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Study: Simulation Helps Nursing Students Feel More Confident

Gayle Morris, BSN, MSN
Updated November 9, 2023
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    As more nursing schools add simulation labs, data shows they build self-confidence in clinical tasks, judgment, and decision-making.
    Nurse simulating patient care to a mannequin in hospital bedCredit: Getty Images
    • A review of primary studies from 2005 to 2020 showed simulations improve nursing students’ confidence in performing clinical tasks and making clinical judgments.
    • A vast majority of nursing programs now offer clinical simulations, with students spending an average of nearly 70 hours in simulation labs.
    • The findings were consistent, even when nursing students had limited exposure to clinical simulation labs.

    A new systematic review found that nursing simulation labs can increase nursing students’ self-confidence, ability to make clinical judgments, and communication and teamwork with colleagues.

    The review appeared recently in BMC Medical Education, and researchers analyzed 15 studies published from 2005-2020.

    “This review has significant ramifications for nursing and medical practice,” wrote first study author Nojoud Alrashidi, a professor and researcher with the College of Nursing at the University of Ha’il in Saudi Arabia. “The self-confidence of students needs to grow if they are to develop post-registration skills and be confident in handling their duties. As this review has demonstrated, developing competence in carrying out clinical tasks or procedures is related to one’s level of confidence.”

    Nursing Simulation: An Overview

    The nursing profession has grown increasingly complex. To keep up with clinical advances, nursing schools have developed simulation labs to better prepare nursing students for practice after graduation.

    Nursing simulation labs are designed to prepare nursing students for practice in the real world. Clinical simulations are just one part of nursing school education, but one that provides students with the opportunity to use hands-on practice in state-of-the-art facilities.

    There are various types of clinical simulations that can be incorporated into nursing school education. For example, clinical simulation labs may use mannequins or volunteers who play the part of the patient.

    High-fidelity mannequins are computer-controlled and can closely replicate physiological responses found in specific clinical situations, while volunteers can improve communication and assessment skills. Virtual reality provides nursing students with the opportunity to interact with patients in realistic situations while solving complex problems.

    The Ohio State University used a grant from the American Nurses Foundation to develop an extended reality simulation lab employing virtual reality experiences to increase students’ ability to use their clinical judgment and clinical reasoning skills.

    A 2017 survey found that 65% of nursing education programs used visual simulation, and nearly 50% expected to incorporate virtual reality within the next 5 years. By October 2022, the NCSBN National Nursing Education Annual Report found that most nursing programs offered simulations of one type or another. The average number of hours nursing students spent in the simulation lab was 69.62.

    Nursing School Simulation: Building Confidence and Know-How

    Researchers in the BMC study sought to analyze whether simulation labs could improve nurses’ self-confidence once they have graduated and are fully practicing in the field.

    “The primary goal of simulation training is to ensure that student nurses acquire the requisite skills to perform clinical procedures, participate in collaborative work with other healthcare practitioners, and enhance safety during the actual care of patients,” Alrashidi and colleagues wrote.

    Nursing simulation labs provide students with an experiential environment without the added pressure of working with live patients. Simulations allow them to hone clinical and decision-making skills without jeopardizing patient safety.

    A growth in self-confidence could improve patient care. Researchers acknowledge that it is a key component and positively connected with a student’s capacity for critical thinking. The objective of a simulation lab is to offer nurses the ability to take risks and try new things in a supported environment.

    “In nursing education, simulation is crucial for the formation of clinical judgment,” wrote the researchers. “It is a cutting-edge method of instruction that aims to replicate key features of clinical cases with effectiveness and learning impact proven in areas like decision-making and clinical reasoning. Simulation is acknowledged as a valuable learning tool in nursing education.”

    The researchers analyzed specific themes that emerged during critical analysis, which included improvement in self-confidence while performing clinical tasks, working in teams, in community work, and communicating with patients and team members.

    “One way to achieve quality care is to ensure that student and registered nurses are confident in carrying out clinical tasks and procedures and in working effectively with patients and their family members in the community and other healthcare settings,” wrote study authors.

    The data shows that nursing simulation increased self-confidence in nursing students when they made clinical judgments, performed clinical tasks, and communicated with patients and team members. They also noted an overall improvement in the nursing students’ ability to work within the team.

    The findings were demonstrated even after nursing students completed a few clinical simulations, which suggested to the researchers that even limited exposure had a significantly positive effect.

    “The findings of the studies also suggested the impact of clinical simulation on the future practice of nursing students,” Alrashidi and colleagues wrote. “As students gain self-confidence, their ability to provide quality care also improves.”