Simulation in Nursing Education: An Evidence Base for the Future

Executive summary: The purpose of this research project was to investigate how simulated learning can transform practice learning by comparing existing learning approaches with emerging simulated and technologyenhanced learning approaches. The project also maps the ability of simulation to meet the NMC (2018) future nurse standards of proficiency for registered nurses. Methods • Phase one – A systematic review of primary studies and regulatory and national standards. • Phase two – A cross-sectional survey to explore organisational readiness for simulation-based education (SBE) and opportunities and challenges of SBE in pre-registration nursing courses in the UK. • Phase three – A case study involving two self-reporting student surveys and a focus group with academic staff acting as practice supervisors. • Phase four - Focus groups with Council of Deans of Health (CoDH) members who have NMC approval for SPL to capture their experiences in the delivery of SPL in pre-registration nursing programmes. Findings and Conclusion This report provides an evidence base demonstrating how simulated learning can transform practice learning in nursing education and meet the NMC (2018) future nurse standards of proficiency for registered nurses. The findings emphasise the significant contribution of simulated practice learning (SPL) in the delivery of pre-registration nursing programmes. The systematic review indicated that, on average, SBE is more effective than traditional clinical education in improving nurse assessment outcomes. The cross-section survey of higher education institutions (HEIs) with pre-registration nursing programmes highlighted their commitment to SBE with the recognition that infrastructure, commitment by faculty leadership, access to facilities, resources and funding were critical for ensuring success and sustainability. SPL was acknowledged as an effective method that complements learning in clinical placements and enables attainment of the future nurse standards of proficiency for registered nurses. This research highlighted the difficulties HEIs face when delivering SPL. There was a strong desire for clarity and a benchmarking tool to ensure consistency in the approach of HEIs. In addition, the planning, design and delivery of simulation was viewed as an advanced skill for academic staff and thus they require sufficient training. There is a need to develop the evidence base of SPL and measure the impact and benefit on student learning and achievement of proficiencies. Creating a standardised tool to evaluate the outcomes of SPL would provide a benchmark for all HEIs to use. It would also be useful for the NMC to monitor the impact of the new definition of SPL. This research has been undertaken after several HEIs have already incorporated SPL into their programmes. In line with ambitions in the NHS England Long Term Workforce Plan, there is now an opportunity to expand the number of HEIs integrating SPL into their pre-registration nursing programmes. The findings provide an important bedrock of evidence for future decisions such as regulatory and financial support for simulated learning. Relevant stakeholders may take a range of positions on this subject, but this evidence base will further inform the conversations ahead.