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AimTo evaluate the simulation design characteristics that may influence the stress, anxiety and self‐confidence of undergraduate nursing students during learning.DesignSystematic review with meta‐analysis.Data SourcesSearchers were conducted in October 2020 and updated in August 2022 in the databases CENTRAL, CINAHL, Embase®, ERIC, LILACS, MEDLINE, PsycINFO®, Scopus and Web of Science, PQDT Open (ProQuest), BDTD, Google Scholar and specific journals on simulation.Review MethodsThis review was conducted according to the recommendations of Cochrane Handbook for Systematic Reviews and reported according to the PRISMA Statement. Experimental and quasi‐experimental studies that compared the effect of simulation on stress, anxiety and self‐confidence of nursing students were included. The selection of studies and data extraction was performed independently by two reviewers. Simulation information was collected as prebriefing, scenario, debriefing, duration, modality, fidelity and simulator. Data summarization was performed by qualitative synthesis and meta‐analytical methods.ResultsEighty studies were included in the review, and most reported in detail the structure of the simulation, contemplating prebriefing, scenario, debriefing and the duration of each step. In subgroup meta‐analysis, the presence of prebriefing, duration of more than 60 min and high‐fidelity simulations helped reduce anxiety, while the presence of prebriefing and debriefing, duration, immersive clinical simulation modalities and procedure simulation, high‐fidelity simulations and use of mannequins, standardised patients and virtual simulators, contributed to greater students' self‐confidence.ConclusionsDifferent modulations of simulation design components imply reduction of anxiety and increased self‐confidence in nursing students, especially highlighting the quality of the methodological report of simulation interventions.Relevance to Clinical PracticeThese findings help to support the need of more rigorous methodology in simulation designs and research methods. Consequently, impact on the education of qualified professionals prepared to work in clinical practice.No Patient or Public Contribution.

Simulation is a teaching-learning strategy aligned with the perspective of an active methodology that, in the context of health and nursing education, enables students to develop skills and build knowledge in cognitive, procedural and attitudinal domains, preparing them for clinical practice (Kim et al., 2016;Lavoie et al., 2018;Onarici et al., 2021). It is associated with the development of skills necessary for nurses, which help in clinical judgement, decisionmaking and resolution of complex situations in health services, in addition to emotional skills that are fundamental for the work process and comprehensive care (Flynn et al., 2017).It is also added that the simulation is recognized for promoting a safe space for learning in which the error does not cause harm to the patient. Moreover, are accompanied by facilitating professors who plan and implement the strategy similar to situations found in health

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Objective: to evaluate the frequency and factors associated to disapproval among nursing students. Method: a descriptive and cross-sectional study, outlined by the convergent mixed method. A total of 88 nursing students of a Brazilian public university took part. The Reduced Academic Experiences Questionnaire was used for evaluating academic adaptation. The association of the variables in the study with disapproval was verified by bivariate analysis. Results: the frequency of disapprovals in the sample was 68.2%, recurrences in the same discipline in 39.8%, with the associated factors: age over or equal to 22 years old (p=0.015), family income below 2 minimum wages (p=0.019) and lag in the curricular flow (p<0.001). Disciplines with higher frequencies of disapprovals are of the basic area, taught in the first two years of the course and common to the health courses. Students without disapprovals had better perception of physical and psychological well-being (p=0.002), good interpersonal relationships (p=0.017) and more assertive study behaviors (p=0.005). Personal, study-related and institutional issues were motivating. Conclusion: the results reveal a high rate of disapproval, especially in the basic area. An association was found between disapprovals and mental health for nursing students during their education process, and difficulties were pointed out that can culminate with the disapproval rate in the curricular flow.