Department of Health, Life and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Center for Nursing Education, Simulation, and Innovation, France Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA.
BMJ Open. 2019 Feb 22;9(2):e025306. doi: 10.1136/bmjopen-2018-025306.
The purpose was to analyse the effectiveness of high-fidelity patient simulation (HFPS) based on life-threatening clinical condition scenarios on undergraduate and postgraduate nursing students' learning outcomes.
A systematic review and meta-analysis were conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and its reporting was checked against the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.
PubMed, Scopus, CINAHL with Full Text, Wiley Online Library and Web of Science were searched until July 2017. Author contact, reference and citation lists were checked to obtain additional references.
To be included, available full-texts had to be published in English, French, Spanish or Italian and (a) involved undergraduate or postgraduate nursing students performing HFPS based on life-threatening clinical condition scenarios, (b) contained control groups not tested on the HFPS before the intervention, (c) contained data measuring learning outcomes such as performance, knowledge, self-confidence, self-efficacy or satisfaction measured just after the simulation session and (d) reported data for meta-analytic synthesis.
Three independent raters screened the retrieved studies using a coding protocol to extract data in accordance with inclusion criteria.
For each study, outcome data were synthesised using meta-analytic procedures based on random-effect model and computing effect sizes by Cohen's d with a 95% CI.
Thirty-three studies were included. HFPS sessions showed significantly larger effects sizes for knowledge (d=0.49, 95% CI [0.17 to 0.81]) and performance (d=0.50, 95% CI [0.19 to 0.81]) when compared with any other teaching method. Significant heterogeneity among studies was detected.
Compared with other teaching methods, HFPS revealed higher effects sizes on nursing students' knowledge and performance. Further studies are required to explore its effectiveness in improving nursing students' competence and patient outcomes.
分析基于危及生命临床情境的高保真患者模拟（HFPS）对本科和研究生护理学生学习成果的有效性。
根据 Cochrane 干预系统评价手册进行系统评价和荟萃分析，并根据系统评价和荟萃分析报告的首选报告项目检查表进行检查。
在 2017 年 7 月之前，在 PubMed、Scopus、CINAHL with Full Text、Wiley Online Library 和 Web of Science 中进行了搜索。作者联系、参考文献和引文列表也进行了检查，以获取其他参考文献。
纳入标准为：（a）已发表的全文必须为英文、法文、西班牙文或意大利文；（b）涉及本科或研究生护理学生，根据危及生命的临床情况场景进行 HFPS；（c）包含控制组，干预前未在 HFPS 上进行测试；（d）包含测量学习成果的数据，如仅在模拟会议后测量的表现、知识、自信、自我效能或满意度；（e）报告数据可进行荟萃分析合成。
三名独立评估员使用编码方案筛选检索到的研究，以根据纳入标准提取数据。
对于每项研究，根据随机效应模型，使用荟萃分析程序对结果数据进行综合，并使用 Cohen's d 计算具有 95%置信区间的效应大小。
共纳入 33 项研究。与任何其他教学方法相比，HFPS 课程在知识（d=0.49，95%置信区间[0.17 至 0.81]）和表现（d=0.50，95%置信区间[0.19 至 0.81]）方面的效果显著更大。研究之间存在显著的异质性。
与其他教学方法相比，HFPS 对护理学生的知识和表现有更高的效果。需要进一步研究来探索其在提高护理学生能力和患者结果方面的有效性。
