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Effectiveness of In-situ Simulation on Clinical Competence for Nurses: A Systematic Review
Karmay Hung1, Casey Santana1, Cara Thurman Johnson1
1Columbia University, School of Nursing, New York, NY 10032, USA.
Clinical Simulation in Nursing
|June 11, 2025
Summary
In-situ simulation (ISS) effectively boosts registered nurses' clinical competence in acute care. This method also helps maintain their existing skills, highlighting its value in nursing education and practice.
Area of Science:
- Healthcare Education
- Nursing Practice
- Clinical Skills Development
Background:
- In-situ simulation (ISS) is recognized for its benefits in healthcare training.
- Assessing the impact of ISS on registered nurses' clinical competence in acute care settings is crucial.
Purpose of the Study:
- To systematically review the effectiveness of in-situ simulation in enhancing cognitive, skills, and affective learning outcomes for registered nurses in acute care.
- To synthesize evidence on ISS's impact on clinical competence within the nursing profession.
Main Methods:
- Systematic review following PRISMA 2020 guidelines.
- Searched databases: PUBMED, EMBASE, CINAHL for peer-reviewed randomized controlled trials.
- Included studies focused on ISS in acute care for registered nurses, assessing skill/knowledge outcomes. Appraised using Joanna Briggs Institute Critical Appraisal Tool.
Main Results:
- Seven randomized controlled trials met the inclusion criteria from an initial search of 22 articles.
- Methodology of included studies was deemed acceptable.
- In-situ simulation was found to generally increase and maintain clinical competence in registered nurses.
Conclusions:
- In-situ simulation is an effective strategy for improving and sustaining clinical competence among registered nurses in acute care environments.
- Further research is recommended to optimize ISS protocols, including frequency, fidelity levels, and comparisons with off-site simulation methods.
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