced learning, active pedagogies, and competency-based approaches prepare nurses for contemporary healthcare challenges. Successful implementation requires faculty development, infrastructure investment, and pedagogical integration that balances technological innovation with humanistic care principles.
Dr. Kavichelvi K, D. Jaspher M· Young Nurses Journal of Rese...· 1 citation
This study analyzes the self-efficacy of simulation-based Related Learning Experience (RLE) in improving clinical skills among second-year nursing students at Dr. Carlos S. Lanting College during clinical practice. Employing a mixed-methods design that integrates quantitative pretest-post-test measures with qualitative focus group discussions, the research utilizes purposive sampling of three sections (approximately 100 students total) who underwent at least one simulation session.
Quantitative data measured clinical skills and self-confidence pre- and post-intervention, complemented by qualitative feedback on the relevance and applicability of the simulated scenarios. Results are expected to highlight improvements in skill performance, critical thinking, clinical judgment, and patient safety awareness. This study aims to provide evidence-based recommendations to inform curriculum development, optimize simulation protocols, and ultimately enhance nursing education outcomes at the institutional level.
Tolentino King Nolan C, Ibañez Ellyza Marie D, Lumbang Freya Mhae L et al.· International Journal of Adv...· 0 citations
Technology-enhanced learning (TEL), including artificial intelligence (AI), virtual reality (VR), high-fidelity simulation (HFS), and gamification, is increasingly used in nursing education to address limitations in clinical training and support the development of students’ clinical reasoning skills. This review aimed to synthesize current evidence on the educational outcomes associated with AI, VR, HFS, and gamification in nursing education, and to identify the factors that facilitate or hinder their successful implementation.
A systematic review was conducted in accordance with PRISMA 2020 and registered in PROSPERO (CRD420251048860). Five electronic databases were searched for English-language studies published between 2015 and 2025. Studies were eligible if they involved undergraduate or postgraduate nursing students and evaluated AI, VR, HFS, or gamification in educational settings. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT 2018).
Forty studies met the inclusion criteria. HFS and VR were most frequently associated with improvements in knowledge, clinical judgment, and procedural skills. Gamification was associated with greater engagement, motivation, and knowledge retention. Evidence on AI was limited and preliminary, with a small number of studies suggesting possible benefits for critical thinking and problem-solving. Common barriers included technical problems, resource constraints, and inadequate faculty preparedness.
TEL methods appear to improve student learning and provide safe environments for practice. Successful integration of TEL into nursing education requires institutional support, evidence-based teaching strategies, and continuous faculty development. TEL should complement rather than replace traditional educational practices. Future research should examine the long-term impact of TEL on learning outcomes, its cost-effectiveness, and its implementation in resource-constrained settings.
Maha Besbes, Anaam Soloh, Mohammed Mustafa et al.· BMC Medical Education· 0 citations
Background: Simulation-based education is increasingly used in physiotherapy training to bridge the gap between classroom learning and clinical practice. High-fidelity simulation (HF-Sim) offers students a realistic yet safe environment to apply theoretical knowledge, practise complex decision-making, and develop the skills in managing critically ill patients. However, evidence on its structured application in physiotherapy curricula, especially for critical care learning, remains limited. Aim: To evaluate the impact of HF-Sim on perceived clinical reasoning and reflective practice in physiotherapy students managing a case in the intensive care setting (ICU). Methods : HF-Sim was structured around predefined objectives focusing on respiratory pathophysiology, airway/ventilator management, interpretation of investigations, and evidence-based physiotherapy. These guided an HF-Sim scenario where students assessed the patient, interpreted data, and performed interventions. The 26-item Self-Assessment of Clinical Reflection and Reasoning (SACRR) survey was administered pre-and post-simulation to measure the perceived changes in clinical reasoning and reflection. Results : SACRR analysis revealed significant improvements in self-perceived clinical reasoning and reflective skills. Post-test results showed increased confidence in patient assessment, interpretation of investigations, treatment planning, and reflective practice, aligning with the learning objectives and emphasising critical thinking and evidence-based decisions. Conclusion : HS-Sim shows promise in physiotherapy education by providing a structured, safe environment for managing complex ICU scenarios. It helped students apply theory to practice and increased perceived readiness. Future studies should include objective measures and comparative designs to evaluate their impact better.
M. Yeung, Melissa Y Chan, Clement C. Yan et al.· Brazilian Journal of Respira...· 0 citations
Simulation-based education (SBE) is increasingly used in health-care training, offering nursing and midwifery students hands-on experiences in realistic controlled environments. This study examined the views of educators, clinical instructors, and final-year students in Malawi, where limited research on SBE exists. Using a descriptive qualitative approach, data were collected through interviews with 35 educators and clinical instructors and focus group discussions with 91 students from hospitals and academic institutions. The findings revealed that SBE enhanced comprehensive skill development, encouraged teamwork in multidisciplinary settings, and improved knowledge retention through repetition and reflection. Participants emphasized that SBE built students' self-confidence by allowing them to learn from mistakes in a safe space, thereby reducing clinical errors. Simulation-based education was seen as a cost-effective, practical tool that supported the development of both technical and nontechnical skills essential for health-care practices. This study underscores the significant role of SBE in preparing students for real-world clinical challenges and advocates for its broader adoption in nursing and midwifery curricula across Malawi to strengthen health-care education and service delivery.
M. Msiska, P. Mapulanga, A. Msosa et al.· Creative Nursing· 0 citations