The effects of simulation-based learning using standardized patients in nursing students: A meta-analysis.

PURPOSE: The aim of this study was to evaluate the effect of simulation-based learning using standardized patients (SPs) on cognitive, affective, and psychomotor domain outcomes of learning in nursing students. METHODS: MEDLINE via PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean electronic databases (to June 2014) were searched. The RevMan 5.3 program of the Cochrane library was used for data analysis. RESULTS: A meta-analysis was conducted of 18 controlled trials (4 randomized and 14 non-randomized designs), with a total of 1326 nursing students. Overall, simulation-based learning using SPs appeared to have beneficial effects on the cognitive, affective, and psychomotor domains of learning. In subgroup analysis, use of SPs showed significant effects on knowledge acquisition (d=0.38, p=.05, I(2)=42%), communication skill (d=1.86, p<.001, I(2)=15%), self-efficacy (d=0.61, p<.001, I(2)=6%), learning motivation (d=0.77, p<.001, I(2)=0%) and clinical competence (d=0.72, p<.001, I(2)=0%). Treatment effects on critical thinking (p=.75) and learning satisfaction (p=.43) were not significant. CONCLUSION: The findings of the current study suggest that simulation-based learning using SPs might have a positive impact on self efficacy and learning motivation that affects knowledge and clinical skill acquisition. Therefore, these findings demonstrate that, if integrated appropriately, an SP educational approach can be used in academic settings as an active learning methodology.