[Document title]
 
Exploring the Impact of Simulation on Nursing students' Knowledge and Skills during Basic and Advanced Cardiac Life Support Training in Saudi Arabia

 

Majed S Al-Za'areer1,2, Ong Swee Leong1, Intan Suhana Mat Azmi3, Bandar Naffaa Alhumaidi4, Nora Helmi Elneblawi5,

Mudathir Mohamedahmed Eltayeb6*

1School of Nursing Science, Faculty of Medicine, Universiti Sultan Zainal Abidin /UniSZA,

Terengganu, Malaysia.

2Medical Simulation Center, AL-Rayan Colleges, Al-Madinah, Saudi Arabia.

3Faculty of Medicine, Universiti Sultan Zainal Abidin /UniSZA, Terengganu, Malaysia.

4Department of Community Health Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia.

5Department of Medical-Surgical Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia.

6Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia.

*Corresponding Author E-mail: m.mohamedahmed@psau.edu.sa

 

ABSTRACT:

Introduction: Basic life support (BLS) and advanced cardiac life support (ACLS) training is crucial for healthcare providers to respond effectively to cardiac emergencies. Simulation-based training has been shown to improve knowledge and skills in nursing students during BLS and ACLS training. Objective: The objective of this study was to review the literature on the impact of simulation-based training on nurses' and nursing students' knowledge and skills during BLS and ACLS training in Arab countries and internationally. Methods: A literature search was conducted in several databases, including PubMed, CINAHL, and Scopus. The search was limited to articles published, written in English, and conducted in Saudi Arabia. Two articles met the inclusion criteria and were included in the review. Results: The reviewed studies reported significant improvements in knowledge scores, ability to respond to cardiac arrest scenarios, and confidence in skills among nursing students who participated in simulation-based training. However, challenges in implementing simulation-based training were reported, including lack of resources, time constraints, and resistance to change. Conclusion: The findings of the reviewed literature suggest that simulation-based training can be an effective tool for improving nurses' and nursing students' knowledge and skills during BLS and ACLS training in both Arab countries and internationally. The use of simulation-based training in nursing education has several advantages, including providing a safe and controlled environment for practicing skills, promoting critical thinking and decision-making, and allowing for repetitive practice. However, challenges in implementing simulation-based training need to be addressed, and strategies for effectively integrating simulation-based training into nursing education programs need to be explored.

 

KEYWORDS: High Fidelity Simulation, Nursing Students, Nurses, Basic life support, Advance cardiac life support, Knowledge, Skills.

 

 

INTRODUCTION: 

HFS is an effective tool in nursing education, which allows students to practice skills and knowledge through practical experience. It enables students to participate in interactive learning experiences in a safe environment, and nursing instructors can regulate the manikin's responses and enable student interventions1,2. HFS fosters critical thinking skills, improves patient care, and enhances knowledge retention, making it a crucial component of nursing education2-4. However, there is limited research on the effectiveness of using HFS as a complement to traditional lecture-based teaching methods, and doubts remain regarding its use in improving nurses' clinical competencies at the bedside 1,2,5. The effectiveness of HFS in acquiring and retaining cardiopulmonary resuscitation (CPR) knowledge and skills is also unclear. Studies suggest that a combination of teaching methods and skill repetition can improve the retention of CPR skills, and nursing students have responded positively to simulation-based learning, as it increases their confidence in performing CPR effectively in real-life situations6,7. The demand for highly skilled nursing students continues to increase, making it crucial to evaluate the effectiveness of current teaching methods and search for alternative teaching methods. Research has shown that additional training sessions supported by simulation have a positive effect on the retention of CPR knowledge and skills among nursing students 6,8-10.

 

Basic Life Support (BLS) is a critical skill for healthcare professionals, particularly for nurses who are often the first responders in emergency situations. In Saudi Arabia, BLS training is an essential component of nursing education aimed at preparing students to handle cardiac arrest and other life-threatening situations4,11-13. However, traditional BLS training methods may not fully prepare nursing students for real-life emergencies, as they lack the opportunity to practice in a realistic and dynamic environment. As such, there is a need for effective and innovative training methods that can enhance nursing students' BLS knowledge, skills, satisfaction, and confidence6-9,12.

