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Simulation-Based Learning for Emergency Preparedness in Nursing Education: A Systematic Review and Meta-Analysis of
1Department of Gastroenterology, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital; yryd3017@outlook.com.
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Simulation-based learning (SBL) is increasingly being incorporated into nursing education to enhance preparedness for emergency situations. Gastrointestinal (GI) emergencies represent high-stakes clinical scenarios that require rapid assessment, effective decision-making, and coordinated teamwork. This systematic review and meta-analysis evaluated the effectiveness of SBL in emergency nursing education, with particular relevance to GI-related clinical scenarios. Searches of PubMed, Scopus, Web of Science, and Embase identified studies comparing SBL with non-simulation-based teaching approaches. Standardized mean differences (Hedges' g) were pooled using random-effects models with restricted maximum likelihood (REML) estimation and Knapp-Hartung adjustment. Heterogeneity was assessed using Q, τ2, and I2 statistics, and publication bias was evaluated using funnel plots and Egger's regression test. Eight studies involving 986 participants were included. Pooled analyses demonstrated positive effects of SBL on knowledge acquisition (g = 0.31, 95% CI: 0.12-0.50), teamwork ability (g = 0.66, 95% CI: 0.18-1.14), and self-confidence (g = 1.05, 95% CI: 0.62-1.49). Effects on clinical thinking (g = 0.17, 95% CI: -0.21-0.55), professional responsibility (g = 0.27, 95% CI: -0.11-0.65), and skill performance (g = -0.39, 95% CI: -0.85-0.07) were inconsistent and did not reach statistical significance. Heterogeneity was substantial across all outcome domains (I2 > 97%). Overall, SBL may improve knowledge, teamwork, and self-confidence in emergency nursing education, including competencies relevant to GI-related clinical scenarios. However, the small number of included studies and the extreme heterogeneity observed across outcomes warrant cautious interpretation of the findings. The effects of SBL on technical skills, clinical thinking, and professional responsibility remain uncertain and require further investigation.
