High-fidelity simulation duration and learning outcomes among undergraduate nursing students: A systematic review and meta-analysis

To explore the effects of different lengths of the three key steps (prebriefing, simulation, and debriefing) of high-fidelity simulation (HFS) on the knowledge and skills of undergraduate nursing students. A systematic review and meta-analysis. A systematic search was conducted for Chinese and English publications from the Web of Science, PubMed, Embase, Cochrane, and two Chinese databases (Wanfang and CNKI) up to November 24, 2021. Two independent raters screened the retrieved studies and extracted data based on a coding protocol from the studies that met the inclusion criteria. Data were synthesized using meta-analytic procedures based on a random-effect model and computing effect sizes by standard mean differences (SMD) with a 95% confidence interval (CI). Results: Forty-four studies were included, and 23 studies were analyzed. High-fidelity simulation (HFS) with debriefing of 10 min or less (SMD = 1.18), simulation of 15–20 min (SMD = 1.43), and debriefing of 11–30 min (SMD = 1.19) showed larger effect sizes for knowledge, while HFS with debriefing of >10 min (SMD = 0.91), simulation of 15 min or less (SMD = 0.89), and over 30 min of debriefing cultivation (SMD = 0.84) showed larger effect sizes for skill. During the prebriefing, simulation, and debriefing, shorter sessions are more effective for improving knowledge in BSN students, whereas longer sessions are most effective for improving skills in BSN students. Nurse educators can schedule HFS to meet the expectations of learning outcomes based on the actual situation.