Objective: To conduct a systematic review to appraise and review evidence on the impact of simulation-based education for undergraduate/pre-licensure nursing students, using existing reviews of literature. 

Design: An umbrella review (review of reviews). 

Data Sources: Cumulative Index of Nursing and Allied Health Literature (CINAHLPlus), PubMed, and Google Scholar. 

Study Selection: Reviews of literature conducted between 2010 and 2015 regarding simulation-based education for pre-licensure nursing students. 

Data Extraction: The Joanna Briggs Institute methodology for conduct of an umbrella review was used to inform the review process. 

Results of Data Synthesis: Twenty-five systematic reviews of literature were included, of which 14 were recent (2013–2015). Most described the level of evidence of component studies as a mix of experimental and quasi-experimental designs. The reviews measured around 14 different main outcome variables, thus limiting the number of primary studies that each individual review could pool to appraise. Many reviews agreed on the key learning outcome of knowledge acquisition, although no overall quantitative effect was derived. Three of four high-quality reviews found that simulation supported psychomotor development; a fourth found too few high quality studies to make a statistical comparison. Simulation statistically improved self-efficacy in pretest-posttest studies, and in experimental designs self-efficacy was superior to that of other teaching methods; lower level research designs limiting further comparison. The reviews commonly reported strong student satisfaction with simulation education and some reported improved confidence and/or critical thinking. 

Conclusion: This umbrella review took a global view of 25 reviews of simulation research in nursing education, comprising over 700 primary studies. To discern overall outcomes across reviews, statistical comparison of quantitative results (effect size) must be the key comparator. Simulation-based education contributes to students’ learning in a number of ways when integrated into pre-licensure nursing curricula. Overall, use of a constellation of instruments and a lack of high quality study designs mean that there are still some gaps in evidence of effects that need to be addressed. 

Denne systematiske oversikten over systematiske oversikter er tilsynelatende utarbeidet på en god måte, men forfatterne burde vært tydeligere på metoden de har brukt for å utarbeide oversikten. Inklusjons- og eksklusjonskriterier er greit definert i teksten, de har inkludert et PRISMA-diagram som dokumenter de ulike stegene i søkeprosessen og de har publisert protokollen på forhånd. De kunne med fordel inkludert mer detaljert informasjon om søkeprosessen, hvordan det er arbeidet med screening og dataekstraksjon og begrunnet hvorfor de begrenser søket til studier gjennomført mellom 2010 og 2015. Det er heller ikke gjort noen vurdering av den metodologiske kvaliteten til de inkluderte studiene, noe forfatterne selv peker på er en begrensning i artikkelen deres.