Effect of simulation on stress, anxiety, and self-confidence in nursing students: Systematic review with meta-analysis and meta-regression

Silva, George Oliveira; Oliveira, Flávia Silva; Coelho, Alexandre Siqueira Guedes; Cavalcante, Agueda Maria Ruiz Zimmer; Vieira, Flavíana; Fonseca, Luciana Mara Monti; Campbell, Suzanne Hetzel; Aredes, Natália Del Angelo

doi:10.1016/j.ijnurstu.2022.104282

Cited by 32 publications

(18 citation statements)

References 79 publications

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“…Considering that the debriefing is a bidirectional step with the participation of the educator/facilitator and the student to discuss the reactions experienced, analyse the content presented, identify gaps in learning; in addition, it has a summary of the SBL, recapitulating the main topics of the simulation and discussion of how competencies can be transferred to practice (INACSL Standards Committee, 2021d). Such results reinforce the role of this stage in the consolidation of learning and, consequently, of self‐confidence (Oliveira Silva, Oliveira, et al, 2022).…”

Section: Discussionsupporting

confidence: 81%

“…In addition, considering that self‐confidence is the conviction that a person has of being able to do or accomplish something (Bandura, 1986; Lundberg, 2008) and is directly related to learning and clinical decision‐making (Fry & MacGregor, 2014; Groom et al, 2014; Oliveira Silva, Fonseca, et al, 2022; Oliveira Silva, Oliveira, et al,2022), understanding aspects of simulation design that best impact this competence can help in the elaboration of SBL for the best achievement of learning outcomes, consequently, impacting on the training of better qualified nurses. In this study, we adopted the recommendation of O'Donnell et al (2014) to treat self‐confidence and self‐efficacy as synonymous; thus, to both concepts we used the term self‐confidence.…”

Section: Introductionmentioning

confidence: 99%

“…Based on this framework, a scoping review identified three major groups of simulation design components (structural, methodological and theoretical‐pedagogical) (Oliveira Silva, Fonseca, et al, 2022; Oliveira Silva, Oliveira, et al,2022), so the focus of this systematic review is to identify the influence of structural components, such as the presence of prebriefing and debriefing, duration, modality, fidelity and type of simulator on stress, anxiety and self‐confidence outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Influence of simulation design on stress, anxiety and self‐confidence of nursing students: Systematic review with meta‐analysis

Silva

Oliveira

Coelho

et al. 2023

Journal of Clinical Nursing

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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.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of simulation design on stress, anxiety and self‐confidence of nursing students: Systematic review with meta‐analysis

Silva

Oliveira

Coelho

et al. 2023

Journal of Clinical Nursing

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“…A different kind of knowledge synthesis study, namely, a systematic review, comes to comparable results regarding virtual reality simulations as an effective pedagogy approach in nursing education 5. A recent meta-analysis and metaregression-based systematic review showed that SBNE, compared with conventional educational strategies, might be a more effective strategy for reducing anxiety and increasing self-confidence among nursing students 6…”

Section: Commentarymentioning

confidence: 99%

Simulations can improve nursing education in general, especially in psychiatric simulation and critical care

Kokol

2022

Evid Based Nurs

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“…Also, newly qualified physicians entering the hospital environment often report feeling scared and underprepared when facing acutely ill, predominantly elderly patients ( 4 ). Simulation has been demonstrated to be effective in increasing medical students' confidence when entering practice ( 5 ), and has been demonstrated to be an effective approach for reducing anxiety and increasing self-confidence, compared with conventional didactic teaching ( 6 ). However, a compromise must be made between realism and cost, whilst maintaining a level of realism appropriate to each stage of clinicians' professional development.…”

Section: Introductionmentioning

confidence: 99%

Technology-enhanced simulation for healthcare professionals: A meta-analysis

Mitchell

Ivimey‐Cook

2023

Front. Med.

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AimThere have been substantial changes in the simulation technology landscape, in particular virtual reality (VR), during the past decade, which have resulted in increased abundance and decreased cost. We therefore updated a previous meta-analysis conducted in 2011, aiming to quantify the impact of digital technology-enhanced simulation (T-ES) compared with traditional teaching in physicians, physicians-in-training, nurses, and nursing students.DesignWe conducted a meta-analysis consisting of randomized controlled trials published in English between January 2011 and December 2021 in peer-reviewed journals indexed in seven databases. Moderators for study duration, instruction, type of healthcare worker, type of simulation, outcome measure, and study quality rated by Medical Education Research Study Quality Instrument (MERSQI) score were included in our model and used to calculate estimated marginal means (EMMs).ResultsThe overall effect of T-ES was positive across the 59 studies included in the analysis compared with traditional teaching [overall effect size 0.80 (95% CI 0.60, 1.00)]. This indicates that T-ES is effective in improving outcomes across a wide variety of settings and participants. The impact of T-ES was found to be greatest for expert-rated product metrics such as procedural success, and process metrics such as efficiency, compared with knowledge and procedure time metrics.ConclusionsThe impacts of T-ES training on the outcome measures included in our study were greatest in nurses, nursing students and resident physicians. T-ES was strongest in studies featuring physical high-fidelity mannequins or centers, compared with VR sensory environment T-ES, though there was considerable uncertainty in all statistical analyses. Further high-quality studies are required to assess direct effects of simulation training on patient and public health outcomes.

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Effect of simulation on stress, anxiety, and self-confidence in nursing students: Systematic review with meta-analysis and meta-regression

Cited by 32 publications

References 79 publications

Influence of simulation design on stress, anxiety and self‐confidence of nursing students: Systematic review with meta‐analysis

Influence of simulation design on stress, anxiety and self‐confidence of nursing students: Systematic review with meta‐analysis

Simulations can improve nursing education in general, especially in psychiatric simulation and critical care

Technology-enhanced simulation for healthcare professionals: A meta-analysis

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