Simulation learning for critical care nurses : an integrative review

Abstract

Background Recommendations have been made that simulation learning should be included in nursing undergraduate education. This advice has been in response to concerns that nursing education lacks adequate practical experience and clinical support in order to prepare nurses for clinical practice. While simulation learning is not thought to replace clinical practice, simulated learning environments are considered to be a means of presenting unique learning opportunities that add to the experiential learning process. Leading medical and nursing educationists have endorsed simulation learning as a positive step in clinical education within the complex environment of modem healthcare. Previous literature reviews of simulation learning have however, criticised the inconsistencies of methodology and lack of rigor peppering the research into simulation learning outcomes. Personal experience, of the author of this study, has found that some nurses can feel overwhelmed and anxious in simulation scenarios. This experience has prompted the author to investigate the whole notion of simulation further including the experiences of simulation participants. Objectives This integrative review sought to investigate the current literature on simulation learning as a learning tool for critical care nursing education. The central questions aimed to identify how the evidence demonstrated simulation was an effective learning tool for nurses who are involved in critical care. Secondly this study endeavoured to explore the experiences of both nurses and educators utilising simulation learning to prepare for critical care nursing. Methods The integrative review was chosen in order to capture a broad range of nursing research from both quantitative and qualitative perspectives. A systematic process was followed to ensure a structured and consistent approach to reviewing the literature. The Joanna Briggs Institute quality appraisal tools and data extraction tables were utilised for this purpose. The fifteen articles meeting the inclusion criteria had various methods, participants, settings and simulation interventions. A thematic analysis was applied to the studies to elicit the common themes and concepts that answered the two central questions of simulation effectiveness and experiences. The data extracted was synthesised and has been reported in a narrative form. Conclusions Simulation learning within the critical care environment had been initiated to improve; patient safety and quality care, training standards and the personal development of the student. The participants of simulation found the experience generally positive with improvements in confidence, anxiety and knowledge. Further clarity into how well simulation learning transfers into the clinical context would be useful, with longitudinal multicentre controlled research designs. Eliciting the attitudes and perceptions of experienced versus inexperienced nurses would also be useful information for nurse educators, to enable them to understand the confounding issues with simulation learning participants and ensure targeted learning .