Simulation-Based CPR Education for Student Nurses: A Narrative Review of Effects on Knowledge, Skills, and Confidence

Abstract

Background Simulation-based education has become an important teaching strategy in nursing education, particularly for high-risk and time-sensitive procedures such as cardiopulmonary resuscitation (CPR). This review aimed to synthesize the available evidence on the effects of simulation-based education on CPR knowledge, skill retention and confidence among nursing students. Methods A narrative review of the literature was conducted using studies identified through Google Scholar and PubMed. Peer-reviewed studies published between 2016 and 2026 were considered. Studies addressing simulation-based CPR education among nursing students and reporting outcomes related to CPR knowledge, skills, or confidence were included. A total of 42 studies were included in the review. Results The current research shows that there are usually associations between simulation-based education and improved levels of CPR knowledge, skills retention, and self-confidence when compared to traditional forms of education. Yet, different simulation designs, facilitators’ experience, evaluation techniques, and available resources may impact the results. Information about retention and transferring learning to clinical settings is rather scarce. Conclusion Simulation-based education may be a useful approach for supporting the development of CPR knowledge, skills, and confidence among nursing students. Further longitudinal studies using standardized assessment methods, particularly in low- and middle income countries, are needed to strengthen the evidence and inform the implementation of simulation-based CPR education.