International Journal of Healthcare Simulation

Introduction:

Whilst the use of simulation-based education (SBE), in nursing education, allows nurse educators to replicate what happens in real-life clinical practice, and enables students to experience experiential learning, most research has focused on students’ skill and knowledge acquisition and self-reported confidence, with limited exploration of transfer of learning from SBE to clinical practice. Research on learning transfer suggests that it is not automatic and can be difficult to stimulate. Although SBE provides the opportunity to recreate realistic patient scenarios whereby students can learn and develop their knowledge and skills in a safe environment, it is not a real-life experience. Whether knowledge and skills gained from SBE can be transferred into nursing practice is a growing area of interest in simulation research. This scoping review aimed to identify and map primary research on transfer of learning transfer from SBE to clinical practice, in pre-registration nursing students.

Research question: What is known from existing empirical evidence about the transfer of learning from simulation-based education (SBE) to clinical practice, in pre-registration nursing students?

Methods:

This scoping review followed the Joanna Briggs Institute, Methodology for JBI Scoping Reviews guidance. The review followed a results-based convergent synthesis design: qualitative, quantitative, and mixed method studies were identified in a single search, analysed separately, and integrated throughout synthesis and presentation. PRISMA and Extension for Scoping Reviews: RISMA-ScR and Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidance were followed. CINAHL Cumulative Index, Medline, British Nursing Index and Google Scholar were searched for eligible studies published between January 2010 and September 2023.

Results:

Thirty-three studies, spanning 17 qualitative studies, 12 quantitative studies and 4 mixed method studies were included. Quantitative evidence highlights the potential benefits afforded to students in terms of developing confidence, competence, knowledge, and skills in the clinical setting. However, qualitative evidence suggests that multiple factors can affect the student’s learning experience, which could consequently limit the transfer of taught knowledge and skills from SBE to clinical practice.

Discussion:

Although there is a consensus that SBE promotes learning transfer, much of the evidence is based on students’ perceptions of their abilities to utilise learning from SBE in the clinical setting. Few studies have explored the processes involved in learning transfer between the two learning environments. Further research is needed to explore the processes by which learning transfer occur¹, including the impact of SBE on student’s clinical performance and patient safety and patient outcomes [1].

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

References

1. Hussein M, Harvey G, Bell N. the influence of nursing simulation on patient outcomes and patient safety: a scoping review. Clinical Simulation in Nursing. 2022;70:37–46.