Innovation and Restructuring of Laboratory and Clinical Simulation in Undergraduate Nursing Programs During the COVID-19 Pandemic: An Integrative Review

Abstract

Background

The COVID-19 pandemic forced nursing education institutions to abruptly shift away from traditional in-person learning and find alternative approaches to fulfill program requirements. This integrative review explores the various innovative and restructured simulation strategies used by undergraduate nursing programs for lab and clinical courses in response to the pandemic.

Methods

Whittemore and Knafl's (2005) five-step framework guided this review. A systematic search of six academic databases and quality appraisal using the Mixed Methods Appraisal Tool yielded 10 studies for the review.

Results

Strategies identified primarily employed virtual simulation methods using avatars or real people. Additional approaches included flipcharts and simulation-based flipped classrooms. Key themes pertaining to language and culture, immersion, facilitation and skills emerged.

Conclusion

Virtual simulation was a valuable tool during the pandemic, though not without challenges. Future implications are discussed. This review highlights the need for standardized terminology and considerations for cultural diversity in simulation. Additionally, further research into the effectiveness of virtual simulation as a replacement for in-person nursing clinical and lab experiences is warranted.