Impact of High-Fidelity Simulation Experiences on Nursing Students' Anxiety and Self-Confidence: A Systematic Review

Background: As an essential component of nursing education process, clinical training allows students to translate and apply the theoretical knowledge gained from the classroom to nursing practice (Killam & Heerschap 2013, Lawal et al. 2016). However, with the increasing complexity of healthcare systems, the nurse faculty shortage, increasing student applications for admission, and limited clinical placement, providing maximum clinical learning experience to students remains as a great challenge to nurse educators (Yuan et al. 2012). Alternative teaching approaches such as simulations are essential to enhance the preparation of students to assume professional nurse roles.

Aim: This systematic review aimed to explore peer-reviewed publications on the influence of HFS utilization on students’ anxiety and self-confidence during nursing education. Such study is necessary to determine the extent to which HFS can be used as a teaching tool in nursing education.

Methods: This review included scientific articles conducted from 2007 to 2016 on the influence of using high-fidelity simulation on students’ self – confidence and anxiety. Six electronic databases (Proquest, SCOPUS, MEDLINE, PubMed, CINAHL, and PsychINFO) were utilized for search of literature. Keywords used in this review were: ‘simulation’, ‘anxiety’, ‘confidence’, ‘nursing student’, and ‘high fidelity’. Thirty six (36) articles were selected for this review.

Findings: This review provides updated evidence on the efficacy of high-fidelity simulation in enhancing confidence in students; however, there was an insufficient evidence to support its effectiveness in reducing anxiety. Moreover, this review highlights the need for more research examining the impact of high-fidelity simulation on students’ anxiety. More research should be done utilizing a more robust method of research and reliable assessment methods.

Conclusion: The findings of this review contribute to a growing body of literature regarding high-fidelity simulation. The findings of this review place emphasis on nursing schools to implement high-fidelity simulations across all courses.

Relevance to Nursing Education: The findings from this review place an emphasis on the enhancement of student self-confidence in caring for patients and performing skills when high fidelity simulation is utilized as a teaching modality. Clinical experiences could be enhanced by the reduction in anxiety and the increase in self-confidence prior to assignments for the care of individuals.