 

Advanced Cardiac Life Support (ACLS) is a set of protocols and interventions that are designed to provide life-saving care to patients experiencing cardiac arrest, stroke, or other medical emergencies. ACLS protocols are based on the latest scientific research and are constantly updated to reflect best practices in emergency medicine. The goal of ACLS is to provide rapid and effective interventions that can help to stabilize the patient and prevent further damage or complications14. ACLS is typically administered by a team of healthcare professionals, including doctors, nurses, and paramedics, who have received specialized training in emergency care. The ACLS team works together to quickly assess the patient's condition and implement appropriate interventions, such as advanced airway management, medication administration, and defibrillation14-16. The ultimate goal of ACLS is to restore blood flow and oxygenation to the brain and other vital organs, while also addressing any underlying medical conditions that may be contributing to the patient's condition. ACLS training is typically provided to healthcare professionals who work in emergency medicine, intensive care, and critical care settings. The training includes both didactic instruction and hands-on practice with simulated scenarios2,14. Participants learn how to recognize and respond to various medical emergencies, including cardiac arrest, stroke, and respiratory distress. They also learn how to manage complex medical conditions, such as acute coronary syndrome and sepsis. ACLS is an important part of modern emergency medicine, and it has been shown to significantly improve patient outcomes8,13,14,17. Studies have demonstrated that ACLS interventions can increase survival rates for patients experiencing cardiac arrest and other life-threatening medical emergencies. In addition, ACLS training can improve the confidence and competence of healthcare professionals, allowing them to provide more effective care in emergency situations. Moreover, ACLS plays an essential role in saving lives and improving patient outcomes. Healthcare professionals who are trained in ACLS protocols and interventions are better equipped to respond to medical emergencies and provide high-quality care to patients in need8,14,18.

 

One such method is HFS, which has been gaining popularity in recent years as a teaching tool for nursing students. HFS involves the use of realistic and immersive simulators that mimic human physiology and can simulate a wide range of clinical scenarios, including cardiac arrest. By providing a safe and controlled environment for nursing students to practice BLS skills, HFS has the potential to enhance the effectiveness of BLS training5,8,11,19.

 

Several studies have investigated the effectiveness of HFS in nursing education, with promising results. For example, a systematic review of HFS in nursing education found that HFS improved clinical performance, knowledge, and confidence among nursing students2,8,9,19. Similarly, a study conducted in Saudi Arabia found that nursing students who underwent HFS training had significantly higher mean scores in ACLS knowledge and skills compared to those who underwent traditional training20.

 

In addition to improving knowledge and skills, HFS has also been shown to enhance nursing students' satisfaction and confidence during BLS and ACLS training. A systemic review article found that nursing students who underwent HFS training reported higher levels of satisfaction and confidence compared to those who underwent traditional training21. Similarly, a previous study found that nursing students who underwent HFS training had significantly higher self-efficacy scores compared to those who underwent traditional training22.

Despite the potential benefits of HFS in nursing education, the use of HFS in BLS and ACLS training in Arab Countries, including Saudi Arabia, is still limited 20,23. To the best of our knowledge, very few literature reviews have examined the impact of HFS on all nursing students' outcome (knowledge, skills, satisfaction, and confidence) in practicing BLS and ACLS in Saudi Arabia. As such, this literature review aims to fill this gap by exploring the existing literature on the topic. Therefore, the primary purpose of this literature review is to examine the impact of HFS on nursing students' BLS knowledge, skills, satisfaction, and confidence during BLS training in Saudi Arabia. Specifically, we will investigate the effectiveness of HFS in enhancing BLS knowledge, skills, satisfaction, and confidence among nursing students in Saudi Arabia. Additionally, we will identify the strengths and weaknesses of existing studies on this topic and provide recommendations for future research.

 

Significance of This Study:

This study has several significant contributions. Firstly, it offers insight into the effectiveness of HFS in teaching BLS and ACLS to nursing students in Saudi Arabia, which is important due to the increasing need for healthcare professionals who can provide BLS and ACLS. Secondly, the study's focus on nursing students in Saudi Arabia is important as the country is trying to improve its healthcare system and training more healthcare professionals, including nurses, is crucial to achieve this. Additionally, the practical implications of this study can inform the development of evidence-based BLS training programs that incorporate HFS, improve patient outcomes, and increase confidence and competence among nursing students. The study's findings will also contribute to the existing body of knowledge on the effectiveness of HFS in nursing education and promote its use globally.

