Utilization and impact of simulation-based education in prelicensure nurse education: An integrative review

Simulation-based education has gained momentum as a teaching technique in prelicensure nurse education programs but actual utilization and evidence of learning impact require further examination. To review contemporary research literature to describe the use and effectiveness of simulation-based education for prelicensure nursing students. An integrative review of literature was conducted. A search was made in four major healthcare databases using MeSH terminology and keywords for relevant contemporary English language nursing simulation studies during the decade 2016–2025. Thirty-four studies were included: 20 primary studies that report first-hand data and 14 literature reviews. Primary research emanating in 11 countries suggests widespread simulation utilization. Clinical nursing knowledge and skills performance were the main learning objectives. Simulation modalities included high fidelity, medium and low fidelity with most simulations conducted face-to-face in a simulation laboratory or classroom. Outcome assessments included surveys and measured competencies. The studies consistently confirmed positive impacts of nursing student simulation education experiences. Many of the 34 studies presented robust evidence of intervention effects. All levels of simulation fidelity (high, medium, low) are confirmed as beneficial for learning. Future longitudinal research should examine knowledge retention and determine the transfer of competencies into nursing practice. • Simulation-based education is widely used in prelicensure nurse education. • International research confirms the positive value of simulated experiences. • All simulation modalities (high, medium, low) contribute to learning. • Sharing of the resource-intensive simulation programs should be addressed. • Escape room simulations and virtual gaming are novel approaches.