Future HFS trials for practising nurses need larger samples, rigorous randomised design and standardised, fully reported measures¶

Strategy · All strategies
Evidence · 4 claims (4 for) · 1 study (1 quant-synthesis), q3 · 1 of 1 report an effect size · 4 claims rest on one study

Description¶

The review recommends strengthening the evidence base through "more rigorous RCTs with larger sample sizes, adequate reporting of HFS design, and standardised outcome measures". It advises following EQUATOR guidelines, particularly the CONSORT extensions for health care simulation research, in trial design, execution and reporting, and suggests multicentre studies to overcome recruitment difficulties with working nurses. It also proposes exploring integration of HFS with other simulation modalities such as computer-based simulation for more flexible, cost-effective training.

Design Implications¶

Context¶

Requirements¶

• Trials should pre-register, report randomisation and allocation concealment, and use uniform outcome measures.

Constraints¶

• Small sample sizes are typical for research with practising nurses because of the difficulty of engaging working staff; the paucity of studies precluded subgroup or meta-regression analyses.

Target Learners¶

• Practising registered nurses

Target Learning Goals¶

• Knowledge acquisition
• Professional/clinical skills
• Self-confidence
• Learning satisfaction

Claims¶

• High-fidelity simulation training improves knowledge acquisition among practising registered nurses (moderate pooled effect) [+W]
• High-fidelity simulation training yields a large effect on learning satisfaction among practising registered nurses [+W]
• High-fidelity simulation training improves professional skills among practising registered nurses (moderate pooled effect) [+W]
• The effect of high-fidelity simulation on practising nurses' self-confidence is inconclusive, varying by study design [+W]

Related Strategies¶

• Integrate high-fidelity simulation into continuing nursing education and professional development programs
• Prioritize larger randomized trials in pedagogical research and more representative evaluations across Africa
• Prioritize rigorous RCTs with retention tests and transfer measures before expanding distance simulation programs
• Integrate quantitative and qualitative approaches in future cardiac arrest simulation feedback research
• Future active-learning research should use randomised controlled designs with larger samples and standardised outcome measures
• Use cluster randomized clinical trials and blinded simulation-based behavior assessment to strengthen NTS training evidence
• Engage target learners to identify needs before designing XR educational tools
• Future simulation research should use rigorous designs, standardized tools, and transparent reporting
• Prioritize rigorous VR training studies with larger samples, validated outcome measures, immersive designs, and LLM integration in mental health education research
• Future active-classroom research should use adequately powered, well-randomized trials measuring a wide range of student outcomes
• Prioritize larger sample sizes, multicentre designs, and rigorous reporting in future simulation-based CRM transfer and patient-outcome research
• Develop standardised delivery-quality assessment using a maximum of two scores (one communication, one content-delivery)

Examples¶

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Key Sources¶

• Zhou Jie, Zhang Guowen, Song Peige, Liaw Sok Ying, Luk Tzu Tsun. (2026). Effects of High‐Fidelity Simulation Training on Learning Outcomes and Satisfaction for Practising Registered Nurses: A Systematic Review and Meta‐Analysis. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.70206