Date of Completion

Fall 12-3-2023

Project Type

Integrative Review

Degree Name




Committee Chair/First Advisor

Rachel Myers


Over the past decade simulation has become a staple of nursing education with increasing use during the COVID-19 pandemic. Both manikin-based and virtual simulation are used to increase the preparedness of nursing students for their roles at the bedside. With the increasing experience-complexity gap, it is important that students enter the workforce prepared to effectively care for patients. Simulation allows students to work with a patient scenario without the possibility of injury; in simulation, mistakes are opportunities instead of harm. This integrative review searched the literature questioning if in pre-licensure Bachelor of Science in Nursing students, do virtual simulation and manikin-based simulation increase critical thinking? Looking through the research, four major themes were found: traits of the nursing program, traits of the simulation, traits of the student, and parallel outcomes. Overall, simulation was shown to have a positive impact on critical thinking as long as the complexity of the simulation was preceded by a foundational knowledge of the material. Critical thinking also had a positive relationship with knowledge and confidence growth as well. As nursing education continues to evolve to a more competency-based curriculum, advancements and use of simulation will need to be carefully developed with critical thinking as the primary outcome.