Systematic ReviewResearchNew Grad Friendly

Adult-nursing simulation improved knowledge and confidence, but knowledge gains faded at follow-up

Nurse education in practice (PubMed)Jul 12, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review of 19 studies found that scenario-based adult-nursing simulation produced moderate cognitive and large affective benefits; knowledge gains were short-lived, while confidence and self-efficacy effects persisted at follow-up.

What NurseJet pulled from the source

This systematic review examined randomized trials of scenario-based simulation in adult nursing education. Nineteen studies were included and 14 contributed to meta-analysis. Simulation produced a moderate pooled effect in the cognitive domain (SMD 0.79, 95% CI 0.46 to 1.13) and a large effect in the affective domain (SMD 0.98, 95% CI 0.39 to 1.58). Knowledge improved immediately after training but was not maintained at later follow-up assessments. In contrast, affective outcomes such as confidence and self-efficacy showed sustained effects over time. The review supports simulation as an educational strategy while highlighting that immediate knowledge gains should not be assumed to persist without reassessment or reinforcement.

Why this matters for nurses

Nurse educators use simulation to prepare students for complex adult-care decisions before clinical exposure. This review matters because it distinguishes short-term knowledge gains from more durable confidence and self-efficacy, helping programs choose outcomes and follow-up intervals that match their educational goals.

Bedside takeaway

Worth knowing that scenario-based adult-nursing simulation improved knowledge and confidence, but only the confidence-related gains persisted at follow-up.

How This Applies in Practice

Use this when: Designing or evaluating scenario-based simulation for prelicensure adult nursing education.

On your shift

Measure knowledge and confidence as separate outcomes because their effects may persist differently.
Add a delayed knowledge check; if adding reinforcement, evaluate it locally because the review did not establish a reinforcement method or interval.

Keep in mind: The review does not establish one best scenario design or reinforcement interval. Follow the nursing program's curriculum standards and organizational policy.

Explain this for my unit

Key takeaways

The review included 19 studies, with 14 contributing data to meta-analysis.
Scenario-based simulation produced a moderate pooled cognitive effect and a large affective effect.
Immediate knowledge improvement was not maintained at subsequent follow-up assessments.
Confidence and self-efficacy benefits were sustained over time in the included evidence.

Practice implications

Education teams can pair scenario-based simulation with delayed knowledge checks and reinforcement rather than relying only on immediate post-training scores. Programs should assess cognitive and affective outcomes separately because the review found different patterns of durability.

Limitations & cautions

Only 14 of the 19 included studies contributed to meta-analysis. The abstract does not report the total number of participants, between-study heterogeneity, or detailed risk-of-bias results, and the cognitive benefit was not maintained at follow-up.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Open source

Public citations are filtered to exact credible source pages. Homepage-only or invalid links stay in admin review and are not shown here.

Nurse education in practice (PubMed)

Nurse education in practice (PubMed). Effectiveness of scenario-based simulation in adult nursing education: A systematic review and meta-analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42447775/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

Related briefs

More updates for this clinical area

Back to Discover

BMC Palliative Care (PubMed)Jul 11, 2026Research Article

In a cluster-randomized study of 10 nursing homes and 119 residents who died, a 40-hour palliative-care course for staff was associated with a greater likelihood that a documented pain event had a subsequent measure recorded.

Geriatrics LeadershipAI summaryReview source

Research ArticleResearchQuality ImprovementAI summary · original source linked below

This cluster-randomized study tested whether a 40-hour multiprofessional palliative-care course for nursing-home staff changed care documented during residents' last three months of life. Five of 10 German nursing homes received the training. Records were analyzed for 119 residents who died during follow-up: 42 in intervention homes and 77 in control homes. Specialized outpatient palliative care was documented for 19.0% of residents in the intervention group and 9.1% in the control group. Pain was documented for 57.1% versus 49.4%, respectively. Across 225 recorded pain events, a subsequent measure was documented in 73.6% of intervention-group events and 61.9% of control-group events; multilevel analysis found higher odds of a follow-up measure after training (OR 1.804). The authors concluded that staff qualification may improve recognition and response, while noting the challenges of inconsistent real-world documentation. The study primarily measured recorded processes rather than resident comfort or symptom relief.

Key takeaways

The cluster-randomized study included 10 nursing homes, with staff at five facilities completing a 40-hour palliative-care course.
Records from 119 residents who died were reviewed for palliative symptoms and measures during the final three months of life.
A subsequent measure was recorded after 73.6% of documented pain events in intervention homes versus 61.9% in control homes.
In multilevel analysis, the odds of a documented follow-up measure after a pain event were higher in the intervention group (OR 1.804).

Why this matters on shift

Palliative needs can be missed when staff lack a shared framework for recognizing symptoms and responding consistently. This study matters for geriatric nurses and educators because it links structured training with a measurable change in documented follow-up after pain events near the end of life.

Bedside takeaway

Worth knowing that after nursing-home staff completed a 40-hour palliative course, documented pain events were more likely to have a follow-up measure recorded, although the study did not establish better resident comfort.

Nursing implications

For long-term-care teams, the findings support reviewing whether palliative education connects symptom recognition to a documented response within the facility's care plan and escalation process. Better documentation is useful, but it should not be treated as proof that pain improved or that one course format fits every facility.

