Simulation-Based Learning for Emergency Preparedness in Nursing Education: A Systematic Review and Meta-Analysis of Gastrointestinal Scenarios

Summary

This study examines how simulation-based learning (SBL) prepares nurses to manage high-risk gastrointestinal emergencies. Overall, SBL improved nurses’ knowledge, teamwork skills, and self-confidence compared with traditional teaching, while its effects on technical skills and professional responsibility were variable. These findings support the integration of simulation training into emergency nursing education.

Abstract

Simulation-based learning (SBL) is increasingly being incorporated into nursing education to enhance preparedness for emergency situations. Gastrointestinal (GI) emergencies represent high-stakes clinical scenarios that require rapid assessment, effective decision-making, and coordinated teamwork. This systematic review and meta-analysis evaluated the effectiveness of SBL in emergency nursing education, with particular relevance to GI-related clinical scenarios. Searches of PubMed, Scopus, Web of Science, and Embase identified studies comparing SBL with non-simulation-based teaching approaches. Standardized mean differences (Hedges’ g) were pooled using random-effects models with restricted maximum likelihood (REML) estimation and Knapp–Hartung adjustment. Heterogeneity was assessed using Q, τ², and I² statistics, and publication bias was evaluated using funnel plots and Egger’s regression test. Eight studies involving 986 participants were included. Pooled analyses demonstrated positive effects of SBL on knowledge acquisition (g = 0.31, 95% CI: 0.12–0.50), teamwork ability (g = 0.66, 95% CI: 0.18–1.14), and self-confidence (g = 1.05, 95% CI: 0.62–1.49). Effects on clinical thinking (g = 0.17, 95% CI: -0.21–0.55), professional responsibility (g = 0.27, 95% CI: -0.11–0.65), and skill performance (g = -0.39, 95% CI: -0.85–0.07) were inconsistent and did not reach statistical significance. Heterogeneity was substantial across all outcome domains (I² > 97%). Overall, SBL may improve knowledge, teamwork, and self-confidence in emergency nursing education, including competencies relevant to GI-related clinical scenarios. However, the small number of included studies and the extreme heterogeneity observed across outcomes warrant cautious interpretation of the findings. The effects of SBL on technical skills, clinical thinking, and professional responsibility remain uncertain and require further investigation.

Introduction

Gastrointestinal emergencies such as acute upper gastrointestinal (GI) bleeding, perforation, or rapid drops in blood pressure due to GI losses require swift decision-making and prompt action. When such cases occur, the role of the nurse becomes essential, beginning with an initial examination and continuing with follow-up, helping with the procedure, and keeping the care team updated. A number of studies have explored the importance of simulation training in equipping nurses to handle such high-intensity situations. Nielsen et al. demonstrated that validated endoscopy simulators can effectively distinguish between novices and experts¹. Rong an....

Protocol

Study design and reporting
This systematic review and meta-analysis was conducted to evaluate the effectiveness of simulation-based learning (SBL) for emergency preparedness and response in nursing education, with a particular focus on gastrointestinal (GI)-related emergency scenarios. The objective was to synthesize standardized effect sizes across six predefined learning domains: knowledge acquisition, skill performance, teamwork ability, clinical thinking, professional responsibility, and self-confidence. The review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 20....

Results

Study selection
The comprehensive search strategy initially identified 540 records from four databases. After the removal of 180 duplicate articles, 360 titles and abstracts were screened. At this stage, 300 records were excluded because they did not involve nursing populations, lacked simulation-based interventions, or were not focused on emergency or GI scenarios. This screening process resulted in 60 full-text articles assessed for eligibility. Of these, 28 articles were excluded due to insufficie.......

Discussion

This systematic review and meta-analysis suggests that simulation-based learning (SBL) may provide selective benefits across several domains of emergency nursing education, with particular relevance to competencies associated with gastrointestinal (GI) emergency care. The most consistent positive effects were observed for knowledge acquisition, teamwork ability, and self-confidence, whereas findings for skill performance, clinical thinking, and professional responsibility were less consistent. Collectively, the findings .......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Embase	Elsevier	https://www.embase.com	Literature database
metafor package	R Foundation/CRAN	https://cran.r-project.org/package=metafor	Meta-analysis package
PubMed	National Library of Medicine	https://pubmed.ncbi.nlm.nih.gov	Literature database
R (v4.3.1)	R Foundation for Statistical Computing	https://www.r-project.org	Statistical analysis
Scopus	Elsevier	https://www.scopus.com	Literature database
Web of Science	Clarivate	https://www.webofscience.com	Literature database