Simulation in preparation or substitution for clinical placement: A systematic review of the literature

Abstract

Background: In recent years, nursing education has undergone changes and restructuring due to changes that have occurred in clinical and academic settings. Currently, academic leaders are facing the challenges of an increasing number of students, the difficulty of recruiting teachers and preceptors to accompany students, and fewer clinical settings that can accommodate many interns at once. To come to terms with these changes, the idea of replacing clinical hours with simulation has emerged. On this issue, little conclusive data is available. The objective of this article is to clarify the contribution of simulation in clinical nursing education in preparation or substitution for clinical placement. Methods: The CIHNAL, MedLine, and PubMed databases, and Google and Google Scholar search engines were consulted between to conduct a systematic review of the literature between 2008 and 2014. Thirty-three articles were selected. Results: Students and teachers perceive the benefits of simulation as an adjunct to clinical placement in terms of effectiveness, self-confidence, and preparation for clinical practice. Substituting clinical placement with simulation does not seem to have a significant impact on clinical competency, critical thinking, knowledge acquisition, and self-confidence. Conclusions: The findings question the very concept of substitution and suggest that the strengths of clinical exposure through both simulation and clinical placement should be highlighted.