Systematic Review of Clinical Reasoning in Technology-Enhanced Nursing Education

Abstract

: Clinical reasoning is a core competence in nursing education. It helps nursing students collect patient cues, interpret clinical information, make safe decisions, and reflect on nursing actions. In recent years, technology-enhanced learning has been widely used in nursing education, including simulation, virtual simulation, virtual patients, online learning, virtual reality, and artificial intelligence-supported learning. These methods may provide safe, repeatable, and interactive learning contexts for students to practise clinical reasoning before entering real clinical settings. This systematic review aims to summarize current evidence on clinical reasoning in technology-enhanced nursing education. The review focuses on three questions: what technologies have been used, how these technologies support clinical reasoning, and what problems still exist in current research. The reviewed literature shows that simulation-based learning and virtual simulation are the most common approaches. These methods can improve students’ clinical reasoning, knowledge retention, self-efficacy, confidence, and satisfaction. Structured debriefing and reflection are important mechanisms that link technology use with reasoning development. However, current studies still have limitations, such as small samples, short intervention periods, inconsistent outcome measures, and limited long-term follow-up. Future research should use stronger designs, clearer theoretical models, and more direct measures of clinical reasoning.