 

The study's significance is mainly attributed to its potential to improve nursing education and enhance the provision of BLS care by nursing students. The findings will inform the development of effective BLS training programs that incorporate HFS, which can ultimately lead to improved patient outcomes. The study's results can guide the allocation of resources for nursing education, ensuring that BLS and ACLS training programs are effective and evidence-based. The study's findings will promote the use of HFS in nursing education and provide insights into its optimal use in BLS training, ultimately leading to a more effective healthcare system.

 

In conclusion, this study's significance lies in its potential to improve the quality of BLS and ACLS training among nursing students in Saudi Arabia and beyond, ultimately leading to improved patient outcomes and a more effective healthcare system. The study's findings can inform the development of effective BLS and ACLS training programs that incorporate HFS, which can be used to guide the allocation of resources for nursing education. The study's findings will also contribute to the existing body of knowledge on the effectiveness of HFS in nursing education and promote its use globally.

 

Research Objectives:

The specific objectives of this study are: 1) to assess the effectiveness of simulation-based training on the knowledge and skills of nursing students in managing basic and advanced cardiac life support scenarios, 2) to compare the knowledge and skills of nursing students who receive simulation-based training with those who receive traditional classroom-based training in managing basic and advanced cardiac life support scenarios, and 3) to identify the barriers and facilitators to implementing simulation-based training in nursing education programs.

 

Literature Overview and Background:

History of using simulation in nursing and medical education in Saudi Arabia:

Worldwide, the use of simulation in nursing and medical education has a long history dating back to the early 20th century. In the early 1900s, nursing educators began using mannequins and role-playing exercises to teach basic nursing skills, such as giving injections and dressing wounds. However, it wasn't until the mid-20th century that simulation technology began to advance rapidly. In the 1950s, the first high-fidelity human patient simulator was developed by Dr. David H. Gaba, a professor of anesthesia at Stanford University24. This was a major breakthrough in medical education, as it allowed students to practice clinical skills in a safe, controlled environment. Over the past few decades, simulation technology has continued to evolve and expand, and is now widely used in nursing and medical education. Today's simulators are highly advanced and can simulate a wide range of medical conditions and scenarios, including cardiac arrest, trauma, and obstetric emergencies24,25. Simulation is now an essential part of nursing and medical education, providing students with the opportunity to develop and practice clinical skills in a safe, controlled environment before working with real patients. Simulation has also been shown to be an effective tool for improving patient safety and reducing medical errors. By providing students with realistic training scenarios and allowing them to practice critical thinking and decision-making skills, simulation can help prepare them for real-world clinical situations. Simulation can also be used to identify and address gaps in knowledge and skills among healthcare providers, which can ultimately lead to improved patient outcomes 21,24.

 

Impact of Simulation on Nursing Education and Training:

Simulation has had a significant impact on nursing education and training, revolutionizing the way students are prepared for clinical practice. One key impact is the enhancement of critical thinking and decision-making skills. Through simulated scenarios, nursing students are exposed to complex patient care situations that require them to analyze information, prioritize interventions, and make sound decisions. This immersive learning experience promotes critical thinking abilities, as students must consider multiple factors and potential outcomes before taking action. By engaging in simulation-based training, nursing students develop the necessary skills to think critically and make effective clinical judgments, which are essential for providing safe and competent patient care7,11,21,24.

 

Another impact of simulation on nursing education is the development of teamwork and communication skills. In healthcare settings, effective teamwork and communication are vital for delivering quality care and ensuring patient safety26. Simulation provides an opportunity for nursing students to practice interdisciplinary collaboration and communication in a controlled environment. By working together with other healthcare professionals, such as physicians, pharmacists, and respiratory therapists, students learn how to communicate effectively, share information, and collaborate to provide comprehensive patient care. These teamwork and communication skills are transferable to real clinical settings, where nursing professionals must collaborate with various team members to achieve optimal patient outcomes1,24,26.

 

Furthermore, simulation allows nursing students to bridge the gap between theory and practice. In traditional classroom-based learning, students often struggle to translate theoretical knowledge into real-world applications. Simulation provides a bridge between the theoretical and practical aspects of nursing education, enabling students to apply their knowledge in a realistic clinical context1,26. By participating in simulated scenarios, students gain hands-on experience, practice clinical skills, and develop a deeper understanding of how theory is applied in actual patient care situations. This integration of theory and practice through simulation prepares nursing students for the complexities and challenges they will encounter in their future nursing careers1,2,24,26.

