High-fidelity simulation and nurse clinical competence-An integrative review.

Abstract

AIM\nThe aim of this review was to synthesise current knowledge of high-fidelity simulation practices and its impact on nurse clinical competence in the acute care setting.\n\n\nBACKGROUND\nThere is no consensus or standardisation surrounding best practices for the delivery of high-fidelity simulation in the acute care setting. This is an understudied area.\n\n\nDESIGN\nAn integrative review using Johns Hopkins Nursing Evidence-Based Practice Model.\n\n\nMETHODS\nMedical subject heading terms Clinical Competence , AND High Fidelity Simulation Training , AND Clinical Deterioration were systematically searched in PubMed, CINAHL and Embase databases for peer-reviewed literature published through September 2020. The current study was evaluated using PRISMA checklist.\n\n\nRESULTS\nSeven studies met the inclusion criteria. Three main concepts were identified: modes of delivery, approach to learner participation and outcome measurement.\n\n\nCONCLUSIONS\nThis review substantiated the use of high-fidelity simulation to improve acute care nurses early identification and management of clinical deterioration. Global variations in course design and implementation highlight the need for future approaches to be standardised at the regional level (i.e., country-centric approach) where differing scopes of practice and sociocultural complexities are best contextualised.\n\n\nRELEVANCE TO CLINICAL PRACTICE\nThese findings add to the growing body of evidence of simulation science. Important considerations in course planning and design for nursing clinical educators were uncovered. This is especially relevant given the current COVID-19 pandemic and urgent need to train redeployed nurses safely and effectively from other units and specialties to acute care.