Effects of the simulation pedagogy utilization in undergraduate nursing and midwifery students' skill development, in low- and middle-income countries: A systematic review

Abstract

Objective: The development of a body of knowledge in simulation pedagogy is a source of enrichment of teaching methods, beneficial for the professional training of nurses and midwives. This review synthesized the effects of the simulation pedagogy utilization in undergraduate nursing and midwifery students' skill development in low- and middle-income countries (LMICs).

Methods: The search for primary research papers was conducted in PubMed, CINAHL, ERIC, and EMBASE. For additional papers, hand-searching was performed in key journals. All studies published in the English language between 2011 and 2020 were included. Titles and abstracts were screened after removing duplicates and then full texts of the remaining studies. Thirteen research studies were initially selected for a full review, with fifteen studies that fulfilled inclusion criteria included in the final analysis. The quality of studies was appraised using the Mixed Methods Appraisal Tool. A narrative approach was used for synthesizing data. 

Results: Of the fifteen primary studies included in the review, there are three qualitative studies, ten quantitative studies, and two mixed methods studies. Among these studies, five were conducted in Turkey, three in South Africa, two in Ethiopia, one in Jordan, one in Kenya, one in Zambia, one in Brazil, and one in China. Student-level outcomes measured included knowledge, attitudes, skill performance, and satisfaction. Most of the outcomes at the reaction level demonstrated students’ satisfaction. At the learning level, outcomes involve knowledge (knowing), attitudes (feeling), and skills (doing).

Conclusions: Educators and researchers in undergraduate education programs need evidence to inform best practice strategies for students’ skill development. This research presents preliminary evidence of the effects of the simulation pedagogy utilization in undergraduate nursing and midwifery students' skill development on satisfaction, knowledge, attitudes, and skills. In addition, it could enlighten policymakers, managers and educators in LMICs countries on the need to use simulation pedagogy in nursing and midwifery professional training institutes.