Objective: To gain insight into the existing scientific evidence on the effect of simulation on critical thinking in nursing education.

Design: A systematic literature review of original research publications.

Data Sources: In this systematic review, the papers published in English and Farsi databases of PubMed, Science Direct, ProQuest, ERIC, Google Scholar and Ovid, MagIran and SID, from 1975 to 2015 were reviewed by two independent researchers.

Review Methods: Original research publicationswere eligible for reviewwhen they described simulation program directed on nursing student and nurses; used a control group or a pretest post-test design; and gave information about the effects of simulation on critical thinking. Two reviewers independently assessed the studies for inclusion. Methodological quality of the included studies was also independently assessed by the reviewers, using a checklist developed by Greenhalgh et al. and the checklist of Cochrane Center. Data related to the original publicationswere extracted by one reviewer and checked by a second reviewer.No statistical pooling of outcomeswas performed, due to the large heterogeneity of outcomes.

Results: After screening the titles and abstracts of 787 papers, 16 ones were included in the review according to the inclusion criteria. These used experimental or quasi-experimental designs. The studies used a variety of instruments and a wide range of simulation methods with differences in duration and numbers of exposures to simulation. Eight of the studies reported that simulation training positively affected the critical thinking skills. However, eight studies reported ineffectiveness of simulation on critical thinking.

Conclusion: Studies are conflicting about the effect of simulation on nurses and nursing students’ critical thinking. Also, a large heterogeneity exists between the studies in terms of the instruments and the methods used. Thus, more studies with careful designs are needed to produce more credible evidence on the effectiveness of simulation on critical thinking.

Problemstilling og bakgrunn beskrives på en tilfredsstillende måte. En svakhet ved artikkelen er at den i hovedsak belyser simulering generelt, selv om det vises til hva slags simulering som er undersøkt i de ulike artiklene og at det avslutningsvis refereres til resultater fra enkeltstudier for å illustrere dette. Inklusjons- og eksklusjonskriteriene beskrives punktvis. Litteratursøket er tilfredsstillende beskrevet, det oppgis hvilke søkeord som er brukt og hvilke baser det er søkt i. Søket dokumenteres i et flowdiagram. Med utgangspunkt i 787 treff endte man opp med 16 publikasjoner, 9 eksperimentelle og 7  kvasieksperimentelle. Det virker ikke som det er brukt andre metoder for å finne relevante studier. Den metodiske kvaliteten er vurdert av to av forfatterne uavhengig av hverandre i henhold til etablerte sjekklister. Generelle kjennetegn som land, type simulering og tema er presentert i teksten. Metodiske kjennetegn og resultatene av de enkelte studiene er presentert i en omfattende tabell og oppsummert i teksten. Det er ikke gjort forsøk på en kvantitativ oppsummering.