 

Impact of using HFS on nursing education and training:

Simulation has emerged as a powerful tool for enhancing nursing students' knowledge and skills. Through simulated scenarios and hands-on experiences, nursing students are exposed to realistic patient care situations in a controlled environment. This allows them to apply their theoretical knowledge and develop a deeper understanding of clinical concepts. By actively engaging in simulation-based education, students can acquire and retain knowledge more effectively compared to traditional classroom-based learning methods2,3,21,26.

 

One significant impact of simulation on nursing students' knowledge is the opportunity for active learning. Simulation enables students to participate in realistic patient care scenarios, where they are required to assess, diagnose, and implement appropriate interventions. This active engagement promotes critical thinking and problem-solving skills, as students must analyze the situation, make decisions, and take action. Through these experiences, nursing students gain a better understanding of the complexities of patient care and the factors influencing decision-making in a clinical setting2,4,24,26.

 

In addition to knowledge acquisition, simulation also plays a vital role in developing nursing students' clinical skills. Simulation allows students to practice technical procedures, such as medication administration, wound care, and patient assessments, in a safe and controlled environment. This hands-on experience helps students build confidence, refine their skills, and develop competency in performing clinical tasks. The repetitive nature of simulation-based training enables students to receive immediate feedback and correct errors, leading to skill improvement and mastery24,26,27.

 

Importance of Acquisition and Retention of BLS and ACLS Knowledge and Skills:

Acquisition and retention of BLS and ACLS knowledge and skills are essential for healthcare professionals, particularly those working in critical care settings. The timely and appropriate administration of BLS and ACLS interventions can significantly improve patient outcomes and survival rates. Healthcare providers must possess the necessary knowledge and skills to respond effectively in emergency situations. Therefore, it is crucial to ensure that healthcare professionals acquire and retain BLS and ACLS knowledge and skills to provide high-quality care19,21,28.

 

Continuous training and education are necessary to ensure healthcare professionals maintain their knowledge and skills. Regular training sessions, including simulation-based training, can enhance healthcare providers' performance and promote optimal patient care. Simulation-based training is a valuable tool for teaching BLS and ACLS interventions, as it allows healthcare professionals to practice their skills in a controlled environment. This type of training can improve healthcare professionals' confidence, decision-making abilities, and teamwork skills. It is essential to incorporate simulation-based training into ongoing educational programs to ensure healthcare providers are adequately prepared to respond to emergencies8,12,19,21.

 

In addition to the significant impact on patient outcomes, acquisition and retention of BLS and ACLS knowledge and skills can also lead to improved job satisfaction and decreased burnout among healthcare professionals. Healthcare providers who possess the necessary knowledge and skills to respond effectively in emergency situations are more likely to feel confident and competent in their roles. This can lead to increased job satisfaction, improved staff morale, and decreased stress levels. Ensuring that healthcare professionals are adequately trained and equipped with the necessary knowledge and skills can positively impact the entire healthcare system, ultimately leading to better patient care and improved health outcomes1,16,21,27.

 

Impact of Simulation on Nurses' Knowledge and Skills in Practicing BLS and ACLS:

Simulation-based training has proven to be a valuable tool in improving nurses' knowledge and skills in practicing BLS and Advanced Cardiac Life Support (ACLS). Nurses who undergo simulation-based training are more likely to feel confident and competent in their abilities to perform BLS and ACLS interventions. This training provides a safe and controlled environment where nurses can practice and receive feedback on their performance without risking the safety of real patients 12,17,18,21.

 

Simulation-based training is also effective in improving nurses' knowledge and decision-making skills related to BLS and ACLS. Simulation scenarios can be designed to simulate real-life situations that nurses may encounter in their practice. This type of training allows nurses to apply their knowledge and skills in a realistic setting, which enhances their ability to make appropriate clinical decisions in high-stress situations8,12,18,24.

 

Moreover, simulation-based training can provide nurses with opportunities to work in interdisciplinary teams and improve their communication and teamwork skills. Effective communication and teamwork are essential in providing high-quality BLS and ACLS care, and simulation training allows nurses to practice these skills in a safe and supportive environment. This can lead to improved patient outcomes and decreased errors in real-life clinical settings.

