Identifying Effective Instructional Design Features of Simulation in Nursing Education: A Realist Review

Simulation is increasingly being used as an instructional strategy, yet evidence-informed guides for how to use simulation effectively in nursing training is lacking. A realist review of the nursing simulation literature was conducted to determine how simulation is currently being used in nursing training. Unfortunately, the majority (69%) of primary studies were excluded due to missing information about the context, mechanism, or outcome of the study. In the remaining 13 studies, four themes of instructional design features emerged including: feedback, debriefing, self-regulated learning, and the intersection between feedback and self-regulated learning. However, the small number of studies permits only cautious recommendations for nursing educators. Improved reporting standards in nursing education journals are imperative so that authors of original studies are prompted to report all relevant information, and so authors of knowledge syntheses are better able to make recommendations about when simulation should be used, for which trainees, under which circumstances, and why.M.Sc