High-Fidelity Simulation and Virtual Technology in Nursing: Stand-Alone or Combined Approaches? A Systematic Review

High-fidelity simulation (HFS) and virtual technology (VT) are transformative in nursing education, yet their comparative effectiveness and optimal integration remain underexplored.

This systematic review evaluated the impact of HFS and VT on nursing students' knowledge and skills, comparing stand-alone and combined approaches.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines, we searched databases (2015-2024) using Population, Intervention, Comparison, and Outcome (PICO) criteria. Two reviewers independently screened studies, extracted data, and assessed quality.

Despite only 5 qualifying studies, all demonstrated that VT (foundational) followed by HFS (practical) produced optimal results, enhancing knowledge, clinical judgment, and technical skills. HFS best developed psychomotor/teamwork abilities, while VT strengthened theory and self-directed learning. Combined approaches with case-based small groups outperformed single methods.

HFS and VT are complementary: integrating VT first, then HFS bridges theory to practice effectively. Nurse educators should adopt this dual-modal approach. Future research should assess long-term outcomes, cost-effectiveness, and structured implementation.