Facilitators and barriers to learning through simulation in undergraduate nursing education: An integrative review

Background: In nursing education, simulation contributes to improve knowledge, competence, and critical thinking. Some criticalities are recognized, too. An overall view on facilitators and barriers to learning through simulation in undergraduate nursing education is still lacking. This study explored facilitators and barriers to learning through a low, medium, or high-fidelity simulation in undergraduate nursing education. Methods: According to the Whittemore and Knafl framework, an integrative review was conducted, performing a systematic search on five databases (Pubmed, CINAHL, PsycINFO, Web of Science, Scopus), from 2012 to September 2024. The Mixed Methods Appraisal Tool (MMAT) assessed the quality appraisal. Results: 32 included studies revealed 29 key factors, grouped into four themes: Realism and environment; Team working; Nursing education; Nursing learning and students' abilities. Nineteen of these were identified as facilitators and 10 as barriers. Conclusion: The review results could provide useful hints to guide the development of effective and efficient simulation training programs, especially after the Covid-19 period that had accelerated the use of technologies in educational setting.