The Role of Simulation-Based Learning in Enhancing Clinical Decision-Making Skills among Nursing Students: A Systematic Review

Background: Clinical decision-making is a core competency in nursing practice, requiring the integration of theoretical knowledge and practical skills. With the evolution of nursing education, simulation-based learning (SBL) has gained prominence as an innovative teaching method designed to bridge the gap between classroom learning and real-life patient care. This systematic review aims to evaluate the effectiveness of SBL in enhancing clinical decision-making skills among nursing students. Methods: A systematic search was conducted across PubMed, Scopus, Web of Science, and CINAHL databases for articles published from January ۲۰۱۴ to June ۲۰۲۴. Inclusion criteria consisted of empirical studies published in English that examined the use of simulation-based learning interventions and their effects on clinical decision-making skills in undergraduate or graduate nursing students. Quality assessment was performed using the Joanna Briggs Institute critical appraisal tools, and data extraction focused on study design, type of simulation, assessment tools, and key outcomes. Results: Out of ۱,۲۵۶ identified articles, ۲۲ studies met the inclusion criteria. The majority employed high-fidelity simulation, scenario-based training, or virtual simulation platforms. Quantitative findings demonstrated significant improvements in nursing students' clinical decision-making ability post-intervention, including enhanced critical thinking, prioritization, risk assessment, and timely response to complex patient situations. Qualitative studies indicated increased learner confidence, improved teamwork, and positive perceptions of clinical preparedness. However, several studies highlighted barriers to effective implementation, such as resource limitations, faculty training needs, and varying fidelity of simulation environments. Conclusion: This systematic review provides strong evidence that simulation-based learning is an effective strategy for developing clinical decision-making skills in nursing students. Integrating SBL into nursing curricula can facilitate experiential learning, promote safe practice, and better prepare students for the complexities of clinical care. Future studies should focus on longitudinal outcomes, cost-effectiveness, and strategies to overcome practical barriers to widespread adoption.

کلیدواژه ها:

simulation-based learning ، clinical decision-making ، nursing students ، systematic review ، nursing education