Effectiveness of scenario-based simulation in adult nursing education: A systematic review and meta-analysis

To evaluate the effectiveness of scenario-based simulation training in adult nursing education on nursing students' cognitive, affective and psychomotor domains.

Systematic review and meta-analysis.

The nursing curriculum consists of various courses, including adult, maternal, pediatric, psychiatric and community nursing. However, previous studies have often aggregated results across nursing courses, limiting the ability to identify subject-specific effects.

The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An extensive search of domestic and international databases was conducted to identify RCTs that evaluated scenario-based simulation in adult nursing education. Effect sizes were calculated using standardized mean differences (SMDs) and 95% confidence intervals (CIs) based on a random-effects model.

The systematic review included 19 studies, while the meta-analysis included 14 studies. Scenario-based simulation showed a moderate effect in the cognitive domain (SMD = 0.79; 95% CI: 0.46-1.13) and a large effect in the affective domain (SMD = 0.98; 95% CI: 0.39-1.58). Within the cognitive domain, knowledge demonstrated a moderate effect size immediately following the intervention, but the effect was not maintained at subsequent follow-up assessments. In contrast, outcomes within the affective domain, such as confidence and self-efficacy, demonstrated sustained effects over time.

The results confirmed that scenario-based simulation training for nursing students produces short-term effects in the cognitive domain and sustained effects in the affective domain.