Objective: This integrative review identified, critically appraised and synthesised the existing evidence on the barriers and enablers to using high-fidelity human patient simulator manikins (HPSMs) in undergraduate nursing education.

Background: In nursing education, specifically at the undergraduate level, a range of low to high-fidelity simulations have been used as teaching aids. However, nursing educators encounter challenges when introducing new teaching methods or technology, despite the prevalence of high-fidelity HPSMs in nursing education.

Design: An integrative review adapted a systematic approach.

Data source: Medline, CINAHLplus, ERIC, PsychINFO,EMBASE, SCOPUS, ScienceDirect, Cochranedatabase, Joanna Brigge Institute, ProQuest, California Simulation Alliance, Simulation Innovative Recourses Center and the search engine Google Scholar were searched. Keywords were selected and specific inclusion/exclusion criteria were applied.

Inclusion criteria: The review included all research designs for papers published between 2000 and 2015 that identified the barriers and enablers to using high-fidelity HPSMs in undergraduate nursing education.

Review methods: Studies were appraised using the Critical Appraisal Skills Programme criteria. Thematic analysis was undertaken and emergent themes were extracted.

Results: Twenty-one studies were included in the review. These studies adopted quasi-experimental, prospective non-experimental and descriptive designs. Ten barriers were identified, including “lack of time,”“fear of technology” and “workload issues.” Seven enablers were identified, including “faculty training,”“administrative support” and a “dedicated simulation coordinator.”

Conclusion: Barriers to simulation relate specifically to the complex technologies inherent in high-fidelity HPSMs approaches. Strategic approaches that support up-skilling and provide dedicated technological support may overcome these barriers

Problemstillingen beskrives på en tilfredsstillende måte: a) Hvilke barrierer finnes for bruk av “high-fidelity mankins”?, og b) Hva kan bidra til effektiv bruk i lavere grads sykepleierutdanning? Begrepene er klart definert, og likeledes er det med inklusjons- og eksklusjonskriteriene som også er presentert i tabell. Søket er utført på en systematisk måte. Søkeord og databaser er oppgitt, og det er i tillegg gjort manuelle søk etter relevant litteratur. De ulike stadiene i prosessen er dokumentert i et flytdiagram. Søket resulterte i 1687 relevante treff og 21 ble inkludert i den integrative reviewen. De inkluderte studiene er presentert på en tilfredsstillende måte i en tabell. Barrierer og bidrag for tilrettelegging er presentert i tabeller og tekst. Den metodiske kvaliteten på studiene ble vurdert opp mot etablerte standarder, men dette resulterte ikke i at noen av studiene ble ekskludert.