High-Fidelity Simulation and Safety: An Integrative Review

Abstract

Previous reviews of simulation relating to critical thinking and efficacy called for more research on the effects of simulation and safety. Safety, as a skill performance outcome of high-fidelity simulation, is reviewed. Data included studies of nursing education that linked safety dimensions with high-fidelity simulation at all student levels. Only primary sources published since 2007 were included. This integrative review evaluates data using scores to assign value to the evidence, analyzes data within categories defined as safety behaviors, and compares evidence using a matrix of factors and outcomes. Definitions of safety and measurement tools are critiqued. Findings reveal that simulation-enhanced clinical experiences may decrease medication errors. Any evidence about perceived improvement in safer communication has not been translated into practice. Knowledge and attitudes of safety may be improved with simulation, depending on the students' educational levels. More comparative studies are needed to support theoretical models of simulation.

Fusion of Psychiatric and Medical High Fidelity Patient Simulation Scenarios: Effect on Nursing Student Knowledge, Retention of Knowledge, and Perception

“…Another weakness identified in the review was a lack of formal measurement tools to evaluate HFS. Shearer (2013) conducted an integrative review of 20 research studies on safety and high fi-delity simulation published in the literature since 2007. Results of this review identified two studies that provide evidence for effectiveness of high fidelity simulation on outcomes of safety, particularly related to patient identification and avoiding medication errors; however, any evidence about perceived improvement in safer communication has not been translated into practice.…”

Learning Outcomes Associated With Patient Simulation Method in Pharmacotherapy Education

“…43Y45 Patient simulation enhances important learning outcomes including commitment to pharmacotherapy learning, evaluation, application, knowledge, and understanding of pharmacotherapy and may decrease medication errors. 15,23,25,27 There were no reports of dissatisfaction with simulation teaching methods, and comparisons against other teaching methods were generally favorable.…”

“…Shearer 15 Evaluate existing evidence that nursing education using HFS improves patient safety outcomes 20, between 2007 and 2011 Qualitative studies (n = 2), descriptive studies (n = 10), quasi-experimental studies (n = 7), experimental study (n = 1) Sample sizes not reported, nursing students at various educational levels, recently graduated nurses…”

“…12 Previous systematic reviews (Table 1) have examined patient simulation as a teaching tool across a range of disciplines, 14 its educational effectiveness, 13 and its impact on attitudes toward patient safety outcomes. 15 These reviews have focused on teaching perspectives. The main interest of this review is to consider pharmacotherapy and medicines' management from the perspective of learning outcomes.…”

Advancing Renal Education: Hybrid Simulation, Using Simulated Patients to Enhance Realism in Haemodialysis Education

“…). In order to develop the empirical evidence base in simulation, simulation research needs to be guided by established theoretical frameworks and use validated instruments to assist in improving our understanding of not only what simulation improves, but how and why (Shearer ).…”