 

The literature supports the positive impact of simulation on nurses' knowledge and skills in practicing BLS and ACLS. Previous studies in different countries found that nursing students who received simulation training had significantly higher scores on BLS and ACLS knowledge tests than those who received traditional lecture-based training3,7,10-12,18,20,23. This suggests that simulation training can improve the acquisition of knowledge necessary for effective BLS and ACLS practice. Additionally, a systematic review by found that simulation-based training improved not only knowledge but also clinical performance in BLS and ACLS21. Moreover, randomized clinical trials, which were conducted in different countries, found that simulation training was associated with improvements in CPR performance, time to defibrillation, and overall team performance. The authors concluded that simulation training should be considered a key component of BLS and ACLS education and training programs12,18,29. Moreover, the researchers found that simulation training can improve the retention of BLS and ACLS skills over time12,18,29. The researchers followed nursing students who had completed simulation training in BLS and ACLS and found that their skills remained significantly better than those of students who had received only traditional lecture-based training12,18. This suggests that simulation training may have a long-term impact on the retention of critical BLS and ACLS skills.

 

METHODS:

Database search:

In this literature review, we explored the impact of high-fidelity simulation on nursing students' knowledge, skills, satisfaction, and confidence during BLS and ACLS training in Saudi Arabia. To conduct this review, we used a systematic approach to search the relevant databases including PubMed, CINAHL, Google scholar, EBSCO and Cochrane Library. The search terms included "high-fidelity simulation", "nursing students", "basic life support", "advance cardiac life support", cardiopulmonary resuscitations", "BLS", "CPR", "ACLS", "Saudi Arabia", and "training". We included studies that were published in the last 15 years and were conducted in Saudi Arabia. We also included both quantitative and qualitative studies that assessed the impact of high-fidelity simulation on nursing students' BLS and ACLS training.

 

After the initial search, we screened the titles and abstracts of the identified articles to exclude the irrelevant ones. We then assessed the full texts of the remaining articles based on the inclusion and exclusion criteria.

 

Inclusion Criteria:

The inclusion criteria were: We included studies that met the following criteria: (1) conducted in Saudi Arabia, (2) involved nursing students as participants, (3) used high-fidelity simulation in BLS and ACLS training, (4) reported outcomes related to knowledge, skills, satisfaction, or confidence, and (5) were published in peer-reviewed journals.

 

Exclusion Criteria:

The exclusion criteria were: (1) the study was conducted outside of Saudi Arabia, (2) the study did not use high-fidelity simulation, or (3) the study did not assess the impact of high-fidelity simulation on nursing students' BLS and ACLS training.

 

Data Extraction:

Data extraction was conducted using a standardized form that included the following variables: study design, sample size, simulation characteristics, BLS and ACLS training outcomes, and limitations of the study. We also assessed the quality of the included studies using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Critical Appraisal Skills Program (CASP) tool for qualitative studies. We also discussed the implications of the findings for nursing education and practice in Saudi Arabia.

 

RESULTS:

The study began with a search of a database using the keywords ("Saudi" and "resuscitation" OR "life support" OR "simulation"), which yielded 48 articles. These articles were then evaluated based on their title and abstract, resulting in 17 articles that focused on "simulation" in "Saudi Arabia," 11 articles on "Saudi" and "life support," and 26 articles on ("Saudi" and "resuscitation" OR "life support"). After excluding 45 articles that did not meet the inclusion criteria, two articles were selected for the final review20,23.

 

Based on the database search, two articles were conducted to investigate the impact of using simulation on participants' knowledge and skills during BLS and ACLS training in Saudi Arabia. The first study found that HFS significantly improved nursing students' knowledge and skills in ACLS in Saudi Arabia20. The second study showed that a simulation-based training program using an enhanced telephone-CPR (T-CPR) protocol improved time to first chest compression and depth of compression among healthcare providers, including nurses, respiratory therapists, and physicians, in Saudi Arabia23. The studies' findings suggest that simulation-based training programs can be an effective tool for improving ACLS knowledge and skills and CPR performance in Saudi Arabia. The researchers recommend incorporating HFS in ACLS training programs for nursing students and implementing simulation-based training programs using enhanced T-CPR protocols for healthcare providers.  Moreover, the findings of the of the studies included in the review reported positive outcomes associated with the use of HFS simulation in BLS and ACLS training for nursing students in Saudi Arabia. Specifically, the use of HFS was found to be associated with improved knowledge, skills and confidence among the nursing students and the participants in the selected studies20,23. Furthermore, the implications of these findings are significant for the healthcare system in Saudi Arabia, as improving healthcare providers' knowledge and skills in ACLS and CPR can lead to improved patient outcomes and reduced mortality rates.

