The Future of Nursing: Simulation Improves Nursing Student Confidence and Competence, Study Shows

• Nursing simulation labs help build nursing students' self-confidence in clinical tasks and clinical judgment.
• Data shows that even limited exposure to sim labs is associated with a positive influence on self-confidence.
• A nursing simulation laboratory may be one solution nursing schools can use to improve quality patient care.

According to a recent analysis, nursing students who were trained using clinical simulation saw higher levels of self-confidence in clinical tasks and overall decision-making compared with those who did not.

"Using simulation-based clinical education, nursing students are provided the opportunity to hone their clinical and decision-making abilities through a variety of real-life situational encounters, without jeopardizing the patient's safety," wrote study lead investigator Nojoud Alrashidi, a researcher with the University of Hail College of Nursing in Saudi Arabia, and colleagues, in the paper.

Here's a breakdown of simulation training and what the study found for nursing students.

What Is a Patient Simulator?

In 1911, a life-size doll known as "Mrs. Chase" was designed to help train healthcare workers. That was the beginning of clinical simulation, which has come a long way since then. Clinical simulation helps nursing students learn critical skills in a controlled environment. Nursing simulation can replicate real-world scenarios in an environment that is safe for experimentation and education.

There are many advantages to utilizing clinical simulation-based learning, including the use of technological advances that provide students with an accurate simulation of complex patient care experiences so they can learn without placing patient lives at risk.

Additionally, clinical simulation labs offer faculty and instructors a clearer picture of a student's skill set within a protected environment and are an effective way for faculty to evaluate and give accurate feedback on student abilities.

One type of simulation used at nursing schools is high-fidelity mannequins, with one extreme example being the prototype developed for Emory University's School of Nursing.

This robot can hold a casual conversation and move his eyes in addition to other physiological responses that could indicate complex health conditions. Nursing schools can also use low-fidelity mannequins that help students build knowledge. Volunteers can act as standardized patients and help students practice communication and assessment skills. And virtual reality creates a realistic simulation used to teach nursing students about complex situations.

These types of technologies allow nursing students to have experiences that may not be available during their clinical hours. A combination of several types of simulations can help students practice more than one skill.

Nursing School Simulators: Instilling Confidence

The researchers noted that past studies demonstrated the positive influence nursing simulation has on nursing education. It has been a valuable teaching strategy since 1911. And technological advancements have developed ways to engage students and improve their learning more quickly.

The researchers identified 15 primary research studies from five academic databases.

The studies were published from 2005-2020 and had to have been published in English, with full text and data available, and were primary research studies that could be applied to the development of the nursing curriculum. Studies that were not peer-reviewed or did not address the outcome measure of interest were not included.

"Nurse educators view repetitive simulation as a beneficial teaching strategy for supporting students' learning objectives," the researchers wrote.

The nursing researchers used a somatic analysis to identify major themes found in the studies. Those themes included:

• Self-confidence to work within a team structure
• Self-confidence in clinical tasks
• Self-confidence in communicating with team members and patients
• Self-confidence in community work

While evaluating the data, the researchers found that most of the studies indicated nursing simulation improved a student nurse's ability to carry out clinical tasks. Three of the 15 studies found that simulation helped nursing students perform community work, and five found an association with improved self-confidence in communication skills with patients and team members.

"Despite limitations, it is noteworthy that all the studies were able to demonstrate that, even with short training sessions on clinical simulation, its impact on the self-reported self-confidence of the students was significant," the researchers wrote.

The researchers believe that the review holds significant ramifications and that developing competence in clinical tasks is linked to the nursing students' level of self-confidence. Using a sim lab may be one solution to improving patient care quality for nurse educators.

The researchers hypothesize that an improvement in class performance may lead to a better standard of patient care when nursing students believe they are capable of carrying out the necessary clinical tasks and appropriately communicating with patients and team members.

"According to this review, clinical simulation is a technique that can both boost students' self-confidence and enhance the standard of patient care," the researchers wrote. "The results of this review may be used by educators, legislators, and other interested parties to assess the relationship between clinical simulation and student confidence growth."

The findings of the literature review also suggest that even when nursing students had limited exposure to simulation-based education, it was still associated with improvements in self-confidence. The researchers caution that while the results are similar to past studies, the findings are based on studies with a limited sample size, which limits the ability to apply the results to a larger population.

"The present literature-based study could provide a background on how clinical simulation improves patient safety by increasing the self-confidence of student nurses," the researchers wrote. "This self-confidence could extend until post-registration, and it would enable the student nurses to be better prepared in their future roles. The wide application of clinical simulation in clinical practice may also promote teamwork."