The field of healthcare simulation continues to make tremendous strides to revolutionize healthcare education through clinical simulation research being conducted across the globe. Multiple peer-reviewed journals now focus on clinical simulation research. This HealthySimulation.com article by Content Manager Teresa Gore, PhD, DNP, APRN, FNP-BC, CHSE-A, FSSH, FAAN, provides an overview of the latest clinical simulation research and reviews as of April 2025. This month the articles are work of the INACSL Standards Committee to stay abreast of the latest research to inform the Standards of Best Practice.
History of the INACSL Healthcare Simulation Standards of Best Practice
The International Nursing Association for Clinical Simulation and Learning (INACSL) developed the “INACSL Standards of Best Practice: Simulation” in 2011 to advance the science of simulation, share best practices, and provide evidence-based guidelines for implementation and training. Developing a set of best practices can help any healthcare simulation flourish, as these guidelines help promote successful learning and training outcomes. These Standards were updated in 2013, 2015, 2017, and 2021. In 2021, the name of these Standards changed to the Healthcare Simulation Standards of Best Practice.
The impact of simulation facilitation on learning outcomes: A systematic review: Although facilitation in simulation-based education can encompass many different methodologies, limited data exists on the outcomes associated with all components of facilitation. Operationally, facilitation is the structure and process necessary to effectively conduct simulated-based experiences, while the facilitator is the individual that directs the learning experience that directly impacts the learner. This systematic review explored the impact of facilitation in simulation-based learning experiences and the effects on healthcare learners’ knowledge, skills, attitudes, and behaviors.
Joanna Briggs Institute methodology and quality appraisal tools for quasi-experimental or cross-sectional studies guided this systematic review. Risk of Bias was assessed using the Risk of Bias Visualization Tool (robvis). Four studies providing an international perspective and involving learners from a variety of health professions were included in this review. These studies were noted as having low risk of bias.
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The impact of simulation debriefing process on learning outcomes: An umbrella review: The Healthcare Simulation Standards of Best Practice (HSSOBP) stress the importance of establishing a psychologically safe environment for the debriefing process to allow learners the opportunity to identify knowledge gaps and develop insights by connecting thoughts, beliefs, and actions. A gap in the literature continues to exist regarding the impact vital debriefing process elements have on learning outcomes. This umbrella review (UR) provides a critical appraisal of the impact the debriefing process of simulation-based experiences (SBEs) has upon healthcare learners’ knowledge, skills, attitudes, and behaviors.
An interprofessional committee of simulation educators under the guidance of a health science librarian searched seven databases for systematic reviews (SRs) using the Joanna Briggs In- stitute (JBI) methodology. Criteria included SRs that focused on the impact of the debriefing process on healthcare learners’ outcomes. Abstracts which met the inclusion criteria underwent full-text review and then proceeded to the data extraction phase. Simulation facilitation methods and facilitator(s) had positive effects on learners’ knowl- edge, skills, and attitudes. It is suggested that simulation facilitation research includes study designs with greater rigor, consistent use of simulation terms that align with the Healthcare Simulation Standards of Best Practice, and comprehensive reporting of the facilitator(s) role(s) as well as facilitation methods utilized during the experience.
The review identified structured debriefing based on theoretical frameworks and/or evidence- based concepts had a positive impact on learning outcomes. The outcomes achieved were related to expertise of the facilitator/s. This expertise included the ability to enhance the debriefing process by: (1) creating a safe learning environment, (2) choosing the appropriate debriefing method, (3) determining the optimal time and duration of the debrief, and (4) integrating timely, relevant questions. This endeavor provided evidence-based practices related to the debriefing process to guide the delivery of high-quality SBEs that promote a culture of inclusion, trust, and safety.
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The impact of professional integrity on simulation learning outcomes: A systematic review: Although simulation-based education (SBE) is widely used in healthcare education, little is known about the learning outcomes achieved with intentional embedding of the INACSL HSSOBP Professional Integrity criteria. This systematic review aimed to analyze the literature to assess impact of intentionally embedding the five criteria of the professional integrity standard in SBE to measure the impact on healthcare learners’ clinical competency. Methods: Joanna Briggs Institute (JBI) methodology and standardized critical appraisal tools and the PRISMA-P and PRISMA-S guidelines were used to examine the current literature and evidence.
Results: Two studies were included in the final analysis. Both utilized mixed methods designs with small sample sizes of prelicensure nursing students and occurred outside of the United States. Quantitatively, both were rated as moderate quality with a high risk of bias. Qualitatively, both were rated as moderate to high quality and low risk of bias. Discussion: Embedding professional integrity principles in SBE does positively impact novice nursing students’ knowledge, skills, and attitudes. More rigorous designs and validated assessment tools are needed for generalizability and reproducibility.
Examining the Impact of the Healthcare Simulation Standards of Best Practice Prebriefing: Preparation and Briefing Standard on Simulation Effectiveness: A systematic review: Simulation learning involves multiple interconnected phases, such as prebriefing, which includes preparation and briefing activities, laying the foundation for a successful learning experience. To date, relatively little knowledge exists on the impact of presimulation preparation and briefing activities on simulation effectiveness, specifically learner knowledge, skills, attitudes, and behaviors. Thus, the purpose of this review was to systematically identify, examine, and synthesize the available literature to understand the impact of presimulation preparation and briefing activities on simulation effectiveness for healthcare professional learners.
The Joanna Briggs Institute methodological framework and critical appraisal tools guided this systematic review of published articles in PubMed, MEDLINE, Embase, ERIC, CINAHL, Scopus, APA PsycINFO, Web of Science, BEME, Medical Modeling and Simulation, and Google Scholar. Twenty-six international studies for health professional learners were included. Studies had a low risk of bias and moderate quality. Presimulation preparation and briefing activities had positive effects on the knowledge, skills, and attitudes of health professional learners.
