title: Simulation in the Internet age: the place of web-based simulation in nursing education. An integrative review.
abstract: OBJECTIVE
  The objective of this article was to review the literature on utilisation and place of Web-based simulation within nursing education. Web-based simulation combines electronic multimedia options with a central video or virtual world to produce interactive learning activities mediated by the learner.
  
  
  METHODS
  An integrative review.
  
  
  METHODS
  A search was conducted of healthcare databases between 2000 and 2014 and of Internet sources for hosted simulation programs in nursing. Eighteen primary programs were identified for inclusion.
  
  
  METHODS
  A strategy for integrative review was adopted in which studies were identified, filtered, classified, analysed and compared.
  
  
  CONCLUSIONS
  Of 18 programs, two game-based programs were identified which represented a 'virtual world' in which students could simultaneously or individually immerse themselves in a character role-play. However, most programs (n=10) taught an aspect of procedural patient care using multimedia (e.g. video, audio, graphics, quiz, text, memo). Time-limited sequences, feedback and reflective activities were often incorporated. Other studies (n=8) taught interpersonal communication skills or technical skills for equipment use. Descriptive study outcomes indicated ease of program use, strong satisfaction with learning and appreciation of program accessibility. Additionally, four studies reported significant improvements in knowledge post-intervention.
  
  
  CONCLUSIONS
  Web-based simulation is highly acceptable to students and appears to provide learning benefits that align with other simulation approaches and it augments face-to-face teaching. Web-based simulation is likely to have a major place in nursing curricula in the next decade, yet further research is necessary to objectively evaluate learner outcomes and to justify its use.
authors.affiliation: School of Nursing and Midwifery, Monash University, 100 Clyde Road, Berwick, Victoria 3806, Australia. Electronic address: Robyn.Cant@monash.edu.
authors.forename: Robyn P
authors.initials: RP
authors.lastname: Cant
authors.affiliation: School of Nursing and Midwifery, Monash University, 100 Clyde Road, Berwick, Victoria 3806, Australia; School of Nursing and Midwifery, University of Brighton, UK. Electronic address: Simon.J.Cooper@monash.edu.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Cooper
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D020375:Education, Distance; D004506:Education, Nursing / Q000379:methods*; D006801:Humans; D020407:Internet; D019212:Multimedia
keywords: Experiential learning; Health professions; Nursing; Simulation; Virtual clinical simulation; Web-based simulation; e-Simulation