Standardized Patient Simulation for More Effective Undergraduate Nursing Education: A Systematic Review and Meta-Analysis

Published:November 15, 2022DOI:


      • Clinical simulation is an increasingly vital part of clinical health care education.
      • Simulation allows for standardization of training experiences with patients.
      • SPS practice reduces the limitations of clinical practice for undergraduate nursing students.
      • SPS practice increases nursing students’ self-efficacy, communication skills, problem-solving and learning satisfaction.
      • SPS practice is more effective for nursing education than standard training alone.


      This systematic review and meta-analysis was designed to investigate the effects of standardized patient simulation on undergraduate nursing students following PRISMA guidelines. We searched seven databases; three reviewers independently performed study selection and data extraction and employed the risk for bias assessment for nonrandomized studies (ROBINS) tool to evaluate the quality of evidence. To estimate effect size, a meta-analysis of the studies was performed using STATA 16.0. We identified 1,276 related published studies; 68 met our inclusion criteria, 14 of which were eligible for final analysis. Our findings indicate that standardized patient simulation can effectively improve undergraduate nursing students’ communication skills, communication self-efficacy, self-efficacy, learning self-efficacy, problem-solving ability, and learning satisfaction; no evidence of publication bias was detected. Further studies are required to define detailed and standardized guidelines for supplementary research designs for experimental studies and effective methods of utilizing standardized patients. Expanding the application of evidence-based standardized patient simulation can improve reproduced clinical experiences and overcome limitations in clinical training for undergraduate nursing students.


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