Limitations & cautions

Only 10 facilities and 119 deceased residents were included, with unequal resident counts between groups. Outcomes came from records and focused mainly on documentation and care processes; the abstract reports no confidence interval for the adjusted odds ratio and no direct resident comfort, pain-severity, or family outcome.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

BMC Palliative Care (PubMed). Better palliative care for residents of inpatient nursing homes through qualification of nursing staff - a cluster randomised study.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Annals of Work Exposures and Health (PubMed)Jun 3, 2026Research Article

In a randomized study of 42 medical and nursing students, N95 instruction improved knowledge and quantitative fit, video and guided training retained better fit than text at 3 months, and standardized exertion reduced fit.

Leadership Med-SurgAI summaryReview source

Research ArticleResearchInfection ControlNew Grad FriendlyAI summary · original source linked below

This prospective study randomized 42 medical and nursing students with little prior N95 experience to text-based, video-based, or person-guided training. Knowledge-question accuracy rose from 46.0% at baseline to 65.9% immediately after training, then declined to 59.2% at 2 weeks and 54.9% at 3 months; knowledge results did not differ significantly among training groups. Median quantitative fit factor increased from 28 before training to 143.5 immediately afterward and remained above baseline at 130 after 2 weeks and 126 after 3 months. At 3 months, fit remained significantly better with video or guided instruction than with text alone (P=0.029). During treadmill walking at 1.5 and 3 miles per hour, fit factor declined as respiratory and heart rates increased. The authors concluded that training effects fade, video or guided formats better preserve fit performance, and exertion may compromise fit. The trial did not measure workplace exposure or infection.

Key takeaways

The randomized study included 42 medical and nursing students assigned to text, video, or person-guided N95 training.
Median fit factor rose from 28 before training to 143.5 immediately after training, then measured 126 at 3 months.
Video and guided instruction retained better quantitative fit than text instruction at 3 months, while knowledge did not differ by group.
Quantitative fit declined during standardized walking as respiratory and heart rates increased.

Why this matters on shift

Passing instruction once does not guarantee that N95 knowledge or fit performance will remain stable during later clinical work. This study matters for infection-prevention nurses and educators because it measures both retention over three months and the effect of movement, not only immediate post-training knowledge.

Bedside takeaway

Be aware that video and guided N95 instruction preserved quantitative fit better than text alone at 3 months in 42 students, while fit declined during exertion; this supports reinforcement but does not define a refresher schedule.

Nursing implications

For respiratory-protection programs, the findings support hands-on or video-supported instruction, objective fit testing, and reinforcement rather than relying on text alone. The study does not define an ideal refresher interval or replace institutional fit-testing requirements, manufacturer instructions, or reassessment when respirator fit may have changed.

Limitations & cautions

The trial included only 42 medical and nursing students, most without prior formal respirator training, so results may not generalize to experienced clinicians. Follow-up lasted three months, exertion was standardized on a treadmill, and the study measured knowledge and fit factors rather than workplace exposure or infection outcomes.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Annals of Work Exposures and Health (PubMed). Temporal effects of educational interventions on fit and knowledge retention of N95 filtering facepiece respirator under rest and exertion.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European Journal of Cardiovascular Nursing (PubMed)Jul 9, 2026Systematic Review

A systematic review and meta-analysis of five studies involving 379 nursing students found that serious games had positive effects on CPR knowledge, but the games, platforms, and methods varied enough that the authors called for more robust trials.

LeadershipAI summaryReview source

Systematic ReviewResearchNew Grad FriendlyAI summary · original source linked below

Serious games are designed around learning goals rather than entertainment alone and are increasingly used in nursing education, but their effect on CPR knowledge had not been synthesized. Following PRISMA guidance, this review searched six databases through January 20, 2025 and included five studies from four countries with 379 nursing students. Three studies were randomized controlled trials and two were quasi-experimental. The meta-analysis found that serious games had positive effects on students' CPR knowledge. At the same time, the included studies used different game formats, platforms, and gamification elements, producing heterogeneity, and the authors identified methodological limitations across the evidence base. The review was prospectively registered in PROSPERO and concludes that serious games are promising for CPR knowledge while stronger studies are still needed before treating one game format as established training practice.

Key takeaways

The review included five studies from four countries and a combined 379 nursing students.
Three included studies were randomized controlled trials and two used quasi-experimental designs.
The pooled evidence indicated that serious games had positive effects on CPR knowledge.
Variation in games, platforms, gamification elements, and study methods limits certainty and supports the need for more robust trials.

Why this matters on shift

CPR knowledge is foundational for nursing students, but repeated learning needs to remain engaging without weakening hands-on competence checks. This review matters for educators because it suggests that serious games can strengthen the knowledge component of CPR training while also showing that the evidence base is still small and inconsistent.

Bedside takeaway

Worth knowing that serious games improved CPR knowledge across five studies of 379 nursing students, but varied interventions and methods mean they should supplement, not replace, hands-on resuscitation training.

Nursing implications

For nurse educators and preceptors, serious games may be useful as a supplement for CPR knowledge review, especially before simulation or skills validation. The review does not support replacing hands-on practice, objective skill assessment, or the current resuscitation curriculum with game-based learning alone.

Limitations & cautions

Only five studies and 379 students were included, with substantial variation in the interventions, platforms, gamification features, and methods. The abstract does not provide the pooled effect estimate, durability of learning, psychomotor performance, transfer to real resuscitation, or patient outcomes, so the conclusion should remain limited to CPR knowledge.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European Journal of Cardiovascular Nursing (PubMed). The effect of serious games on cardiopulmonary resuscitation training in nursing students: A systematic review and meta-analysis.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

A 40-hour palliative-care course was linked to more follow-up action after documented pain in 10 nursing homes

Video or guided N95 training preserved quantitative fit better than text alone at 3 months in a 42-student trial

Serious games improved nursing students' CPR knowledge across five studies, but the evidence was small and varied