A systematic review of the effectiveness of simulation-based education on satisfaction and learning outcomes in nurse practitioner programs.
BACKGROUND
High-fidelity simulation (HFS) is becoming an integral component in healthcare education programs. There is considerable evidence demonstrating the effectiveness of HFS on satisfaction and learning outcomes within undergraduate nursing programs; however, there are few studies that have investigated its use and effectiveness within nurse practitioner (NP) programs.


OBJECTIVE
To synthesize the best available evidence about the effectiveness of HFS within NP education programs worldwide. The specific review question was: what is the effect of HFS on learner satisfaction, knowledge, attitudes, and skill performance in NP education?


METHODS
Joanna Briggs Institute systematic review methodology was utilized. The following databases were searched: MEDLINE, CINAHL, EMBASE, Epistemonikos, PROSPERO, HealthSTAR, AMED, Cochrane, Global Health and PsycINFO. Studies were included if they were quantitative in nature and reported on any aspect HFS within a NP program.


RESULTS
Ten studies were included in the review. All studies were conducted in the United States and published between 2007 and 2014. Outcomes explored included: knowledge, attitudes, skills and satisfaction. The majority of studies compared HFS to online learning or traditional classroom lecture. Most study scenarios featured high acuity, low frequency events within acute care settings; only two studies utilized scenarios simulated within primary care.


CONCLUSIONS
There is limited evidence supporting the use of HFS within NP programs. In general, HFS increases students' knowledge and confidence, and students are more satisfied with simulation-based teaching in comparison to other methods. Future studies should explore the effectiveness of simulation training within NP programs in reducing the theory to practice gap, and evaluate knowledge retention, transferability to real patient situations, and impact of simulation on patient outcomes.
School of Nursing, Queen's University, Kingston, Ontario K7L 3N6, Canada. Electronic address: jwarren@crchc.on.ca.
Jessie N
JN
Warren
School of Nursing, Queen's University, Kingston, Ontario K7L 3N6, Canada. Electronic address: mfl1@queensu.ca.
Marian
M
Luctkar-Flude
School of Nursing, Queen's University, Kingston, Ontario K7L 3N6, Canada. Electronic address: christina.godfrey@queensu.ca.
Christina
C
Godfrey
School of Nursing, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, Newfoundland A1B 3V6, Canada. Electronic address: jlukewich@mun.ca.
Julia
J
Lukewich
D002983:Clinical Competence; D004506:Education, Nursing / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D000070856:High Fidelity Simulation Training / Q000379:methods*; D006801:Humans; D007858:Learning; D009722:Nurse Practitioners / Q000193:education*; D010549:Personal Satisfaction
Acute care; Advanced practice nurses; Education; High-fidelity; Nurse practitioners; Patient simulation; Primary care