 

DISCUSSION:

Simulation has had a profound impact on nursing education and training. It enhances critical thinking and decision-making skills, fosters teamwork and communication abilities, and bridges the gap between theory and practice. By incorporating simulation into nursing curricula, educational institutions can provide students with realistic and immersive learning experiences that better prepare them for the complexities of clinical practice. Simulation-based training equips nursing students with the necessary skills, competencies, and confidence to deliver high-quality care and contribute to positive patient outcomes24,26,28. Moreover, simulation has a significant impact on nursing students' knowledge and skills. It provides an active learning environment that promotes critical thinking, problem-solving, and decision-making abilities. Through simulation, students can apply their theoretical knowledge to realistic patient care scenarios, enhancing their understanding of clinical concepts21,24,26. Additionally, simulation-based training allows students to practice and refine their clinical skills, leading to increased competence and confidence in performing various nursing procedures. By integrating simulation into nursing education, institutions can better prepare students for the challenges of real-world patient care and ensure their readiness to provide high-quality nursing care1,24,26.

 

The literature suggests that simulation training can have a significant impact on nurses' knowledge and skills in practicing BLS and ACLS. This impact can extend beyond initial training to long-term retention of skills. Therefore, simulation-based training should be considered an essential component of nursing education and training programs focused on BLS and ACLS3,6,8,24.

 

Only two published articles were found through a database search on the impact of using simulation on nurses' knowledge and skills during BLS and ACLS training in Saudi Arabia20,23. One of these studies was conducted in Saudi Arabia and found that a simulation-based training program using an enhanced T-CPR protocol improved time to first chest compression and depth of compression among healthcare providers. This study highlights the significance of improving healthcare providers' knowledge and skills in ACLS and CPR as it can lead to improved patient outcomes and reduced mortality rates. The researchers recommend incorporating HFS in ACLS training programs for nursing students and implementing simulation-based training programs using enhanced T-CPR protocols for healthcare providers23. The study was conducted to improve the quality of chest compressions during CPR in Saudi Arabia using a pre-post design. The study concluded that the enhanced T-CPR protocol is effective in improving the quality of chest compressions during CPR in Saudi Arabia. The study highlights the significance of using simulation-based training to improve the quality of healthcare services in Saudi Arabia. The study's findings indicate that healthcare providers who receive additional simulation-based training are more likely to perform better in emergency situations, ultimately improving patient outcomes. The study also emphasizes the importance of regularly updating and enhancing CPR protocols to keep up with advancements in medical technology and best practices. The study recommends healthcare facilities in Saudi Arabia incorporate simulation-based training as a standard part of their training programs to ensure that healthcare providers are adequately prepared to handle emergency situations. These findings can potentially be applied in other countries and regions to improve the quality of CPR and save more lives during cardiac arrest events. The study recommends the implementation of the enhanced T-CPR protocol in all hospitals and healthcare facilities in Saudi Arabia to improve the quality of CPR and highlights the importance of regular training and updates for healthcare providers to maintain and improve their CPR skills23.

 

The second study is conducted to investigate the impact of simulation experience on the knowledge and skills of Saudi nursing students in ACLS. The study used a quasi-experimental design, with a pre-test and post-test assessment of ACLS knowledge among nursing students 20. The students were divided into two groups, one receiving simulation-based training and the other receiving traditional lecture-based training. The study found that the simulation group had a significantly higher improvement in ACLS knowledge compared to the lecture group. The article highlights the importance of using simulation-based training to improve nursing students' knowledge and skills in ACLS. The study results suggest that simulation-based training can be an effective tool for improving nursing education and preparing students for real-life situations. The study also highlights the need for ongoing training and updates to ensure that nursing students have the necessary skills and knowledge to provide quality care in emergency situations. The findings of this study have significant implications for nursing education and training in Saudi Arabia. The study recommends the incorporation of simulation-based training in ACLS courses for nursing students, as it can lead to better outcomes in terms of knowledge and skills acquisition. The study also emphasizes the need for ongoing evaluation and assessment of nursing education programs to ensure that students are adequately prepared to provide high-quality care in emergency situations20.

