Impact of Simulation-Based Learning on Problem-Solving Skills in Nursing Education

Abstract

Introduction: Simulation - Based Learning (SBL) provides a safe, controlled, and realistic environment where nursing students can practice clinical skills, develop clinical reasoning, and enhance decision-making abilities. Recent studies report that over 80% of nursing students demonstrate improved clinical competence following simulation-based training. As nursing education increasingly integrates technological tools such as high-fidelity manikins and virtual simulation, SBL has shown significant potential to improve students’ problem-solving competencies, confidence, and patient-care readiness. Objectives: To assess the impact of Simulation-Based Learning on problem-solving skills among nursing students. Methodology: A systematic review was conducted following PRISMA-2020 guidelines. Electronic databases including PubMed/MEDLINE, CINAHL, and Scopus were searched for studies published between January 2018 and August 2025. Eligible studies included undergraduate and postgraduate nursing students exposed to simulation-based learning interventions. Randomized controlled trials, quasi-experimental studies, systematic reviews, and meta-analyses were included. Data were extracted and synthesized narratively due to methodological heterogeneity among studies. Results: A total of 45 studies met the inclusion criteria, comprising 15 randomized controlled trials, 20 quasi-experimental studies, and 10 systematic reviews/meta-analyses. Approximately 84.4% of studies reported significant improvements in nursing students’ problem-solving skills following simulation-based learning interventions. Improvements in clinical reasoning and critical thinking were reported in 88.9% and 82.2% of studies, respectively. Compared with traditional teaching methods, SBL demonstrated superior outcomes in problem-solving competency (86% vs. 68%), clinical reasoning (89% vs. 70%), critical thinking (84% vs. 66%), student confidence (91% vs. 62%), and learning satisfaction (93% vs. 65%). High-fidelity and virtual simulation modalities were particularly effective in enhancing cognitive and clinical competencies. Conclusion: Simulation-Based Learning significantly improves problem-solving skills, clinical reasoning, critical thinking, decision-making ability, confidence, and learning satisfaction among nursing students. The findings support the integration of simulation-based strategies into nursing curricula as an effective approach to bridging the theory-practice gap and preparing students for safe and competent clinical practice