 

The findings of these two studies and previous international studies showed that using of simulation-based training has become increasingly popular in nursing education, particularly in basic and advanced cardiac life support (BLS and ACLS) training. Simulation training provides an opportunity for nurses and nursing students to develop and enhance their knowledge and skills in a safe and controlled environment20,23. Several studies have explored the impact of simulation-based training on nurses' and nursing students' knowledge and skills during BLS and ACLS training in Arab countries and internationally. One study conducted Jordan to evaluate the effectiveness of simulation-based training on the knowledge, knowledge retention, and confidence of nursing students in Jordan regarding advanced cardiac life support (ACLS). The study utilized a quasi-experimental design, with 102 nursing students randomly assigned to either the simulation group or the control group. The simulation group received ACLS training using high-fidelity manikins, while the control group received traditional lecture-based training. The results indicated that the simulation group had significantly higher knowledge scores and confidence levels immediately after the training and at a three-month follow-up than the control group. The study suggests that simulation-based training is an effective method for improving nursing students' knowledge and confidence in ACLS in Jordan 8. In international studies, several studies were conducted to explore the impact of simulation-based training on nurses' and nursing students' knowledge and skills during ACLS training. The studies found that simulation-based training improved the participants' ability to manage cardiac arrest scenarios and increased their confidence in their skills21,30-32. 

 

Moreover, the findings of the reviewed studies and several of previous studies suggest that simulation-based training can be an effective tool for improving nurses' and nursing students' knowledge and skills during BLS and ACLS training in both Arab countries and internationally. The studies reported significant improvements in knowledge scores, ability to respond to cardiac arrest scenarios, and confidence in skills among nursing students who participated in simulation-based training8,13,17,20,23,30. The use of simulation-based training in nursing education has several advantages, including providing a safe and controlled environment for practicing skills, promoting critical thinking and decision-making, and allowing for repetitive practice. These advantages are particularly important in Arab countries, where limited clinical placement opportunities and cultural factors may limit nursing students' exposure to critical situations8,13,17,20,21,23,27,30,32.

 

However, simulation-based training can provide several benefits to nursing students during BLS and ACLS training, there are also some disadvantages, challenges, and barriers associated with its use. One of the main challenges is the high cost of equipment and resources required for simulation-based training. Equipping a training lab with high-fidelity manikins, simulation software, and other equipment can be expensive and may require ongoing maintenance and updates. In addition, simulation-based training may require significant time and resources to develop and implement, which may not always be feasible in resource-limited settings33-35.

 

Another challenge is the need for skilled faculty and staff to facilitate and evaluate simulation-based training. Developing and delivering effective simulation-based training requires expertise in simulation-based education, clinical practice, and subject matter expertise in BLS and ACLS. The availability of such expertise may be limited in some settings, which may further hinder the implementation and success of simulation-based training33-35.

 

Despite these challenges, many nursing education programs have found that simulation-based training is worth the investment. Simulation-based training can provide a safe and controlled learning environment for nursing students to practice and refine their skills. In addition, simulation-based training can promote critical thinking, decision-making, and teamwork skills, which are essential for nursing practice36. Therefore, while there may be challenges and barriers associated with the use of simulation-based training in nursing education, its potential benefits suggest that it may be worth the investment. Future studies should explore strategies for addressing these challenges and integrating simulation-based training into nursing education programs in Arab countries and internationally.

 

CONCLUSION:

In conclusion, the reviewed literature highlights the potential of simulation-based training in improving nurses' and nursing students' knowledge and skills during BLS and ACLS training in Arab countries and internationally. The findings suggest that simulation-based training can provide a safe and effective learning environment for nurses and nursing students, and can help prepare them for real-world clinical situations. Further research is needed to explore strategies for effectively integrating simulation-based training into nursing education programs and addressing the challenges associated with its implementation.

 

AUTHORS DECLARATION STATEMENT:

The authors declare that they have no conflicts of interest or competing interests, nor do they have any personal financial interests that could influence the content or results of this manuscript.

 

ACKNOWLEDGEMENT:

This study is supported via funding from Prince Sattam Bin Abdulaziz University project number (PSAU/2023/R/1444).

 

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Received on 08.04.2023           Modified on 03.05.2023

Accepted on 13.06.2023          © RJPT All right reserved

Research J. Pharm. and Tech 2023; 16(11):5453-5461.

DOI: 10.52711/0974-360X.2023.00883